Reawakening anaesthesia research.

Abstract

Each year, more than 230 million surgical procedures are performed under general anaesthesia worldwide, and most of us will experience going under at some point in our lives. We take that dreamless sleep through an otherwise unbearably painful procedure for granted, yet it is one of the greatest achievements of medicine. “Before October 1846, surgery and pain were synonymous. These gruesome interventions were carried out with requisite haste and inevitable commotion. Absent was the precision and calm that we associate with modern surgery. It consisted of pulling, cutting, sewing, sawing, manipulation of joints, and slicing of skin”, wrote Daniel Robertson and Alexander Toledo in their recent account of the invention of anaesthesia [1]. Although attempts at putting patients to sleep had been reported since ancient times, the dawn of modern anaesthesia is unanimously set on 16 October 1846, when surgeon John Collins Warren removed a tumour from the neck of a local printer with the help of a young Boston dentist, William T.G. Morton, who had discovered that inhaled ether made tooth extraction painless (Fig 1). Figure 1. Anaesthesia inhalation, the old way Allis’ Ether Inhaler: a circular apparatus, slotted to accept a weave of fabric and fitted with an outer covering, is placed over a reclining patient's nose and mouth; ether is being administered from a bottle, a few drops at a time onto the fabric. Allis’ instrument can be considered as a development of the original Morton's inhaler (see main text). Wood engraving, published in Artificial anaesthesia. A manual of anaesthetic agents and their employment in the treatment of disease , by Laurence Turnbull, Blakiston, Philadelphia, 1896. Credit: US National Library of Medicine, History of Medicine Division. But oddly enough, despite the fact that general anaesthesia has been around for some 170 years and that anaesthetics are among the most common drugs administered …