The History of Anesthesia
The specialty of anesthesia began in the
mid-nineteenth century and became firmly established less than six decades ago.
Ancient civilizations had used opium poppy, coca leaves, mandrake root,alcohol,
and even phlebotomy (to the point of uncon-sciousness) to allow surgeons to
operate. Ancient Egyptians used the combination of opium poppy (containing
morphine) and hyoscyamus (contain-ing scopolamine); a similar combination,
morphine and scopolamine, has been used parenterally for premedication. What
passed for regional anesthesia in ancient times consisted of compression of
nerve trunks (nerve ischemia) or the application of cold (cryoanalgesia). The
Incas may have practiced local anesthesia as their surgeons chewed coca leaves
and applied them to operative wounds, particularly prior to trephining for
headache.
The evolution of modern surgery was
hampered not only by a poor understanding of disease pro-cesses, anatomy, and
surgical asepsis but also by the lack of reliable and safe anesthetic
techniques. These techniques evolved first with inhalation anesthesia, followed
by local and regional anesthesia, and finally intravenous anesthesia. The
development of surgical anesthesia is considered one of the most important
discoveries in human history.
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