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.