The Practice of Anesthesiology

The Practice of Anesthesiology

The Greek philosopher Dioscorides first used the term anesthesia in the first century AD to describe the narcotic-like effects of the plant mandragora. The term subsequently was defined in Bailey’s AnUniversal Etymological English Dictionary (1721) as“a defect of sensation” and again in the EncyclopediaBritannica (1771) as “privation of the senses.”

Oliver Wendell Holmes in 1846 was the first to propose use of the term to denote the statethat incorporates amnesia, analgesia, and narcosis to make painless surgery possible. In the United States, use of the term anesthesiology to denote the practice or study of anesthesia was first proposed in thesecond decade of the twentieth century to emphasize the growing scientific basis of the specialty.

Although anesthesia now rests on scientific foundations comparable to those of other special-ties, the practice of anesthesia remains very much a mixture of science and art. Moreover, the practice has expanded well beyond rendering patients insen-sible to pain during surgery or obstetric delivery (Table 1–1). The specialty uniquely requires a work-ing familiarity with a long list of other specialties, including surgery and its subspecialties, internal medicine, pediatrics, and obstetrics as well as clinical pharmacology, applied physiology, and biomedical

technology. Recent advances in biomedical technol-ogy, neuroscience, and pharmacology continue to make anesthesia an intellectually stimulating and rapidly evolving specialty. Many physicians entering residency positions in anesthesiology will already have multiple years of graduate medical education and perhaps even certification in other medical specialties.