Pre- 1846: – The foundation of anesthesia 1846-1900: Establishment of anesthesia 20th century: Consolidation and growth 21st century: – The future

1. HISTORY OF
ANESTHESIA
Presented by
Dr. Md Mizan Ullah
Dept of anesthesia ,analgesia,ICM
Shaheed Suhrawardy Medical college
Hospital

2. WHY NEED H/O
ANESTHESIA
 Understanding of our past guides our future
 The history of surgery link to the development
of appropriate anesthetic technique and so H/o
surgery follows the history of anesthesia
 We are all part of it

3. WHAT IS ANESTHESIA
 Greek an- without and aesthesia – sensation
refers to the inhibition of sensation
 Origin of anesthesia :
– Oliver Wendell Holmes Sr 1846
 Insensitivity to pain , especially as artificially
induced by the administration of gases or the
injection of drugs before surgical operation

4. WHY ANESTHESIA
 Loss of awareness/Amnesia
 Analgesia
 Reduce the movement in response to stimuli
 Minimize the autonomic response to surgical
stimuli
 Muscle relaxant
 Autonomic regulation

5. HISTORY OF
ANESTHESIA
 Pre- 1846: – The foundation of anesthesia
 1846-1900: Establishment of anesthesia
 20th
century: Consolidation and growth
 21st
century: – The future

6. PRE- 1846
THE FOUNDATION OF ANESTHESIA

7. METHOD OF ANESTHESIA
 Drug method
 Non-drug method

8. DRUGS METHOD
 Alcohol
 Opium
 Hyoscine
 Cannabis
 Cocaine

9. NON DRUGE METHOD
 Cold
 Concussion
 Carotid compression
 Nerve compression
 Mesmeric Magnetism
 Hypnosis
 Blood letting

10. ANCIENT ANESTHESIA
 Status of surgery
– Barber shop surgery
 Type of surgery
– Amputation and dental
extraction
– No antiseptic
– Appalling mortality
 Indication
– Unbearable pain
– Crippling deformity
– Imminent death

11. HISTORICAL PERSON IN
ANESTHESIA

12. WILLIAM T G MORTON
 First GA was given by
use diethyl ether
 Inventor and Revealer
of inhalational
anesthesia : Before
whom ,in all time
surgery was agony.

13. 1846 (16TH
OCTOBER)
 Anesthetist
– William T G Morton
 Agent: Ether
 Patient
– Gilbert Abort
 Operation
– Excision of tumor
under jaw
 Surgeon
– John Collin Warren

14. JOHN SNOW
 Use chloroform to deliver
the last two children of
Queen Victoria
 First anesthesiologist
 Describe the stage of
ether anesthesia
 Improve the method of
administration of ether
and chloroform

15. HISTORICAL PLACE
Boston memorial Massachusetts memorial

16. ETHER
 1540: Synthesized and named “sweet oil of
vitriol” by Valerius Cordus
 Renamed ether by: Frobenius
 1744 : Matthew discovered it inhalational
properties
 1818: Michel Faraday discovered “narcotic
effect”

17. Cont….
 1842 :
– first use as clinical
anesthetics in USA
 1846 (16th
October):
– first public demonstration
in Boston

18. NITROUS OXIDE
 Joseph Priestley
– First prepared by 1773
 Humphrey Davy
– applied N2O on himself
by face mark deign for
industry.
– Noted it analgesic
properties 1800

19. CHLOROFORM
 1831: Synthesized :
 1847: Anesthetic properties discovered
 1847 : First clinical use London
 1847: James Young Simpson use it for
obstetric anesthesia
 1847: John snow regulating inhaler
 1847: Hannah Greener first anesthetic death

20. 20TH
CENTURY
CONSOLIDATION AND GROWTH

21. CONT…
 Intubation and airway advance
 Anesthetic equipment
 Monitoring
 Drug advance
 Pain management
 Intensive care
 Local anesthesia
 Organization of specialty

22. INTUBATION & AIRWAY
ADVANCE
 1919: Endotrachial intubation
 1928: blind nasal intubation
 1950: PVC tube introduce
 1954: Classification of breathing circuit
 1972: Bain circuit
 1980: LMA

23. ANESTHETIC
EQUIPMENT
 1908: Rota meter
 1917: Boyles machine
 1938: Mechanical ventilation
 1940: Oxford vaporizer

24. MONITORING
 Bp Monitor: MGH
 1946: O2 analyzer
 1949: Nerve stimulator
 1956: Blood gas monitor

25. DRUG ADVANCE
 1911: Balance anesthesia
 1942: Curare
 1951: Suxamethonium
 1956: Halothane
 1964: Entonox
 1980: fentanyl/Propofol/vecuronium
 1990: Sevuflurane

26. LOCAL ANESTHESIA
 Definition:
– Any substance that prevent the conduction of nerve
impulse is called local anesthetics.
 Substance that block the voltage- activate Na+
channel.

27. CONT…
 Cocaine:
– Naturally occurring compound, indigenous
to the Andes mountains.
– Alkaloid obtain from:
 Leaves of Erythroxylum coca
– First LA to discover 1800
– Only naturally occurring LA
– Koller use as a LA in 1883 in eye
– Hall introduce it in dentistry

28. CONT……
 Procaine :
– Developed : 1904
– First synthetic LA
 Lidocaine :
– Discovered by : Lofgren 1943
– Market available : 1947 (xylocaine)
– First amide LA
– Most widely use cocaine derivatives
 Bupivacaine :
– Discovered : 1957
– Market available : 1965

29. REGIONAL ANESTHESIA
 Spinal anesthesia :
– 1885: by Leonard Corning
– 1898: August Bier
 Epidural : 1921
 IVRA:
– 1908 by “August Bier”
– Use procaine in a vein
between two
tourniquets
August Bier

30. ANESTHESIA IN BD
 Local anesthesia and regional block was done
by surgeon themselves at DMCH
 GA was done under supervision of surgeon
and use by the house surgeon by respective
department
 Dr. Beni Madhab Basak : GA
 Dr. S M Mukhlesur rahman 1948

31. CONT….
 First post graduate
– Dr A.S.M.A Quader (DA) London
 1951:
– Dr. A Quader has been in charge Department of
anesthesia DMC
 Prof S N Samad Chowdhury
 DA (London,) FCPS, FFARCS
– was long time president of BSA and has a great
contribution of expansion of anesthesia in BD

32. MANPOWER IN BD
 1947: No recognized trainee anesthesiologist
 1948: Two self trained and in 1951 one ,total
three with one recognized
 1980: gradual increase the interest in this
field due to national demand . still improving
but slow.

33. POST GRAGUATE
 DA
– Dr. Fakhrun Nissa Dr. Dilip Kumar Dar
 MCPS:
– Dr. M Khalilur Rahman 1976
 FCPS:
– Dr. Selim M Jahangir 1983
 MD:
– Dr. Abdul Hai 1987

34. ANESTHESIA EXPANSION IN
BD
 Pre –operative management
 Pain clinic
 Intensive care unit
 Palliative care
ICU started in 1985 in DMCH with six bed

35. BSA
 Established: 1974
 President : Dr. K S A M Quader
 Secretary: Dr. Shafiqur Rasul
 Journal: 1987 Dr. K M Iqbal was editor

36. CONCLUSION
 Now a day complicated surgical procedure is
possible due to improvement of anesthesia
 Still we are lacking some basic infrastructural
problem like
 Proper placement and distribution of man
power
 Availability of equipment
 Standard monitoring
 However we are very much hopeful and
awaiting for our golden future

37. THANK YOU