The document provides a history of anesthesia, covering developments from ancient times through the 20th century. It discusses early non-drug pain management techniques and the discovery of anesthetic agents such as nitrous oxide, ether, and chloroform. Key developments included Morton's public demonstration of ether anesthesia in 1846, the introduction of tracheal intubation in the late 19th century, advances in ventilation equipment and patient monitoring, and the discovery and use of muscle relaxants and intravenous anesthetics. The history shows how anesthesia evolved from simple restraint to a specialized field utilizing various drugs, equipment, and techniques.

1. HISTORY OF
ANAESTHESIA
SPEAKER: DR V.SRAVANI
MODERATOR: DR.JAGADISH OMKAR
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2. OVERVIEW
✓ Anesthesia before ether
✓ Anesthesia principles, equipment & standards
✓ The history of anesthetic agents and adjuvents
✓ Professionalism & anesthesia practice
✓ Conclusion
✓ References
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4. The common method used to achieve a relatively quiet surgical
field was simple restraint of the patient by force
MIDDLE AGES
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5. ✓ Anaesthesiology is an amalgam of specialized techniques,
equipment, drugs, and knowledge that, like the growth rings of a
tree, have built up over time.
✓ Knowledge of the history of anaesthesia enhances our
appreciation of current practice and intimates where our
specialty might be headed.
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6. ✓ Oliver Wendell Holmes (1809-1894)- term anesthesia-1846 –
greek an- “without”and aisthesis- “sensation”.
✓ Terminologies varies within the countries- North America-
Anesthesiology, United Kingdom- Anaesthesiology.
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7. PRE 1846- THE FOUNDATION OF ANESTHESIA
✓ Dioscorides, a Greek physician-first century AD-mandragora, a
drug- bark and leaves of the mandrake plant.
✓ From the ninth to the thirteenth centuries, the soporific sponge -
pain relief during surgery.
✓ Alcohol-Induce stupor and blunt the impact of pain
✓ An English surgeon-Henry Hill Hickman-high concentrations of
carbon dioxide- inhaled anesthetic to relieve pain in his patients.
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8. Non Drug Methods:
✓ refrigeration anesthesia- 17th century, Marco Aurelio-snow -
parallel lines across the incisional plane such that the surgical
site became insensate within minutes.
✓ Brachial plexus compression- Egyptian pictographs
✓ Mesmerism, Hypnosis
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9. NITROUS OXIDE
✓ Joseph Pristley- prepared in 1773
✓ Humphrey Davy-Medical Assistant to
Thomas Beddos @ Pneumatic
Institution of Bristol
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10. 1798- on the day when inflammation was troublesome,
Davy breathed 3 large doses of N2O, pain diminished
after first 4/5 respirations.
Davy suggested N2O be used for painless surgical
operations and named it LAUGHING GAS.
He published his work in book- Researches, Chemical &
Philosophical- 1799
1815- invented Davy lamp- allowed minors to work
safely in presence of inflammable gases.
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11. ETHER
✓ 1540-Synthesised & named-Sweet Oil of Vitriol-Valerius Cordus
& Paracelus
✓ 1842- William E. Clarke-a medical student -first ether anesthetic
✓ 1846-Public Demonstration of Ether-WTG Morton(1819-1868)-
Father of surgical anesthesia.
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12. ✓ After anesthetizing a pet dog, Morton became confident of his
skills and anesthetized patients in his dental office.
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13. Public demonstartion of anesthetic effect of ether on
October 16,1846 at Bullfinch Theatre, Boston General
hospital for the removal of congenital vascular tumor on
left side of Gillbort Abott neck by John Collins
Warren,prof of surgery, harvard medical school.
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14. ETHER INHALER
✓ A large glass bulb containing a sponge soaked with colored
ether and a spout that was placed in the patient's mouth. An
opening on the opposite side of the bulb allowed air to enter
and be drawn over the ether-soaked sponge with each breath.
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15. CHLOROFORM
✓ James Young Simpson-Ist to use
ether for relief of labour →not very
satisfied→inhaled chloroform after
dinner party on nov 4 1987 and
promptly fell unconcious→first
published this finding in Lancet.
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16. ✓ John Snow used Chloroform to deliver
last two children of Queen Victoria
✓ Chloroform inhaler
✓ Concept of MAC (combination of ether
with chloroform)
✓ now published two remarkable books,
On the Inhalation of the Vapour of
Ether (1847) and On Chloroform and
Other Anaesthetics (1858).
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18. Joseph Clover
✓ Joseph Clover (1825–1882) became the leading anaesthetist of
London after the death of John Snow in 1858.
✓ Joseph Clover anesthetizing a patient with chloroform and air
passing through a flexible tube from a Clover bag.
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19. Clover was the first anaesthetist to
administer chloroform in known
concentrations through the Clover
bag.
After 1870, Clover favored a nitrous oxide–ether sequence.
The portable anesthesia machines that he designed were in
popular use for decades after his death.
He was the first Englishman to urge the now universal
practice of thrusting the patient's jaw forward to overcome
obstruction of the upper airway by the tongue
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20. TRACHEAL INTUBATION
✓ The first tracheal tubes were developed for the resuscitation of
drowning victims.
✓ July 5, 1878→Scottish surgeon William Macewan.
✓ 1900-1912- nasal And oral intubation technique
✓ 1919- self trained British anesthetist Sir Ivan Magill→ blind nasal
intubation
✓ 1920= magil angulated forceps→apploed cocaine to nasal
mucosa to facilitate awake blind nasal intubation
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21. ✓ 1926- Arthur Guedel- introduced cuffed tubes→dunked dog
demonstartion
✓ 1941-Robert Miller of San Antonio, Texas→ Miller brought
forward the slender, straight blade with a slight curve near the
tip to ease the passage of the tube through the larynx.
✓ Robert Macintosh of Oxford University→ The Macintosh blade,
which is placed in the vallecula rather than under the epiglottis,
was invented as an incidental result of a tonsillectomy
TRACHEAL INTUBATION
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22. ✓ 1953- single-lumen tubes were supplanted by double-lumen
endobronchial →Frank Robertshaw of Manchester, England
✓ David Sheridan→centimeter markings along the side of tracheal
tubes
✓ 1964-japanese physician Shigeto Ikeda (1925-2001)- developed
first fibreoptic bronchoscope
✓ 1981-Dr Archie I.J. Brain – laryngeal mask airway
TRACHEAL INTUBATION
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24. ✓ 1937- Philip Ayre-Valveless T piece to reduce effort of breathing
in neurosurgery patients. PPV could be achieved when
anesthetist obstructed the expiratory limb
✓ Gordon Jackson Rees- improved control of ventilation
substituting a breathing bag on outflow
✓ 1972- Bain spoerel apparatus
ALTERNATIVE CIRCUITS
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25. VENTILATORS
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26. FLOWMETERS
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28. VAPORISERS
✓ A device which delivers a given concentration of a volatile
anesthetic agent.
✓ 1952- Dr Lucien E Morris introduced the copper kettle at
University of wisconsin in response to Ralph Waters plan to test
chloroform by giving it in controlled concentration
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30. 30

31. PATIENT MONITORS
✓ Joseph Clover was one of the first clinicians to routinely
perform basic hemodynamic monitoring
✓ Two American surgeons, George W. Crile and Harvey Cushing,
developed a strong interest in measuring blood pressure during
anesthesia.
✓ The transition from manual to automated blood pressure
devices, which first appeared in 1936 and operate on an
oscillometric Principle, has been gradual.
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32. ✓ The first precordial stethoscope was believed to have been used
by S. Griffith Davis at Johns Hopkins University
✓ Albert Codesmith, of the Hospital for Sick Children, Toronto
fabricated his first esophageal stethoscope from urethral
catheters and Penrose drains
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33. ECG
✓ Clinical electrocardiography began with Willem Einthoven's
application of the string galvanometer in 1903
✓ Within two decades, Thomas Lewis had described its role in the
diagnosis of disturbances of cardiac rhythm, while James
Herrick and Harold Pardee first drew attention to the changes
produced by myocardial ischemia
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34. PULSE OXIMETRY
✓ American physiologist, Glen Millikan created an oxygen-sensing
monitor worn on the pilot's earlobe, and coined the name
oximeter to describe its action.
✓ Refinements of oximetry by a Japanese engineer, Takuo Aoyagi,
led to the development of pulse oximetry.
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35. ✓ In 1981, anesthesiologist William New and two colleagues
formed a new company called Nellcor. They released their first
pulse oximeter, called the Nellcor N-100, in 1983.
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36. ✓ 1954→K. Luft described the principle of infrared absorption by
CO2 and he developed an apparatus for measurement
✓ Routine application of capnography in anesthesia practice was
pioneered by Dr. Bob Smalhout and Dr. Zden Kalenda in the
Netherlands.
✓ Breath-to-breath continuous monitoring and a waveform display
of CO2 levels help anesthesiologists recognize abnormalities in
metabolism, ventilation, and circulation.
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37. Seshhagiri Rao Mallampati 1941
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38. INHALED ANESTHETICS
✓ 1540-Valerius Cordus-synthesised diethyl ether
✓ Paracelsus- analgesic effect
✓ 1774-Pristley-N20
✓ 1800-Davy- analgesic effect
✓ 1831-Von Liebig-chloroform
✓ 1847-Simpson-analgesic effect
✓ N20, Ether with oxygen
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39. ✓ 1894-Ethyl Chloride-Swedish dentist named Carlson
✓ 1923-Ethylene
✓ trichloroethylene.
✓ first attempt to prepare a fluorinated anesthetic by Harold Booth
and E. May Bixby in 1932.
✓ 1947-Julius Shukys-trifluoroethyl vinyl ether, or fluroxene,
became the first fluorinated anesthetic.
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41. BOYLE APPARATUS
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42. ✓ 1917- Dr. Henry E. G. Boyle (1875-1941) nitrous oxide, oxygen
and ether anesthesia machine.
✓ The gases were routed through two perforated tubes in a glass
mixing chamber containing water.BOYLE APPARATUS
✓ Halothane quickly grew in popularity, because it offered a non-
explosive alternative to ether and cyclopropane.
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44. INTRAVENOUS ANESTHETICS
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45. MUSCLE RELAXANTS
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46. ✓ In 1906, Reid Hunt and R. Taveaux prepared
succinylcholine among a series of choline esters, which
they had injected into rabbits to observe their cardiac
effects
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47. ✓ Credit for successful and safe introduction of curare and d-
tubocurarine into anesthesia must in part be given to a Squibb
researcher named H. A. Holaday. Crude, unstandardized
preparations of curare produced uncertain clinical effects and
undesirable side effects related to various impurities.
✓ Succinylcholine was prepared by the Nobel laureate Daniel
Bovet in 1949 and was in wide international use before
historians noted that the drug had been synthesized and tested
long beforehand.
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48. MUSCLE RELAXANTS
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49. LOCAL ANESTHETICS
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50. ✓ The first local anesthetic introduced into medical practice
Cocaine was isolated from Coca leaved by German chemist
Albert Niemann & Wilhelm Lossen in 1860.
✓ The first clinical use of Cocaine was in 1884 was by Sigmund
Freud who used it to wean a patient from morphine addiction
✓ Freud and his colleague Karl Koller first noticed its anesthetic
effect and introduced it to clinical ophthalmology as a topical
ocular anesthetic
✓ 1891-pure cocaine was isolated
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52. The Discovery of Regional
Anesthesia in the 19 Century
Karl Koller Sigmund Freud
Austrian Ophthalmologist Austrian Neurologist
1857-1944 1856-1939
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54. SPINAL ANESTHESIA
✓ The term spinal anesthesia was
coined in 1885 by Leonard
Corning, a Neurologist who had
observed Hall and Halsted.
✓ Corning wanted to assess the
action of cocaine as a specific
therapy for neurologic problems
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55. ✓ 1898- August Bier and Theodor Tuffier→described authentic
spinal anesthesia,with mention of CSF, injection of cocaine, and
an appropriately short onset of action.
✓ Heinrich Quincke of Kiel, Germany, had described his technique
of lumbar puncture property of baricity was investigated by
Arthur Barker, a London surgeon
✓ 1944 Edward Tuohy of the Mayo Clinic introduced two
✓ important modifications of the continuous spinal techniques
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56. EPIDURAL ANESTHESIA
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58. ✓ 1893 The London Society of Anaesthetists, the world's first
anesthesia society, is formed in London, England.
✓ American Society of Anesthetists (ASA) in 1936
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59. HISTORY OF ANESTHESIA IN INDIA
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60. ✓ Jan 12,1925- Mahatma Gandhi underwent an emergency
appendicectomy at Sasoon hospital ,Pune. During an electricity
failure the mahatma was administered open drop chloroform
anesthesia with surgery being completed by the light of
kerosene and battery operated torch
✓ Until 30 yrs ago anesthetic equipments in indian operating
rooms consisted of simple anesthesia machine , suction unit,
ecg monitor, O2 supply by cylinders.
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61. DA-1946-
mumbai
university
MD-
1955-
Darbhanga
medical college,
Bihar
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64. ✓ It was during IInd Hyderabad Chloroform
Commission name of Roopa Bai Furdoonji
came under spotlight
✓ She was a member of commision
✓ She later received part of her training in
Edinburgh & worked as full time
anesthesiologst at British Residency
Hospital in Hyderabad
Dr. (Miss) Rupa Bai Furdoonji:
World’s first qualified
lady anaesthetist
Miss Rupa Bai with Surgeon major
Edward Lawrie (sitting on her right)
and Sir Thomas Lauder Brunton,
F.R.S. (sitting on her left)
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65. ➢ By virtue of their ability to administer emergency life support
measures and perioperative management skills,
Anesthesiologists were at forefront in
▪ 2001 gujrat earthquake rescue teams
▪ Tsunami disaster rescue teams
▪ 2011 mumbai and ndelhi bomb blast rescue teams
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