Wednesday, October 13, 2010

Anesthesia by Gus Joseph

Introduction:

Anesthesia is a word that means the condition of having sensation, such as pain, being blocked or taken away temporarily. It is a state of amnesia, loss of responsiveness, loss of reflexes, and lowered stress response. Because of the conditions induced by anesthesia, it allows people to undergo various surgeries and procedures without feeling pain that would be typically be felt. This state of numbness is brought on by a drug called an anesthetic. The pain killing aspect of anesthetics makes it one of the most helpful and influential drugs of all time.

History:

Different versions of anesthesia have been attempted over the years, even dating back to the Incan Empire. The first “use” of anesthesia was when Incan shamans chewed coca leaves and spit into the drill wounds (which the shamans had inflicted to let the bad spirits exit the body) which would numb the wound. Anesthesiology next appears in history thanks to a man named Joseph Priestley. Joseph Priestley enjoyed mixing different gases together, and even discovered oxygen. In 1772, he mixed up some of the gases he had already discovered and created a gas called nitrous oxide. Priestley inhaled some of the nitrous oxide, which made him laugh uncontrollably. He then named the gas “Laughing Gas”.

In December of 1844, a nitrous oxide show came to Hartford Connecticut, where a dentist named Horace Wells lived. Wells observed one of his friends cut open his leg while under the influence of nitrous oxide and not feel a thing. He then conducted what he thought would be the first ever painless tooth extraction on a patient on nitrous oxide. Unfortunately Wells did not give the patient enough nitrous oxide to completely numb his pain, and the patient cried out, ruining Wells’ reputation. But, in 1846 the use of a slightly different anesthetic in surgery would be attempted by a man named William Thomas Green Morton. He used sulfuric acid as an anesthetic for a surgery to remove a tumor in a man’s jaw. This surgery is the first painless surgery using an anesthetic. In the next few years a political battle broke out regarding who was to be credited with the discovery of anesthesia between Morton, Wells, and Charles Jackson, who was Morton’s chemistry professor while at school. In France, Wells was given credit of discovering it, but soon the US House of Representatives passed a bill giving credit to Morton. Then, Jackson disproved Morton’s work and the Senate denied the bill. In the following years Wells committed suicide, Morton died of a cerebral hemorrhage, and Jackson died in an insane asylum in 1880.

Impact on Humanity:

There is no doubt that the discovery of anesthesia is one of the most influential discoveries of all time. Without it, there would be countless surgeries that would be impossible to perform because of the massive amount of pain felt by the patient. Take open heart surgery or brain surgery for example. Without anesthesia, these two surgeries would not even be suggested to patients because of the ridiculous amount of pain that they would experience. But with the help of anesthesia, both surgeries are possible and are performed every day. Thanks to the discovery of anesthesia, humans have conquered pain.

Different Types of Anesthesia:

There are many different types of anesthetics being used today. There are local anesthetics, which are usually injected, general anesthetics, which consist of both inhalant and injection anesthetics, and intravenous opioid analgesic agents. Muscle relaxants are technically anesthetics but are usually used after an anesthetic has already been administered.

Local anesthetics, such as procaine, bupivacaine, dibucaine, and even cocaine, are used to stop nerve impulses from being sent but do not cause unconsciousness. These are used for less severe surgeries such as getting stitches and other small surgeries.

General anesthetics, such as desflurane, halothane, nitrous oxide (the original laughing gas) and even xenon in rare cases, are used to cause anesthesia and also unconsciousness when needed. Most of these types of anesthesia have slight side effects, or are not potent enough to cause anesthesia, so it is common for anesthesiologists to use two of these general anesthetics on a patient. For example, nitrous oxide is not strong enough to cause anesthesia, so it is usually used along with other agents. The anesthetics above are called volatile agents, and can be used alone or used in combination.

The last types of anesthetics are intravenous opiod analgesic agents, such as alfentanil, buprenorphine, diamorphine (heroin), and morphine. These anesthetics are commonly used during general anesthesia to relieve any pain the patient may be feeling. They can cause unconsciousness, but they do so with side effects and are also unreliable. They usually have a short duration. It is also common to use these anesthetics after surgery to relieve the patient of any post-surgery pains.

Journal Summary:

The First Administration of Anesthesia in Military Surgery: On Occasion of the Mexican-American War.

The journal I chose to write about was about the first use of anesthesia in the treatment of soldiers in war. The first time anesthesia was used on a soldier was in the Mexican-American War, performed by a man named Edward H. Barton. He had to perform surgery on a man whose legs had been shattered by an accidental discharge of a carelessly loaded musket. The man’s legs were so badly shattered that they had to be amputated. The first leg was removed very painfully, without anesthesia. The doctors concluded the second one could not be removed soon after the first one, so they pushed the procedure back a day. In the meantime, Dr. Barton arrived at the hospital that was caring for the patient, bringing knowledge of anesthesia and how to administer anesthetics to people. He had with him a tool called the letheon, a new device that could easily give the patient laughing gas.

THE LETHEON

The patient was given anesthetic via the letheon and had the other leg amputated without any feeling of pain. This marked the first time not only the first time anesthetics were used in helping soldiers wounded in battle, but also the first time the letheon had successfully administered anesthetic to a patient. The anesthetic used as ether, which Dr. Barton’s assistant John B. Porter wrote in a journal at a different time in the Mexican-American War. Porter also states that on a different occasion in the war a soldier needed to have his thigh amputated and was put on ether before the procedure. As the surgery began, the patient began hemorrhage, or to spew blood rapidly, which in hindsight was accredited to the use of ether in the procedure. What Porter didn’t know is that it wasn’t the drug ether that caused the hemorrhage, it due to the vaporization of it, which caused the drug to respond differently to the particular patient.

List of Sources:

Joseph Priestley. (n.d.). Retrieved from

http://en.wikipedia.org/wiki/Joseph_Priestley

Discovery of Anesthesia. (n.d.). Retrieved from

http://www.answers.com/topic/anesthesia-discovery-of

History of Anesthesia. (n.d.). Retreived from

http://www.mnwelldir.org/docs/history/anesthesia.htm

Anesthesia. (n.d.). Retrieved from

http://en.wikipedia.org/wiki/Anesthesia

Anesthetic. (n.d.). Retrieved from

http://en.wikipedia.org/wiki/Anesthetic

The First Administration of Anesthesia in Military Surgery. (J. Antonio Aldrete, M.D., M.S., G. Manuel Marron, M.D., A. J. Wright, M.L.S.). Retreived from

http://journals.lww.com/anesthesiology/Abstract/1984/11000/The_First_Administration_of_Anesthesia_in_Militray.19.aspx

http://www.general-anaesthesia.com/images/the-letheon.html

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