History of anaesthesia | Anesthesia: What is that?

History of anaesthesia

In Genesis (2:21) it says: “Then the Lord God caused a deep sleep to fall upon man, and he fell asleep. And he took one of his ribs, and shut up the place with flesh”. Strictly speaking, the first performance of an anaesthetic is already described here in the Bible.

However, the first anaesthesia performed by a human being came barely 2000 years later. Ever since 1800 when Humphrey Davy recognized the pain-relieving properties of nitrous oxide, medicine has tried to make use of these properties in practice. A first public demonstration of anaesthesia using nitrous oxide in 1845 failed, however.

Horace Wells, a dentist from Hartford, wanted to demonstrate the anaesthetic effect of nitrous oxide, but the patient cried out loudly when he tried to pull a tooth. It was William Thomas Green Morton, a dentist from Charlton, Massachusetts, who one year later (October 16, 1846) performed the first successful anesthesia. The patient was suffering from an ulcer on his neck, which was to be removed.

Unlike Wells, Morton used ether for anesthesia. The ether ball he had made especially for this purpose served to enable the patient to inhale the volatile gas. This day went down in medical history as “Ether Day”.

On its successful way to today’s professional anaesthesia, anaesthesia often had to assert itself against adversaries. For a long time, people were not aware of the importance of pain and believed that suppressing the pain was detrimental to the patient’s recovery. Pain is a part of life.

Most of the anaesthetics in use today are not older than 20 years – with the exception of nitrous oxide itself. General anaesthesia means the reversible elimination of consciousness, i.e. artificial sleep. This sleep state can be used, for example, to perform an operation.

The loss of consciousness is achieved either by medication injected directly into the bloodstream via a venous catheter (so-called TIVA = total intravenous anaesthesia) or by a mask over the mouth and nose in the form of gases (so-called inhalation anaesthesia). Both forms are often combined in practice: The process of falling asleep is induced by injection anaesthetics (e.g. propofol), while the maintenance of the sleeping state is ensured by gases (e.g. sevoflurane, desflurane).

Such a combination is called “balanced anaesthesia”. The state of deep unconsciousness is accompanied by a loss of reflexes – including the respiratory reflex. Therefore, the patient must be artificially ventilated during general anaesthesia.

General anaesthesia is always accompanied by the administration of strong painkillers (opioids) and is often supplemented by drugs that relieve muscle tension (muscle relaxants). General anaesthesia can be supplemented by regional anaesthesia (e.g. spinal anaesthesia, epidural anaesthesia) in many surgical procedures (for more details see “Pain therapy” below). General anaesthesia is also used in intensive care medicine to keep the patient in an artificial coma for a longer period of time (in serious cases even for several months). General anaesthesia always carries the risk of some side effects. You can find more information under our topic: General anaesthesia