INTRODUCTION TO ANAESTHESIA

Fatiş AltındaşDepartment of Anesthesiology

Dioscorides first used the term

anesthesia in first century AD

To describe the narcotic-like effects

As “a defect of sensation” in Bailey’s

An Universal Etymological English

Dictionary (1721)

Oliver Wendell Holmes used its

present meaning (1846)

means the sleeplike state

makes possible painless surgery

History of Anesthesia

In ancient time, people used Opium poppy, coca leaves, mandrake root, alcohol, phlebotomy

Ancient Egyptians used the combination of opium poppy and hyoscyamus morphine and scopolamine

EtherPrepared in 1540 by Valerius CordusUsed as sedative in

tuberculosisasthma and whooping cough remedy for toothache

Crawford W. Long and William Clark used it on patients in 1842

William Morton(1819-1868)

The first succesful surgical anesthesia, 1846, Boston

Professor James YoungSimpson (1811-1870)found chloroform tobe efficacious andreasonably safeused for PrinceLeopold’s andPrincess Beatrice’sbirhts

Chloroform

Nitrous oxide (N2O)Produced by Joseph Priestly1772,Humphrey Davy first notedits analgesic properties in 1800.Horace Wells first used it in humans for anesthesia in 1844Less popular in tree agents

Low potencyTendency to cause asphyxia H. Davy

Intravenous Anesthesia (IVA)

Pierre Cyprien OrePioneer of IVAChloral hydrate in 1872

Barbiturates weresynthesized 1903

For induction of anesthesia

Regional AnesthesiaIn 1860, Albert Niemann isolatedcrystalized alcoloids of coca.Karl Koller used cocain for eye block in 1884In 1885, first epidural blockIn 1898, first spinal anesthesia byAugust BierSecond local anesthetic agent (prilocain) was founded in 1904 Lidocain was founded in 1946

Evolution of the specialty

The development of theindepented medical specialtyof anesthesiology would not occur until the early 20th century.

In England, in 1893, the firstorganization of physician specialists in anesthesia, “The Society of Anesthetists”

In the United States, the firstorganization of physician anesthetistswas formed in 1911.

invented an inhalerfor ether

published the firstbook on general anaesthesia:On theInhalation of Ether

John Snowthe father of anaesthesia

History of Anesthesia in Turkey-1 The first publications belong to surgeonsThey made great contributions toanesthesia in TurkeyPublication of Miralay Ahmet Bey

includes the information about the use of ether

Ether anesthesia was first used in Gülhane Askeri Hospital in 1898 byRieder Paşa

History of Anesthesia in Turkey-2Dr. Sadi Sun is thefirst anesthesiologistin TurkeyThe first endotrachealentubation wasperformed by Dr SunIn 1955, anesthesiawas accepted as a medical specialty byMinistry of Health

What is Anesthesiology?

Practice of medicinededicated to the relief of pain and total care of thesurgical patient before, during and after surgery.

Anesthesiologists are a physician who complete a sixyears of medical school andfour more year anesthesiologyresidency training program.

Anesthesiologist is the perioperativephysicianProvides medical care to each patient

Evaluating the patient before surgery(preoperative)Consulting with the surgical teamProviding pain controlSupporting of life functions duringsurgery (intraoperative)Supervising care after surgery(postoperative)

In the operating roomThe role of anesthesiologist is to providecontinual medical assessment of thepatient

Monitor and control the patient’s vitalfunctions

Heart rate, rhythm, breathing, blood pressure, body temperature, fluid balanceImmediately diagnose and treat any medical problems during surgery or recovery period

Control pain and level of unconsciousness

In the postanesthesia care unitPatients aretransferred to recoveryroom after surgery

Allowing them to emergefully from the anesthetics’effects

They are observed byskilled nursingpersonnel

After stabilizationsufficiently, transferred toregular room or home

What is Scope of Anesthesiologist?Anesthesiologists work in ICU

Sedation and providing anesthesia outsidethe operating room

Magnetic resonance imaging, cardiaccatheterization etc.

Pioneers in cardiopulmonary resuscitationIn childbirth, anesthesiologists manage thecare of two personsAnesthesiologists are also involved in painmanagement,

to diagnose and treatment of acute and chronicproblems.

Happy New Year!