History of Anesthesia Flashcards
Test 1
Anesthesia is the lack of ______
feeling/sensation
What defines General Anesthesia?
A drug induced loss of consciousness ONLY
What are the types of regional anesthesia?
Peripheral
Spinal
Epidural
What are the 3 categories of sedation? What things are effected?
Minimal (Anxiolysis): This is usually versed in preop. nothing is usually effected, BUT CAN BE.
Moderate: Able to still respond to verbal commands/touch; ventilation = adequate; CVS = usually maintained
Deep: Responsive after repeated/painful stimulation; may need assistance maintaining airway and ventilating; CVS = usually maintained
Acupuncture is associated with _______
Asian culture
____________ below Apollo’s temple were used to predict the future
Ethylene fumes
___________ was used to temporarily get people to forget painful stimulus
carotid compression
Significance: Hippocrates
Wanted pt to stop moving to specifically accommodate to surgeon
Significance: Dioscorides
1st pharm book:
Materia Medica
What was the 1st pharm book? Describe it
Materia Medica
Focused on plants, animals, mineral products
360 medical properties
5 volumes
Significance: Mandragor & wine
Hallucinogenic
Human shaped
“magical properties”
Dioscorides had alot of details about this in materia medica
What was used as a reversal agent for inhaled substances in the Middle Ages?
inhaled vinegar
What was the 1st true inhalation vapor?
Diethyl ether
Significance: Valerius Cordus
-Made Diethyl Ether which was very flammable
–Used for recreation dt whiskey tax
-German botanist, physician
Significance: Sir Christopher Wren & Robert Boyle
Created IV using goose quill
-used bladder as IV bag
-member of royal society of London members
-learned about metabolism
Significance: Joseph Priestly
-Discovered o2, nitrous oxide
-discovered photosynthesis
Significance: Humphry Davy
Discovered K, Na, Ca, Mg
-suggested nitrous oxide for pain control
Significance: Horace Wells
Dentist
-used nitrous oxide and realized pts had no recall of pain/injury
-self administered for tooth extraction
Significance: Andrews
chicago surgeon
-1st person to mix nitrous w/ o2 to prevent hypoxia
Significance: Hewitt
1st anesthesia machine with nitrous/oxygen
Significance: Crawford Long
Used ether for pt with 2 vascular neck tumors
Significance: William Morton
Dentist
-Used ether for denture fittings
Significance: Robinson Squibb
Developed process for pure ether
The 1st public demonstration of ether was in _____
1846
Significance: James Simpson
OB doctor
-Didnt want women to have pain during childbirth
-defined pain as “actual or potential tissue damage”
Significance: John Snow
Anesthetist
-Treated Queen Victoria
-discovered epidemiology when he traced London cholera outbreak to water supply
What are considerations with chloroform?
Causes hepatotoxicity in children
-light chloroform increases adrenaline –>fatal vtach (deep prevents this)
Significance: Levy
-light chloroform increases adrenaline –>fatal vtach (deep prevents this)
Significance: Guthrie
Delayed causes of hepatotoxicity in children
Significance: Koller
Ophthalmologist
-used anesthesia for eye sx
Significance: Halsted
1st regional (mandibular) nerve block w/ cocaine
Significance: August Bier
1st spinal w/ cocaine
Significance: Mary Bernard
1st nurse anesthetist
Significance: Alice Magaw
“Mother of Anesthesia”
14000 ether cases without death
Significance: Agatha Hodgin
Opened 1st CRNA school in france
Founded AANA
Compare: Cyclopropane
Halothane
isoflurane
Cyclopropane: violently explosive
Halothane: cause hepatitis; slow onset/emergence
Isoflurane: relatively safe; less N/V than halothane; quicker onset
Significance: Desflurane
Rapid uptake and distribution(most rapid onset/offset)
-large quantity needed to achieve anesthesia = expensive
Significance: Edmund Egar
Anesthesiologist
-experimented w/ Desflurane
-end-tidal concentration correlated to movement
Significance: sevoflurane
-intermediate action between isoflurane & desflurane
unstable in lime soda
-doesn’t irritate airway
LAST NEW INHALED ANESTHETIC CREATED
What is the triad that we want to create in anesthesia consist of? What is this called?
Amnesia
Analgesia
Muscle relaxation
“balanced anesthesia”
Curare is a ______neuromusclar blocker. ________ is based off this drug.
Non-depolarizing
Rocuronium
Significance: Liston
Sx longer than 20 mins = death
-Killed 3 people in 1 operation (1 pt & 2 assistants)
Significance: George Crile
local infiltration of procaine
-has instrument named after him
Significance: Harvey Cushing
big on data collection
- anesthetic records
-BP/HR measurements
What are the 5 phases of anesthesia?
- Preoperative
- Induction.
- Maintenance.
- Emergence.
- Postoperative.
How many stages are there in anesthesia?
4
What is stage 1 of anesthesia?
Beginning of induction to loss of consciousness:
1st plane: no meds
2nd plane: amnestic; partially analgesic
3rd plane: Loss of conscioisness (complete analgesia/amnesia)
What is stage 2 of anesthesia?
Loss of consciousness to onset of automatic breathing
-eyelash reflex disappears
-coughing, vomiting and irregular respirations may occur
What are considerations do we need to have during stage 2 of anesthesia?
Risk for aspiration
-risk for Laryngospasm
- decreased HR/CO
want to get out this stage as quickly as possible
no stimulation during this stage
What is stage 3 of anesthesia?
Onset of automatic respirations to respiratory paralysis
1st plane: automatic respiration to cessation of eyeball movements
2nd: sensation of eyeball movements to beginning of intercostal muscle paralysis; secretion of tears increase
3rd: beginning to completion of intercostal muscle paralysis; pupils dilate; desired plane prior to muscle relaxant
4th: complete intercostal paralysis to diaphragm paralysis
What stage are we able to begin surgery in?
Stage 3
What is stage 4 of anesthesia?
Stoppage of respiration till death
don’t want to get here; sedation too deep
