The History of Modern Anaesthesia Flashcards
When and how was anaesthesia first popularized
In 1846, Dentist Dr William TG Morton publicly demonstrated the efficacy of ether as an anaesthetic for the removal of a vascular tumor in the neck of a patient
What is the etymology of the word anaesthesia?
Greek origins
‘an’ - without
‘aesthesia’ - perception
Suggested to Dr William TG Morton by Dr John Warren in a private letter to Morton dated 21 Nov 1846
In which hospital was the first public demonstration of ether’s efficacy for use as an anaesthetic done by Dr William TG Morton
In Boston USA: Massachusetts General Hospital
Who was the first South African to use ether as a general anaesthetic. What year was this in?
Dr William Guybone Atherstone of Grahamstown
- First anaesthetist outside USA and Europe to use ether as an anaesthetic during an operation to amputate a patient’s leg.
This occurred June 1847
What else was Dr William Guybone Atherstone known for
He was also a prominent geologist and palaeontologist and is remembered for being the person who identified the hope diamond as a diamond, triggering the Kimberly diamond rush.
What were the problems with ether
Flammable
Slow onset
Significant PONV
Why was chloroform introduced and who introduced it?
The search for an agent that was not flammable and caused less PONV than ether.
Dr James Simpson 1847 (Obstetrician) introduced
Who wrote the first textbook on anaesthesia and what was it called? What else did this doctor do
Dr. John Snow
“On the inhalation of Ether in Surgical Operations”
He also administered chloroform to Queen Victoria whilst she was giving birth to her son Leopold.
Describe the first recorded death under anaesthesia
Ms Hannah Greener
Ingrowing toe nail
Had Chloroform died
Multiple deaths after chloroform followed and its use was discontinued in favour of ether
Following ether what and when was the next volatile agent discovered and why was it superior to ether. What were its draw backs
1954 - Halothane discovered by Charles Suckling - British Chemist
Superior to halothane
- Potent
- Non-flammable
- Pleasant odour
- Favourable kinetic characteristics
Small potential to cause hepatotoxicity especially with repeat anaesthetics resulted in it being replaced by isoflurane in first world countries
What were the first induction agents developed and how were the dangers of CVS collapse discovered
Barbiturates
- hexobarbital (1932)
- Thipentone (1934)
—> balanced anaesthesia (reduce doses of other agents to minimize side effects
CVS collapse was noticed when inducing shocked patients after the bombing of Pearl Harbour in 1942
What is the history of the development of muscle relaxants
1814 - UK - Brodie and Waterton - South American Arrow poison worked by paralysing skeletal muscle
- Injected a donkey and ventilated the paralysed donkey for 2 hours via a tracheotomy. The donkey survived and lived for another 25 years.
1857 - French - Claude Bernard - Used frogs to determine that muscle relaxants work at the neuromuscular junction rather than the nerve or the muscle
1940 - Canada - Harold Griffith popularised curare use during surgery for muscle relaxation
When was the Boyle machine described by Henry Boyle
1917
When, where and why were intensive care units first suggested and implemented
1952 in Copenhagen (Denmark)
Bjorn Ibsen
Polio pandemic
Iron lung = Drinker Respirator
What did the following UCT Professors achieve:
Prof Arthur Bull (1965 - 1981)
Prof Gaisford Harrison (1981 - 1987)
Prof Michael James (1987 - 2012)
Prof Swanevelder (2012 - present
Dr Joseph Ozinsky
Prof Arthur Bull (1965 - 1981)
- Taurus blood warmer
Prof Gaisford Harrison (1981 - 1987)
- Dantrolene for MH
Prof Michael James (1987 - 2012)
- MgSO4 for phaeo and blunt intubation response in pre-eclampsia
Prof Swanevelder (2012 - present - World renowned TOE expert
Dr Joseph Ozinsky
- Anaesthetised world first heart transplant without a-line or pulse oximetry
