What Exactly is Anesthesia?

Written By Devika Chauhan

A dimly lit hall in the 1830s, where doctors and observers gathered around the operation table where the patient lay… wide awake. Dr. Robert Liston, world renowned for his immaculate speed of surgery, would perform the operation as the patient glared right at him. It is said that before each of his procedures, he would tell the observing medical students, “Now gentlemen, time me.” (Hawk 2021)

Before the discovery of anesthesia, patients were forced to endure every moment of surgery, wide awake. This is where speedy surgeons such as Dr. Liston, were very much needed. Findings leading up to modern day anesthesia are described as far back as 200 CE, where Chinese physician Huo Tuo, suggested the use of alcohol mixed with a powder of various ingredients. Furthermore, 13 century Arab surgeon, Ibn al-Quff, described the use of drugs such as cannabis, opium, and mandrake from saturated sponges. 

One common form of anesthesia is regional anesthetics. These work to form an electrical barricade like structure, which restricts the movement of pain impulses from a specific body part, to travel through the nervous system. One such example is cocaine. 

Inhalation anesthetics were also introduced as they work by restricting pain signals from the entire nervous system. Diethyl Ether, is one of the first inhalation aesthetics to arise, originally used as a recreational drug. It was later discovered that those under the influence of Ether, did not react to injuries they received. The 1840s were a time where the use of Ether in dental extraction and surgeries started to gain popularity. Later, nitrous oxide was also commonly used. 

When a patient is anesthetized, their brain function is heavily reduced, acting in a more calmer and “organized” manner. This is incredibly helpful in reducing pain signals to be sensed by the patient. Whereas, when a person is awake and aware of their surroundings, brain connectivity is “chaotic.” Despite all its wonderful perks, some anesthetics bring along their side effects. This is where the role of anesthesiologist is crucial to surgery, as they need to create a balance of the right amount of drugs, whilst carefully monitoring the anesthetized patient. 

The world of anesthetics is intricate, but over the decades, medicine has evolved to gain many insights on the developmental and functional aspects of anesthesia. All which have led to precise and quick surgical processes, saving thousands of lives. As for the patient, it's just like waking from an afternoon nap. 

References

Hawk, A. J. (2021). ArtiFacts: Built for Speed—Robert Liston’s Surgical Technique. Clinical Orthopaedics & Related Research, 479(4), 679–680. https://doi.org/10.1097/corr.0000000000001712

TED-Ed. (2015). How does anesthesia work? - Steven Zheng. On YouTube.

TED-Ed. (2023). What did people do before anesthesia? - Sally Frampton. On YouTube.

Written By Devika Chauhan from MEDILOQUY