By Andrew Ellsworth, MD
Anesthesiology is the branch of medicine committed to pain relief and patient care before, during, and after surgery and other procedures. It has origins in ancient times but made large advances in the last two centuries.
It is one of medicine’s greatest achievements that someone can comfortably drift off to sleep, have their knee replaced, or their gallbladder removed, and wake up with minimal pain.
Ancient civilizations used herbal remedies to help numb pain with forms of cannabis, opium, mandrake, or alcohol. Even by the time of the Revolutionary War, these remained the only options, which did little for the pain of an amputation. Survival depended on the speed of the surgeon. Patients would “bite the bullet” and literally clench down on a lead bullet or piece of leather to help endure the pain and protect their teeth. Surgeries were completed in minutes, and most amputees did not survive due to infection or blood loss.
Major advances in anesthesia came in the mid-1800s with the emergence of ether and chloroform. American dentist William Morton was the first to publicly show ether’s use as an anesthetic, famously demonstrated at Massachusetts General Hospital in 1846.
During the Civil War, anesthesia became widely adopted in the military and used in the vast majority of surgeries. Typically, ether or chloroform was soaked in a cloth and placed over the patient’s face for inhalation. After the war, the physicians with a new understanding of anesthesia were dispersed across the country, and use of anesthesia went from a sporadic, questionable intervention to standard practice.
Epidurals are another major advance in anesthesia, decreasing the pain of childbirth, surgery, and some forms of back pain. Epidurals numb pain by delivering medication near the spinal nerves with an injection in the back. First developed in the early 1900’s, epidurals became widely used in the United States by the 1970’s. The addition of a catheter allowed continuous pain relief throughout labor, replacing a single injection.
Modern anesthesia has continued to evolve. Propofol, first developed in the 1970s and approved in the United States in 1989, is now commonly used to start and maintain anesthesia. Often called the “milk of amnesia,” it works quickly and allows for a smooth, clear-headed recovery.
Anesthesia techniques continue to improve and become safer and more effective. With the expertise and close monitoring of an anesthesiologist or nurse anesthetist, patients can undergo complex procedures with excellent pain control and minimal risk.
Dr. Andrew Ellsworth is a Family Medicine Physician at Avera Medical Group Brookings in Brookings, SD. He serves as one of the Prairie Doc Volunteer Hosts during its 24th Season providing Health Education Based on Science, Built on Trust. Follow The Prairie Doc® at www.prairiedoc.org, Facebook, Instagram, YouTube, and Tik Tok. Prairie Doc Programming includes On Call with the Prairie Doc®, a medical Q&A show (most Thursdays at 7pm on YouTube and streaming on Facebook), 2 podcasts, and a Radio program (on SDPB, Sundays at 6am and 1pm).