Anaesthetics are medical agents employed for the removal of pain, especially in surgical operations, by suspending sensibility either locally or generally.
In ancient writers we read of insensibility or indifference to pain being obtained by means of Indian hemp, (canuabis Indica) either inhaled or taken into the stomach. The Chinese more than 1,500 years ago used a preparation of hemp, or ma-yo, to annul pain. The Greeks and Romans used mandragora for a similar purpose, (poiein, anaisthesian) and as late as the 13th century the vapor from a sponge filled with mandragora, opium, and other sedatives was used. Compression of the nerves and blood-vessels and the inhalation of the vapor of mixtures containing carbonic anhydride were practiced at an early date. In the 16th century ether was probably the active ingredient of a volatile anaesthetic described by Porta. The use of anaesthetics was, however, but little understood and rarely practiced. Even the suggestion of Sir Humphry Davy that nitrous oxide should be used in minor operations not attended by loss of blood was of little practical value, on account of the inefficient apparatus then available.
In 1818 Faraday established the anaesthetic properties of sulphuric ether, but this agent made no advance beyond the region of experiment, until 1844, when Dr. Horace Wells, an American dentist of Hartford, Connecticut, applied the inhalation of sulphuric ether in the extraction of teeth, but owing to some misadventure did not persevere with it an in 1845 Horace Wells inhaled laughing-gas so successfully that he may be said to have introduced the practice; but he appears to have so often failed to produce the desired effect that this agent fell into disuse on the introduction of ether in 1846 by Dr. Morton, a Boston dentist, who also extended the use of ether to other surgical operations. The practice was soon after introduced into England by Mr. Listen, and a London dentist, Mr. Robinson. A few weeks later Sir James Simpson made the first application of ether in a case of midwifery. This was early in 1847. Towards the end of the same year Simpson had his attention called to the anaesthetic efficacy of chloroform, and announced it as a superior agent to ether. This agent was at the start of the 20th century the most extensively used anaesthetic, though the use of ether still largely prevailed in the United States. In their general effects ether and chloroform are very similar; but the latter tends to enfeeble the action of the heart more readily than the former. For this reason great caution has to be used in administering chloroform where there is weak heart action from disease. Local anaesthesia is produced by isolating the part of the body to be operated upon, and producing insensibility of the nerves in that locality. Dr. Richardson's method was to apply the spray of ether, which, by its rapid evaporation, chills and freezes the tissues and produces complete anaesthesia. This mode of treatment, besides its use in minor surgical operations, has recently begun to have important remedial applications. Around 1905 a new valuable local anaesthetic, cocaine was
duced which is now the prevalent local anaesthetic in use.
In 1933 the first barbiturate general anaesthetic was used, hexobarbitone, other barbiturates are now used, most commonly thiopentone and also propofol and ketamine which have effects lasting a shorter period of time and less of a hangover effect on the patient. Chloroform and ether not being used since the introduction of barbiturates due to the reduction of complications, though barbiturates are still dangerous and premedication is widely used with them.
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Ketamine (xylazine or Ketalar) is an injected dissociative anesthetic and central nervous system stimulant used for superficial operative procedures, particularly with children and the relief of cancer pain and reduction of preoperative anxiety.
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