History of anaesthesia

Anaesthetics were administered from the early 1840s, but the impact on general medical practice began after William Morton publically administered ether to Gilbert Abbott on 16 October 1846 at Massachusetts General Hospital, Boston.

On 19 December 1846, Francis Boott, an American botanist who had heard the news from Boston, watched dental surgeon James Robinson administer the first ether anaesthetic in England. Two days later, Robert Liston operated on Frederick Churchill at University College Hospital and a medical student, William Squire administered the anaesthetic.

Before anaesthesia, surgery was a terrifying last resort, a final attempt to save life.   Few operations were possible and surgeons were judged by their speed.   Some doctors had tried using alcohol, morphine and other sedatives to dull the pain of surgery but most patients were held or strapped down, some luckily fainted from the agony.   Many died.   Anaesthesia allowed surgeons to take more time, be more accurate and undertake more complex procedures.

Other agents soon followed.   In November 1847, James Simpson, Professor of Obstetrics in Edinburgh, introduced chloroform.   It was more potent but could have severe side effects such as sudden death and late onset severe liver damage.   It became popular because it worked well and was easier to use than ether.

Major advances and developments include the introduction of local anaesthesia in 1877, which in turn led to the introduction of infiltration anaesthesia, nerve blocks, spinal and epidural anaesthesia, then at the turn of the century came control of the airway using tubes placed in the trachea to help breathing.

By the 1920's intravenous induction agents were introduced which enabled patients to fall asleep quickly and pleasantly.   Muscle relaxants were introduced in the 1940s.

Today, anaesthetists are highly trained and skilled physicians who provide a wide range of patient care.   They often run High Dependency and Intensive Care Units.  They are involved in obstetric analgesia and anaesthesia, emergency medicine in A & E departments, resuscitation, major accident care, pain management and patient transfers between hospitals.

Anaesthesia is now very safe, with mortality of less than 1 in 250,000 directly related to anaesthesia.   Nevertheless with today's sophisticated monitoring systems and a greater understanding of bodily functions, the anaesthetic profession will continue to strive for improvement over the next 150 years.