Anaesthetic Topics

• datura inoxia
• opium poppies
• pedanius dioscorides
• opium poppy
• tropane alkaloids
• ebers papyrus
• 13th century italy
• coca leaves
• medical texts
• minoan temple
• spongia
• saturated solution
• metel
• pliny the elder
• anaesthetics
• theodoric
• aconitum
• henbane
• anodynes
• anaesthesia

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Opium poppy capsules were collected in 4200 BC, and opium poppies were farmed in Sumeria and succeeding empires. The use of opium-like preparations in anaesthesia is recorded in the Ebers Papyrus of 1500 BC. By 1100 BC poppies were scored for opium collection in Cyprus by methods similar to those used in the present day, and simple apparatus for smoking of opium were found in a Minoan temple. Opium was not introduced to India and China until 330 BC and 6001200 AD respectively, but these nations pioneered the use of cannabis incense and aconitum. In the second century, according to the Book of Later Han, the physician Hua Tuo performed abdominal surgery using an anesthetic substance called mafeisan ( "cannabis boil powder") dissolved in wine. Throughout Europe, Asia, and the Americas a variety of Solanum species containing potent tropane alkaloids were used, such as mandrake, henbane, Datura metel, and Datura inoxia. Classic Greek and Roman medical texts by Hippocrates, Theophrastus, Aulus Cornelius Celsus, Pedanius Dioscorides, and Pliny the Elder discussed the use of opium and Solanum species. In 13th century Italy Theodoric Borgognoni used similar mixtures along with opiates to induce unconsciousness, and treatment with the combined alkaloids proved a mainstay of anaesthesia until the nineteenth century. In the Americas coca was also an important anaesthetic used in trephining operations. Incan shamans chewed coca leaves and performed operations on the skull while spitting into the wounds they had inflicted to anaesthetize the site. Alcohol was also used, its vasodilatory properties being unknown. Ancient herbal anaesthetics have variously been called soporifics, anodynes, and narcotics, depending on whether the emphasis is on producing unconsciousness or relieving pain.

Anaesthetics were sometimes administered in the spongia somnifera, a sponge into which a large quantity of drug was allowed to dry, from which a saturated solution could be trickled into the nose of the patient. At least in more recent centuries, trade was often highly standardized, with the drying and packing of opium in standard chests, for example. In the 19th century, varying aconitum alkaloids from a variety of species were standardized by testing with guinea pigs. Despite these refinements, the discovery of morphine, a purified alkaloid that soon afterward could be injected by hypodermic for a consistent dosage, was enthusiastically received and led to the foundation of the modern pharmaceutical industry.

All anaesthetics in the UK, Australia, New Zealand and Japan are administered by physicians. Nurse anesthetists also administer anesthesia in 109 nations.

These include intensive care medicine and pain medicine. Specialists in these disciplines have usually done some training in anaesthetics. The role of the anaesthetist is changing. It is no longer limited to the operation itself. Many anaesthetists perform well as peri-operative physicians, and will involve themselves in optimizing the patient's health before surgery (colloquially called "work-up"), performing the anaesthetic,including specialized intraoperative monitoring (like http://en.wikipedia.org/wiki/Echocardiography#Transesophageal_echocardiogram transesophageal echocardiography), following up the patient in the post anesthesia care unit and post-operative wards, and ensuring optimal analgesia throughout.

They have a slower onset and longer half-life than ester anaesthetics, and are usually racemic mixtures, with the exception of levobupivacaine (which is S(-) -bupivacaine) and ropivacaine (S(-)-ropivacaine). These agents are generally used within regional and epidural or spinal techniques, due to their longer duration of action, which provides adequate analgesia for surgery, labor, and symptomatic relief.

Anesthesia practitioners must possess a comprehensive and intricate knowledge of the production and use of various medical gases , anaesthetic agents and vapours , medical breathing circuits and the variety of anaesthetic machines (including vaporizers, ventilators and pressure gauges) and their corresponding safety features, hazards and limitations of each piece of equipment, for the safe, clinical competence and practical application for day to day practice.

Source: Wikipedia > Anesthesia