What is Anaesthesia ?
Surgery without adequate pain control may seem cruel to the modern reader, yet this was the common practice throughout most of history. While anesthesia is considered a relatively new field, surgery predates recorded human history. Human skull trephinations occurred as early as 10,000 BC, with archaeologic evidence of post-procedure bone infection and healing, proving these primitive surgeries were performed on living humans. Juice from coca leaves may have been dribbled onto the scalp wound but the recipient of these procedures was almost certainly awake while a hole was bored into his or her skull with a sharp flake of volcanic glass. This was a unique situation in anesthesia; there are no other instances in which both the operator and his patient share the effects of the same drug.
In contemporary practice, we are prone to forget the realities of pre-anesthesia surgery. Fanny Burney, a well-known literary artist from the early nineteenth century, described a mastectomy she endured after receiving a “wine cordial” as her sole anesthetic. As seven male assistants held her down, the surgery commenced: “When the dreadful steel was plunged into the breast-cutting through veins-arteries-flesh-nerves-I needed no injunction not to restrain my cries. I began a scream that lasted unintermittently during the whole time of the incision—& I almost marvel that it rings not in my Ears still! So excruciating was the agony. Oh Heaven!—I then felt the knife racking against the breast bone-scraping it! This performed while I yet remained in utterly speechless torture.”1 Burney’s description reminds us that it is difficult to overstate the impact of anesthesia on the human condition.
Anaesthesia is a word derived from the Greek, meaning ‘without sensation’. ‘An’-means absence and asthesia or esthesia means Anaesthesia may be applied to the whole body, when it is known as general anaesthesia, or to part of the body, when it is known as regional or local anaesthesia. All of these techniques involve giving specific drugs that interfere with the transmission of nervous impulses so as to reduce sensation.
‘Anaesthetic’ is the term applied to some or all of the drugs used to produce anaesthesia and is also used to describe the whole process. For example, one might say, ‘Peter had a general anaesthetic.’
Anesthesia is used in a wide range of procedures, from highly invasive surgeries, such as open heart surgery, to more minor procedures, such as having a tooth extracted.
Anesthesiologists: Physicians Who Provide Anesthesia
Anesthesia is given by a wide range of medical practitioners for many different reasons. The training and experience level of anesthesia providers varies greatly, ranging from a four-year residency in anesthesia to training classes added to a dental school program.
An anesthesiologist is a physician who, after completing four years of medical school, completed a four-year residency in anesthesia to earn the credential MDA. In addition to residency, board-certified anesthesiologists have passed a grueling 3-part written test and a 2-part oral examination on the practice of anesthesiology. Anesthesiologists may elect to supervise the work of other types of anesthesia providers, including nurse anesthetists (CRNA) and anesthesiologist assistances (AA). Anesthesiologists primarily function in the operating room and post-anesthesia care unit, but some elect to practice in the area of chronic pain management.
