In what country is anesthesia performed? Before anesthesia. What did our ancestors use for anesthesia? changes occurring in nerve cells are expressed by a cloudy swelling of the cell protoplasm with the disappearance of the nucleus, peripheral and central edema. Changes are noticeable in the nuclei

Anesthesia with the help of natural intoxicants of plant origin (mandrake, belladonna, opium, Indian hemp, some varieties of cacti, etc.) has long been used in the ancient world (Egypt, India, China, Greece, Rome, among the aborigines of America).

With the development of iatrochemistry (XIV-XVI centuries), information began to accumulate about the analgesic effect of certain chemical substances obtained as a result of experiments. However, for a long time, random observations by scientists of their soporific or analgesic effect were not associated with the possibility of using these substances in surgery. Thus, the discovery of the intoxicating effect of nitrous oxide (or “laughing gas”), which was made by the English chemist and physicist Humphry Davy (N. Davy) in 1800, as well as the first work on the soporific effect of sulfur, remained without due attention ether, published by his student Michael Faraday (M. Faraday) in 1818.

The first doctor who drew attention to the analgesic effect of nitrous oxide was the American dentist Horace Wells (Wells, Horace, 1815-1848). In 1844, he asked his colleague John Riggs to remove his tooth under the influence of this gas. The operation was successful, but its repeated official demonstration in the clinic of the famous Boston surgeon John Warren (Warren, John Collins, 1778-1856) failed, and nitrous oxide was forgotten for a while.

The era of anesthesia began with ether. The first experience with its use during operations was made by the American physician C. Long (Long, Crawford, 1815-1878), on March 30, 1842, but his work went unnoticed, since Long did not report his discovery in print, and it was repeated again.

In 1846, the American dentist William Morton (Morton, William, 1819-1868), who experienced the soporific and analgesic effects of ether vapor, suggested that J. Warren test this time the effect of ether during surgery. Warren agreed and on October 16, 1846, for the first time successfully removed a tumor in the neck area under ether anesthesia, which was given by Morton. It should be noted here that W. Morton received information about the effect of ether on the body from his teacher, the chemist and physician Charles Jackson (Jackson, Charles, 1805-1880), who should rightfully share the priority of this discovery. Russia was one of the first countries where ether anesthesia found the widest use. The first operations in Russia under ether anesthesia were performed in Riga (B.F. Behrens, January 1847) and Moscow (F.I. Inozemtsev, February 7, 1847). An experimental test of the effect of ether on animals (in Moscow) was led by physiologist A. M. Filomafitsky.

The scientific basis for the use of ether anesthesia was given by N. I. Pirogov. In experiments on animals, he conducted an extensive experimental study of the properties of ether using various methods of administration (inhalation, intravascular, rectalBom, etc.), followed by clinical testing of individual methods (including on himself). On February 14, 1847, he performed his first operation under ether anesthesia, removing a breast tumor in 2.5 minutes.

In the summer of 1847, N.I. Pirogov was the first in the world to use ether anesthesia en masse at the theater of military operations in Dagestan (during the siege of the village of Salta). The results of this grandiose experiment amazed Pirogov: for the first time, operations took place without the groans and screams of the wounded. “The possibility of broadcasting on the battlefield has been indisputably proven,” he wrote in “Report on a trip to the Caucasus.” “...The most comforting result of the broadcast was that the operations we performed in the presence of other wounded did not frighten them at all, but, on the contrary, reassured them about their own fate.”

This is how anesthesiology arose (Latin anaesthesia from Greek anaisthesia - insensitivity), the rapid development of which was associated with the introduction of new painkillers and methods of their administration. Thus, in 1847, the Scottish obstetrician and surgeon James Simpson (Simpson, James Young sir, 1811-1870) first used chloroform “as an anesthetic in obstetrics and surgery. In 1904, S.P. Fedorov and N.P. Kravkov laid the foundation for the development of methods of non-inhalation (intravenous) anesthesia.

With the discovery of anesthesia and the development of its methods, a new era in surgery began.

N. I. Pirogov - the founder of Russian military field surgery

Russia is not the birthplace of military field surgery - just remember the ambulance volante of Dominique Larrey (see p. 289), the founder of French military field surgery, and his work “Memoirs of military field surgery and military campaigns” (1812-1817 ). However, no one has done as much for the development of this science as N.I. Pirogov, the founder of military field surgery in Russia.

In the scientific and practical activities of N. I. Pirogov, many things were accomplished for the first time: from the creation of entire sciences (topographic anatomy and military field surgery), the first operation under rectal anesthesia (1847) to the first plaster cast in the field (1854) and the first idea on bone grafting (1854).

In Sevastopol, during the Crimean War of 1853-1856, when the wounded arrived at the dressing station in the hundreds, he was the first to justify and put into practice the sorting of the wounded into four groups. The first category consisted of the hopelessly sick and mortally wounded. They were entrusted to the care of nurses and a priest. The second category included the seriously wounded, requiring urgent surgery, which was performed right at the dressing station in the House of the Noble Assembly. Sometimes they operated on three tables at the same time, 80-100 each patients per day. The third troupe consisted of the moderately wounded, who could be operated on the next day. The fourth group consisted of the lightly wounded. After providing the necessary assistance, they were sent back to the unit.

Postoperative patients were first divided into two groups: clean and purulent. Patients of the second group were placed in special gangrenous departments - “memento mori” (Latin - remember “death”), as Pirogov called them.

Assessing the war as a “traumatic epidemic,” N. I. Pirogov was convinced that “it is not medicine, but the administration that plays the main role in helping the wounded and sick at the theater of war.” And he passionately fought against the “stupidity of the official medical staff”, the “insatiable predation of the hospital administration” and tried with all his might to establish a clear organization of medical care for the wounded, which under tsarism could only be done through the enthusiasm of the obsessed. These were the sisters of mercy.

The name of N.I. Pirogov is associated with the world’s first involvement of women in caring for the wounded at the theater of military operations. Especially for these purposes, in St. Petersburg in 1854, the “Establishment of the Cross-women’s community of sisters caring for wounded and sick soldiers” was founded.

N.I. Pirogov with a detachment of doctors left for Crimea" in October 1854. Following him, the first detachment "of 28 nurses was sent. In Sevastopol, N.I. Pirogov immediately divided them into three groups: dressing nurses, who helped doctors during operations and with dressings; sisters-pharmacists, who prepared, stored, distributed and distributed medicines, and sisters-housewives, who monitored the cleanliness and change of linen, maintenance of the sick and housekeeping services. Later, a fourth, special transport detachment of sisters appeared, who accompanied the wounded during long-distance transport Many sisters died from typhoid fever, some were wounded or shell-shocked, but all of them, “enduring without complaint all the labors and dangers and unselfishly sacrificing themselves to achieve the goal undertaken... served for the benefit of the wounded and sick.”

N.I. Pirogov especially highly valued Ekaterina Mikhailovna Bakunina (1812-1894) - “the ideal type of nurse,” who worked in the operating room along with surgeons and was the last to leave the hospital when evacuating the wounded, being on duty day and night.

“I am proud to have led their blessed one. activities,” wrote N. I. Pirogov in 1855.

The history of the Russian Red Cross Society, which was created in St. Petersburg in 1867 (the original name was “Russian Society for the Care of Wounded and Sick Warriors”), dates back to the sisters of mercy of the Holy Cross community. Nowadays, the Union of Red Cross and Red Crescent Societies plays an important role in the development of domestic healthcare and the activities of the International Red Cross, founded by A. Dunant (Dunant, Henry, 1828-1910) (Switzerland) in 1864 (see p. 341) .

A year after the Crimean War, N.I. Pirogov was forced to leave his service at the academy and retired from teaching surgery and anatomy (he was then 46 years old).

A. A. Herzen called the resignation of N. I. Pirogov “one of the most vile deeds of Alexander... dismissing a person of whom Russia is proud” (“Bell”, 1862, No. 188).

“I have some right to gratitude to Russia, if not now, then perhaps someday later, when my bones are rotting in the ground, there will be impartial people who, having looked at my labors, will understand that I worked not without a purpose and not without inner dignity,” Nikolai Ivanovich wrote then.

Having high hopes for improving public education, he accepted the post of trustee of the Odessa, and from 1858, the Kyiv educational district, but a few years later he was again forced to resign. In 1866, he finally settled in the village of Vishnya near the city of Vinnitsa (now the Museum-Estate of N.I. Pirogov, Fig. 147).

Nikolai Ivanovich constantly provided medical assistance to the local population and numerous people. patients who came to him in the village of Vishnya from different cities and villages of Russia. To receive visitors, he set up a small hospital, where he operated and bandaged almost every day.

To prepare medicines, a small one-story house - a pharmacy - was built on the estate. He himself was engaged in growing plants necessary for the preparation of medicines. Many medicines were dispensed free of charge: pro pauper (Latin - for the poor) was listed on the prescription.

As always, N.I. Pirogov attached great importance to hygienic measures and the dissemination of hygienic knowledge among the population. “I believe in hygiene,” he asserted. “This is where the true progress of our science lies. The future belongs to preventive medicine. This science, going hand in hand with state science, will bring undoubted benefit to humanity.” He saw a close connection between the eradication of disease and the fight against hunger, poverty and ignorance.

N.I. Pirogov lived on his estate in the village of Vishnya for almost 15 years. He worked a lot and rarely traveled (in 1870 to the theater of the Franco-Prussian War and in 1877-1878 to the Balkan Front). The result of these trips was his work “Report on a visit to military medical institutions in Germany, Lorraine, etc. Alsace in 1870" and a work on military field surgery "Military medicine and private assistance at the theater of war in Bulgaria and in the rear of the army in 1877-1878." In these works, as well as in his major work “The Beginnings of General Military Field Surgery, Taken from Observations of Military Hospital Practice and Memoirs of the Crimean War and the Caucasian Expedition” (1865-1866), N. I. Pirogov laid the foundations of organizational tactical and methodological principles of military medicine.

N. I. Pirogov’s last work was the unfinished “Diary of an Old Doctor.”

Anesthesia during surgery was first demonstrated by William Morton, a dentist at the General Hospital, Boston, on October 16, 1846. The audience where he performed the operation was later called the House of Ether, and this date was called Ether Day. In the same year, the anesthetic properties of ether were demonstrated during a meeting of the London Medical Society.

On December 21, 1846, William Squire performed the first leg amputation using ether in London, and the operation was observed by many witnesses; she was a success. The following year, Professor Simpson of Edinburgh pioneered the use of a method in which chloroform was dropped onto a mesh covered with gauze, which was placed over the face of the person being operated on. In 1853, chloroform anesthesia was given by John Shaw to Queen Victoria during the birth of Prince Leopold.

Local anesthesia had not been scientifically described until 1844; Karl Koller accepts the offer of his friend Sigmund Freud and evaluates the effect of cocaine, subsequently describing the use of cocaine in anesthesia of the conjunctival sac, this operation is practiced in ophthalmic surgery.

The beginning of the era of ties was marked by the appearance of neckerchiefs in Ancient Rome. But still, the real triumph of the tie can be considered the 17th century. After the end of the Turkish-Croatian war, Croatian soldiers were invited to →

The first newspaper, very similar to modern ones, is considered to be the French “La Gazette”, which was published since May 1631.

The predecessors of the newspaper are considered to be the ancient Roman news scrolls Acta diurna populi romani (Urgent affairs of the population of Rome) - →

2 years after the failure that befell Wells, his student dentist Morton, with the participation of the chemist Jackson, used diethyl ether for anesthesia. Soon the desired result was achieved.

In the same Boston surgical clinic where Wells' discovery was not recognized, ether anesthesia was successfully demonstrated on October 16, 1846. This date became the starting point in the history of general anesthesia.

Professor John Warren operated on the patient in a Boston surgical clinic, and medical student William Morton euthanized the patient using his own method.

When the patient was placed on the operating table, William Morton covered his face with a towel folded in several layers and began to sprinkle liquid from a bottle he had brought with him. The patient shuddered and began to mutter something, but soon calmed down and fell into a deep sleep.

John Warren began the operation. The first cut is made. The patient lies quietly. The second one was made, and then the third one. The patient is still fast asleep. The operation was quite complicated - a tumor in the patient’s neck was removed. A few minutes after it ended, the patient came to his senses.

They say it was at this moment that John Warren uttered his historic phrase: “Gentlemen, this is not a hoax!”

Subsequently, Morton himself told the story of his discovery as follows: “I purchased Barnett’s ether, took a bottle with a tube, locked myself in the room, sat down in the operating chair and began to inhale the vapors. The ether turned out to be so strong that I almost suffocated, but the desired effect was not came. Then I wet a handkerchief and brought it to my nose. I looked at my watch and soon lost consciousness. When I woke up, I felt as if I was in a fairy-tale world. All parts of my body seemed numb. I would have renounced the world if anyone had come to this minute and woke me up. The next moment I believed that, apparently, I would die in this state, and the world would greet the news of this stupidity of mine only with ironic sympathy. Finally, I felt a slight tickling in the phalanx of the third finger, after which I tried to touch it thumb, but could not. On the second attempt I succeeded in doing it, but the finger seemed completely numb. Little by little I was able to raise my hand and pinch my leg, and found that I could hardly feel it. Trying to get up from the chair, I fell back on it. Only gradually did I gain control over parts of my body, and with it full consciousness. I immediately looked at my watch and found that I had been insensible for seven or eight minutes. After that, I rushed to my office shouting: “I found it! I found it!”

Anesthesiology, especially during its development, had many opponents. For example, the clergy were especially vehemently opposed to pain relief during childbirth. According to biblical legend, expelling Eve from paradise, God commanded her to give birth to children in pain. When the obstetrician J. Simpson successfully used anesthesia to relieve labor pain for Queen Victoria of England in 1848, it caused a sensation and further intensified the attacks of the clergy. Even the famous French physiologist F. Magendie, Claude Bernard's teacher, considered anesthesia "immoral and takes away self-awareness and free will from patients and thereby subjugates the patient to the arbitrariness of doctors." In a dispute with the clergy, Simpson found a witty way out: he declared that the very idea of ​​anesthesia belonged to God. After all, according to the same biblical tradition, God put Adam to sleep in order to cut out his rib from which he created Eve. The scientist's arguments somewhat calmed the fervor of the fanatics.

The discovery of anesthesia, which turned out to be a very effective method of surgical anesthesia, aroused widespread interest among surgeons around the world. Skepticism about the possibility of painless surgical interventions quickly disappeared. Soon anesthesia received universal recognition and was appreciated.

In our country, the first operation under ether anesthesia was performed on February 7, 1847 by Moscow University professor F.I. Inozemtsev. A week after this, the method was used equally successfully by N.I. Pirogov in St. Petersburg. Then a number of other major domestic surgeons began to use anesthesia.

Much work on study and propaganda in our country was carried out by the anesthesia committees created shortly after its opening. The most representative and influential among them was the Moscow one, which was headed by Prof. A.M. Philamothite. The result of the generalization of the first experience of using ether anesthesia in the clinic and in experiment were two monographs published in 1847. The author of one of them (“Practical and physiological studies on etherization”) was N.I. Pyrrgov. The book was published in French, targeting not only domestic but also Western European readers. The second monograph (“On the use of sulfuric ether vapor in operational medicine”) was written by N.V. Maklakov.

Having perceived ether anesthesia as a great discovery in medicine, leading Russian surgeons not only did everything possible to widely use it in practice, but also sought to penetrate into the essence of this seemingly mysterious condition and to find out the possible adverse effects of ether vapor on the body.

The greatest contribution to the study of ether anesthesia at the stage of its development and later when chloroform anesthesia was introduced into practice was made by N.I. Pirogov. In this regard, V. Robinson, the author of one of the most informative books on the history of surgical anesthesia in 1945, wrote: “Many of the pioneers of pain management were mediocre. As a result of accidental circumstances, they had a hand in this discovery. Their quarrels and petty envy left an unpleasant mark on science. But there are figures of a larger scale who participated in this discovery, and among them the most important person and researcher should be considered, first of all, N.I. Pirogov."

About how purposefully and fruitfully N.I. worked. Pirogov in the area under consideration is evidenced by the fact that a year after the discovery of anesthesia, in addition to the mentioned monograph, he published: the articles “Observation of the effect of ether vapor as an analgesic in surgical operations” and “Practical and physiological observations of the effect of ether vapor on animals organism." In addition, in the “Report on a trip to the Caucasus,” also written in 1847, there is a large and interesting section “Anesthesia on the battlefield and in hospitals.

After the first use in patients with H.I. Pirogov gave the following assessment of ether anesthesia: “Ether steam is a truly great remedy, which in a certain respect can give a completely new direction to the development of all surgery.” Giving this description of the method, he was one of the first to attract the attention of surgeons to other complications that can arise during anesthesia. N.I. Pirogov undertook a special study to find a more effective and safe method of anesthesia. In particular, he tested the effect of ether vapor when introduced directly into the trachea, blood, and gastrointestinal tract. The method of rectal anesthesia with ether that he proposed received wide recognition in subsequent years, and many surgeons successfully used it in practice.

In 1847, Simpson successfully tested chloroform as a narcotic drug. The interest of surgeons in the latter quickly increased, and chloroform became the main anesthetic for many years, pushing diethyl ether to second place.

In the study of ether and chloroform anesthesia, the introduction of these drugs into widespread practice in the first decades after their development, in addition to N.I. Pirogov, many surgeons of our country made a significant contribution. A.M. was especially active in this area. Filamofitsky, F.I. Inozemtseva, A.I. Polya, T.L. Vanzetti, V.A. Karavaeva.

From foreign doctors to study, improve and promote anesthesia methods in the second half of the 19th century. D. Snow did a lot. He was the first who, after the discovery of anesthesia, devoted his entire activity to surgical anesthesia. He consistently defended the need for specialization of this type of medical care. His works contributed to the further improvement of anesthesiological support for operations.

After the discovery of the narcotic properties of diethyl ether and chloroform, an active search began for other drugs that have an analgesic effect. In 1863, the attention of surgeons was again drawn to nitrous oxide. Colton, whose experiments at one time gave Wells the idea of ​​​​using nitrous oxide for pain relief, organized an association of dentists in London who used this gas in dental practice.

Since ancient times, people have been thinking about how to relieve pain. The methods used were quite dangerous. Thus, in Ancient Greece, the root of mandrake, a poisonous plant that can cause hallucinations and severe poisoning, even death, was used as an anesthetic. It was safer to use “sleeping sponges.” Sea sponges were soaked in the juice of intoxicating plants and set on fire. Inhalation of the vapors put patients to sleep.

In Ancient Egypt, hemlock was used for pain relief. Unfortunately, after such anesthesia, few survived to the operation. The ancient Indian method of pain relief was more effective than others. Shamans always had an excellent remedy at hand - coca leaves containing cocaine. The healers chewed magic leaves and spat on the wounded warriors. Saliva soaked in cocaine brought relief from suffering, and shamans fell into a drug trance and better understood the instructions of the gods.

Chinese healers also used drugs for pain relief. Coca, however, cannot be found in the Middle Kingdom, but there were no problems with hemp. Therefore, the analgesic effect of marijuana has been experienced by more than one generation of patients of local healers.

Until your heart stops

In medieval Europe, methods of pain relief were also not particularly humane. For example, before an operation, a patient was often simply hit on the head with a mallet so that he would lose consciousness. This method required considerable skill from the “anesthesiologist” - it was necessary to calculate the blow so that the patient lost consciousness, but not life.

Bloodletting was also quite popular among doctors of that time. The patient's veins were opened and they waited until he lost enough blood to faint.

Since such anesthesia was very dangerous, it was eventually abandoned. Only the speed of the surgeon saved the patients from painful shock. For example, it is known that the great Nikolay Pirogov spent only 4 minutes amputating a leg, and removed the mammary glands in one and a half minutes.

Laughing gas

Science did not stand still, and over time, other methods of pain relief appeared, for example, nitrous oxide, which was immediately dubbed laughing gas. However, initially nitrous oxide was not used by doctors at all, but by traveling circus performers. In 1844, a magician Gardner Colton He called a volunteer onto the stage and let him inhale the magic gas. A participant in the performance laughed so hard that he fell off the stage and broke his leg. However, viewers noticed that the victim does not feel pain, as he is under anesthesia. Among those sitting in the hall was a dentist Horace Wells, who instantly appreciated the properties of the wonderful gas and bought the invention from the magician.

A year later, Wells decided to demonstrate his invention to the general public and staged a demonstration tooth extraction. Unfortunately, the patient, despite inhaling laughing gas, screamed throughout the entire operation. Those who gathered to look at the new painkiller laughed at Wells, and his reputation came to an end. Only a few years later it became clear that the patient was not screaming from pain, but because he was terribly afraid of dentists.

Among those present at Wells' disastrous performance was another dentist - William Morton, who decided to continue the work of his unlucky colleague. Morton soon discovered that medicinal ether was much safer and more effective than laughing gas. And already in 1846 Morton and the surgeon John Warren performed an operation to remove a vascular tumor using ether as an anesthetic.

And again coca

Medical ether was good for everyone, except that it only provided general anesthesia, and doctors also thought about how to obtain a local anesthetic. Then their eyes turned to the most ancient drugs - cocaine. In those days, cocaine was widely used. They were treated for depression, asthma and stomach upset. In those years, the drug was freely sold in any pharmacy along with cold remedies and ointments for back pain.

In 1879, a Russian doctor Vasily Anrep published an article on the effects of cocaine on nerve endings. Anrep conducted experiments on himself, injecting a weak solution of the drug under the skin, and found out that this leads to loss of sensitivity at the injection site.

The first person who decided to try Anrep’s calculations on patients was an ophthalmologist Karl Koller. His method of local anesthesia was appreciated - and the triumph of cocaine lasted for several decades. Only over time, doctors began to pay attention to the side effects of the miracle drug, and cocaine was banned. Koller himself was so amazed by the harmful effect that he was ashamed to mention this discovery in his autobiography.

It was only in the 20th century that scientists managed to find safer alternatives to cocaine - lidocaine, novocaine and other drugs for local and general anesthesia.

By the way

One in 200 thousand planned operations - this is the probability of dying from anesthesia today. It is comparable to the probability of a brick accidentally falling on your head.

Getting rid of pain has been the dream of mankind since time immemorial. Attempts to stop the suffering of the patient were used in the ancient world. However, the methods by which the healers of those times tried to relieve pain were, by modern standards, absolutely wild and themselves caused pain to the patient. Stunning with a blow to the head with a heavy object, tight constriction of the limbs, squeezing of the carotid artery until complete loss of consciousness, bloodletting to the point of brain anemia and deep fainting - these absolutely brutal methods were actively used in order to lose pain sensitivity in the patient.

There were, however, other ways. Even in Ancient Egypt, Greece, Rome, India and China, decoctions of poisonous herbs (belladonna, henbane) and other drugs (alcohol until unconsciousness, opium) were used as painkillers. In any case, such “gentle” painless methods brought harm to the patient’s body, in addition to a semblance of pain relief.

History stores data on amputations of limbs in the cold, which were carried out by Napoleon's army surgeon Larrey. Right on the street, at 20-29 degrees below zero, he operated on the wounded, considering freezing to be sufficient pain relief (in any case, he had no other options anyway). The transition from one wounded person to another was carried out even without first washing hands - at that time no one thought about the obligatory nature of this moment. Larrey probably used the method of Aurelio Saverino, a doctor from Naples, who back in the 16th-17th century, 15 minutes before the start of the operation, rubbed snow on those parts of the patient’s body that were then subjected to intervention.

Of course, none of the listed methods provided the surgeons of those times with absolute and long-term pain relief. The operations had to be carried out incredibly quickly - from one and a half to 3 minutes, since a person can withstand unbearable pain for no longer than 5 minutes, otherwise a painful shock would occur, from which patients most often died. One can imagine that, for example, amputation took place under such conditions by literally cutting off a limb, and what the patient experienced at the same time can hardly be described in words... Such anesthesia did not yet allow performing abdominal operations.

Further inventions of pain relief

The surgery was in dire need of anesthesia. This could give most patients who needed surgery a chance of recovery, and doctors understood this well.

In the 16th century (1540), the famous Paracelsus made the first scientifically based description of diethyl ether as an anesthetic. However, after the death of the doctor, his developments were lost and forgotten for another 200 years.

In 1799, thanks to H. Devi, a variant of pain relief using nitrous oxide (“laughing gas”) was released, which caused euphoria in the patient and gave some analgesic effect. Devi used this technique on himself during the eruption of wisdom teeth. But since he was a chemist and physicist, and not a physician, his idea did not find support among doctors.

In 1841, Long performed the first tooth extraction using ether anesthesia, but did not immediately inform anyone about it. Subsequently, the main reason for his silence was the unsuccessful experience of H. Wells.

In 1845, Dr. Horace Wells, who had adopted Devi's method of pain relief using laughing gas, decided to conduct a public experiment: extracting a patient's tooth using nitrous oxide. The doctors gathered in the hall were very skeptical, which is understandable: at that time no one completely believed in the absolute painlessness of operations. One of those who came for the experiment decided to become a “test subject,” but due to his cowardice, he began screaming even before the anesthesia was administered. When anesthesia was finally carried out, and the patient seemed to pass out, “laughing gas” spread throughout the room, and the experimental patient woke up from a sharp pain at the moment of tooth extraction. The audience laughed under the influence of the gas, the patient screamed in pain... The overall picture of what was happening was depressing. The experiment was a failure. The doctors present booed Wells, after which he gradually began to lose patients who did not trust the “charlatan” and, unable to bear the shame, committed suicide by inhaling chloroform and opening his femoral vein. But few people know that Wells’s student, Thomas Morton, who was later recognized as the discoverer of ether anesthesia, quietly and imperceptibly left the failed experiment.

T. Morton's contribution to the development of pain management

At that time, Thomas Morton, a prosthodontist, was experiencing difficulties regarding the lack of patients. People, for obvious reasons, were afraid to treat their teeth, much less remove them, preferring to endure rather than undergo a painful dental procedure.

Morton perfected the development of diethyl alcohol as a powerful pain reliever through multiple experiments on animals and his fellow dentists. Using this method, he removed their teeth. When he built an anesthesia machine that was most primitive by modern standards, the decision to conduct public anesthesia became final. Morton invited an experienced surgeon to assist him, assigning himself the role of an anesthesiologist.

On October 16, 1846, Thomas Morton successfully performed a public operation to remove a tumor on the jaw and a tooth under anesthesia. The experiment took place in complete silence, the patient slept peacefully and did not feel anything.

The news of this instantly spread throughout the world, diethyl ether was patented, as a result of which it is officially considered that Thomas Morton was the discoverer of anesthesia.

Less than six months later, in March 1847, the first operations under anesthesia were already performed in Russia.

N. I. Pirogov, his contribution to the development of anesthesiology

The contribution of the great Russian doctor and surgeon to medicine is difficult to describe, it is so great. He also made a significant contribution to the development of anesthesiology.

He combined his developments on general anesthesia in 1847 with data previously obtained as a result of experiments conducted by other doctors. Pirogov described not only the positive aspects of anesthesia, but was also the first to point out its disadvantages: the likelihood of severe complications, the need for precise knowledge in the field of anesthesiology.

It was in the works of Pirogov that the first data appeared on intravenous, rectal, endotracheal and spinal anesthesia, which is also used in modern anesthesiology.

By the way, the first surgeon in Russia to perform an operation under anesthesia was F.I. Inozemtsev, and not Pirogov, as is commonly believed. This happened in Riga on February 7, 1847. The operation using ether anesthesia was successful. But between Pirogov and Inozemtsev there were complex, strained relations, somewhat reminiscent of the rivalry between two specialists. Pirogov, after a successful operation performed by Inozemtsev, very quickly began to operate, using the same method of administering anesthesia. As a result, the number of operations he performed noticeably overlapped those performed by Inozemtsev, and thus Pirogov took the lead in numbers. On this basis, many sources name Pirogov as the first doctor to use anesthesia in Russia.

Development of anesthesiology

With the invention of anesthesia, a need arose for specialists in this field. During the operation, a doctor was needed who was responsible for the dose of anesthesia and monitoring the patient’s condition. The Englishman John Snow, who began his work in this field in 1847, is officially recognized as the first anesthesiologist.

Over time, communities of anesthesiologists began to appear (the first in 1893). Science has developed rapidly, and purified oxygen has already begun to be used in anesthesiology.

1904 - intravenous anesthesia with hedonal was performed for the first time, which became the first step in the development of non-inhalation anesthesia. It became possible to perform complex abdominal operations.

The development of drugs did not stand still: many drugs for pain relief were created, many of which are still being improved.

In the second half of the 19th century, Claude Bernard and Greene discovered that anesthesia could be improved and intensified by pre-administering morphine to calm the patient and atropine to reduce salivation and prevent heart failure. A little later, antiallergic drugs were used in anesthesia before the operation. This is how premedication began to develop as a medicinal preparation for general anesthesia.

One drug (ether) constantly used for anesthesia no longer satisfied the needs of surgeons, so S.P. Fedorov and N.P. Kravkov proposed a mixed (combined) anesthesia. The use of hedonal turned off the patient's consciousness, chloroform quickly eliminated the phase of the patient's excited state.

Now in anesthesiology, too, a single drug cannot independently make anesthesia safe for the patient’s life. Therefore, modern anesthesia is multicomponent, where each drug performs its own necessary function.

Oddly enough, local anesthesia began to develop much later than the discovery of general anesthesia. In 1880, the idea of ​​local anesthesia was expressed (V.K. Anrep), and in 1881 the first eye surgery was performed: ophthalmologist Keller came up with the idea of ​​performing local anesthesia using the injection of cocaine.

The development of local anesthesia began to gain momentum quite quickly:

• 1889: infiltration anesthesia;
• 1892: conduction anesthesia (invented by A.I. Lukashevich together with M. Oberst);
• 1897: spinal anesthesia.

Of great importance was the still popular method of tight infiltration, the so-called case anesthesia, which was invented by A. I. Vishnevsky. Then this method was often used in military conditions and in emergency situations.

The development of anesthesiology in general does not stand still: new drugs are constantly being developed (for example, fentanyl, anexate, naloxone, etc.), ensuring safety for the patient and a minimum of side effects.