THE EVOLUTION OF ANAESTHESIA : BIRTH TO REBIRTH

ITS JUST ABOUT “GOING TO SLEEP”,  AM I RIGHT?

A general FAQ by random acquaintance, projecting dearth of adequate information and markedly lower level of understanding, sent a cringe on my face, being an avid admirer of the branch, “ANAESTHESIOLOGY”, a recognized speciality of field of Medicine.

The speciality which has witnessed ebb and flow of diversities and variations since its advent, in every nook and cranny, was seemingly destined to flourish from a barely diminutive existence to the staggering galactic stature. An ancient era of scientific revolution was strategically characterized by remarkable inventions and evolution in the field of Medicine. The advent of Surgery demanded need of Anaesthesia with an intention of enduring immense physical pain, perhaps one less thing to worry about, allowing surgical handiwork and ability to focus properly without the ‘distracting screams’. The mesmerizing golden past has been a testimony to the strife, discord and struggle of the field of Anaesthesia; from  primitive “ Thump over the head with hammer” to the sophisticated gadgets to knock down the patient; from raw “Jadi-Buti” extracts to the modernised drugs; from sniffers to recent inhalational agents;  from “Open drop” to techno-sound workstations ; many more instances to quote.

On 16th October, 1846, when first successful public demonstration of Ether Anaesthesia was accomplished, the milestone event was looked upon as freedom from agony, pain and misery. It opened gates to Pandora box which paved the path towards advancements not only in technique but also in technology and methodology.  The questions unanswered so far, are that; Was it, the actual birth of Anaesthesia? When was the Anaesthesia given for the first time on this planet?  Was Anaesthesia, a nonexistent entity before?   Let’s take the help of mythology and tickle the minds a bit, to find out the answers . So, When was the first surgery done?  Lord Shiva ordered head transplant of Lord Ganesha and the divine procedure was done uneventfully. Off-course, an unlabeled, undescribed and unclear method of anaesthesia must have been administered. Coming to stone age, the pictorial evidences of horrific forms of knocking down the patient during some surgical procedures are available. For instance, a procedure of right leg trauma was accomplished by striking on left leg with a heavy bamboo stick so as to divulge the victim from pain of surgical site. The anaesthesia techniques are too complex to be described in such a crude way. The speciality is neither too raw , nor a naïve invention, rather an eternal science,  though an unpolished, rough-hewn culture hustling through anonymity, since medieval times.   It is not merely about abolishing the screams, for sure. The intrigued mechanisms of algesia, conscience and bio-equilibrium are amicably required to formulate the techniques and methods. The tremendous research, scientific progress and prolific up-gradation has led the subject to giant escalation. In last one and half century, the subject achieved utmost refinement and phenomenally processed from rudimentary element to the astronomically gigantic prominence.

The present anaesthesiologist is a thorough clinician with wide spectrum of expertise, command and proficiency. The modern anaesthesiologist is physician par excellence, rendering services, not only in surgical areas , but also, out of confines  beyond four walls of operation theater viz. Casualty, trauma center, emergency medicine, critical care, pain medicine, radiology suites, off-site locations , rehabilitation, hospice and palliative care, disaster management , etc., with comprehensive Covid care , a recently added arena. With the gloom of pandemic, the anaesthesiologists have emerged as dynamic intensivists, critical care physicians , disaster team leaders, administrators, policy makers and controllers. The bio-technological development and creative medical engineering plays an immense role in building up sophisticated inventory and providing logistic support in comprehensive health care. In present era, the state of art gadgets and equipments are mainstay in health system. The progressive journey from natural resources to modern artificial intelligence is inclusive of growth and transcendence. If I label this as Rebirth of the field, it would be reasonably acceptable.    

The life of anaesthesiologist bristles with challenging waxes and wanes customarily. The combating obstacles are endless. In today’s era,  the anaesthesiologists are, not only, expected to serve the society judiciously but also should strive towards creating awareness about the branch with a goal directed approach intending to clear myths and facts, and to eradicate associated prejudices. The existence of our branch stumbles upon past experiences and advances towards “ SAFETY, QUALITY AND ACCLIVITY”

“I believe that more you know about the past, better you are prepared for the future”

Theodore Roosevelt

The future, though uncertain, shall be bright and illuminating with continued research, amendments and expedition. The evidences of Nuclear Physics, Robotic science, Nano- technology and Molecular biology are emergent in Medical science. The day is not far when such revolutionary technology shall be adopted in routine anaesthesia practice. The evolutionary journey of anaesthesia branch from ‘BIRTH TO REBIRTH’ has been characteristically strategic, conquering breakthrough landmarks.

“The deeds in the present will redeem the past and thereby, change the future”

Paulo Coelho

The future aims and objectives towards achieving targets are a staunch task to attain. The ultimate goal is “The Ideal scenario”; in which none shall question the dignity, prowess and integrity of the field of Anasesthesia ; the branch shall blossom to  the pinnacle of  advancement ; and the universe shall be at the summit of awareness about the science.

“The past is your lesson, the present is your gift, the future is your motivation”

Dr. Umesh Ramtani,
Past secretary, ISA-NCB