A little bit about Anaesthesia! - An art of "No Pain & Loads of Gain"

Dr.Prakash Bharamagoudar

Neuroanaesthesiologist

Kolhapur

drprakashcb@yahoo.com

My article on Anaesthesia on World Anaesthesia Day! (16th October)!

In the pre - Anaesthesia era, an article in the New York Herald, 21 July 1841, of an amputation was published like this "The case was an interesting one of a white swelling, for which the thigh was to be amputated. The patient was a youth of about fifteen, pale, thin but calm and firm. One Professor felt for the femoral artery, had the leg held up for a few moments to ensure the saving of blood, the compress part of the tourniquet was placed upon the artery and the leg held up by an assistant. The white swelling was fearful, frightful. A little wine was given to the lad; he was pale but resolute; his Father supported his head and left hand. A second Professor took the long, glittering knife, felt for the bone, thrust in the knife carefully but rapidly. The boy screamed terribly; the tears went down the Father’s cheeks. The first cut from the inside was completed, and the bloody blade of the knife issued from the quivering wound, the blood flowed by the pint, the sight was sickening; the screams terrific; the operator calm’

As I read this I feel the pain not only of the patient but also the pain of physicians and surgeons of that time.

Everything changed after 5 years. The date was October 16, 1846. At the Bulfinch Building, Massachusetts General Hospital, Boston.

John Collins Warren, an eminent Boston surgeon was waiting with his anxious patient - A young painter named Gilbert Abbott. Abott had a superficial large tumor in his jaw. Along with them physicians, surgeons and dentists were eagerly waiting for William Thomas Green Morton, a dentist who had told everyone that he is going to demonstrate a miracle. Impatient, Warren told Morton who came late that your patient is ready!!

Morton quickly made Abbott inhale ether and in 5 minutes Morton replied to Warren with the same words “Sir, your patient is ready”.

Warren performed surgery and removed the tumor without the patient screaming, flailing, fainting or even crying. He was anesthetized!

Warren turned towards audience and said, “Gentlemen, it's not humbug!”

W.T.G. Morton , a dentist had successfully demonstrated anaesthesia to the world!!!

It is not surprising then that the epitaph on his tombstone reads. “Inventor and Revealer of Inhalation Anesthesia: Before Whom, in All Time, Surgery was Agony; By Whom Pain in Surgery was Averted and Annulled; Since Whom, Science has Control of Pain.”170 years later today as I give anaesthesia to a brain tumor patient , patient sleeps and wakes up as if he had a good night sleep. Without any pain , anxiety and memory. In last 170 years Anaesthesiology has developed from being a humbug to magic science. Today, as Anaesthesiologists, we look after patients right from the time of entering the hospital to recovery at home.

Today Anaesthesiologists are involved in Resuscitation in emergency rooms, giving anaesthesia in operation theatre, post surgery pain relief, intensive care unit management, chronic pain management and even in palliative care.

Anaesthesiology has classified and sub - classified itself, now, into super-specialities like cardiac, paediatric, regional, neuro anaesthesiology and many more.

Because of Anaesthesiologists today, young pregnant women can have normal vaginal deliveries without any pain. If you tell your grandmother that you have delivered a baby normally without any pain I bet she won't believe it! Because of labour epidural analgesia many young women are opting for normal delivery, otherwise who wanted to undergo Cesarian section just because they were afraid of labour pain? Because of Anaesthesiologists today, a young musician can undergo a surgery where a brain tumor residing near his creativity centre in the brain can be excised while he will be awake and playing a guitar! Because he doesn't want to lose his musical skills because of surgery and we as Anaesthesiologists can give a luxury to a surgeon to operate on awake patient, without patient feeling pain and any discomfort. If a surgeon is the Captain of a sailing ship, An Anaesthesiologist is the Captain of the sinking ship. No surgeon will deny that! Surgeons won't look at the monitor when the ship is sinking, he looks into Anaesthesiologists' eyes. Being calm and doing right things at right steps is what makes the Anaesthesiologist unique. On this day while I was penning down my thoughts my software friend called saying that his dad has to undergo laparoscopic adrenalectomy. A Surgery where a tumor in the adrenal gland (which is secreting excessive adrenaline like hormones) will be excised laparoscopically “An Expert surgeon has been called from a metro city,... The hospital has all the facilities required,.... do I need to worry about anything?" he asked!! As he said this, I simply asked him "Who is captain of the ship?" :) Dr.Prakash Bharamagoudar (Neuro Anaesthesiologist) I am proud to be an Anaesthesiologist! [Pictures and images are taken from the internet unless and otherwise specified]