Early Developments in Anesthesia and Pain Management with Special Reference to Children

Abstract

It is useful when inaugurating a new journal on Anesthesia Research and Pain management to know something about the beginnings and development of the field. Earlier doctors giving anesthetics had many problems to overcome. They had to try new drugs and develop new techniques and how best to perform them. Some of these have passed into oblivion but others are now taken for granted without the thought that someone had to work them out. It is hoped that this paper will provide some interesting insights about what has gone before. Ether and chloroform dominated the first 100 years of anesthesia, along with nitrous oxide, the analgesic properties of which Humphrey Davy suggested as early as 1799 "might be useful to relieve pain in operations where there was no great effusion of blood". The analgesic properties of these drugs were recognized during their use as party drugs when they were inhaled. From the beginning, there were a few individuals like John Snow and Joseph Clover who recorded their experience and developed appropriate equipment for their administration. John Snow's ether inhaler was remarkable because he had baffles which extended the time the ether was exposed to the air flowing over it to enhance vaporization and it had a water bath to reduce heat loss which is associated with ether vaporization. At first, the liquid drugs were administered drop by drop on to a handkerchief or cloth held over the patient's face. Then metal framed masks, such as Schimmelbusch's, were constructed to hold gauze on