60 Fun Facts About Anesthesia

What are the three broad categories of anesthesia?

General anesthesia produces unconsciousness; sedation dampens anxiety and memory; regional and local block nerves in one part of the body.

What are the three basic goals or endpoints of anesthesia?

In a pharmacological context hypnosis means a temporary loss of consciousness and memory.

Roughly what proportion of patients experience anesthesia awareness under general anesthesia?

An estimated 22% of people dream under general anesthesia.

What percentage of people are estimated to dream while under general anesthesia?

It is not known whether animals dream under anesthesia.

The potency of an inhaled anesthetic correlates with its solubility in what?

The drugs bind directly to cavities in proteins of the central nervous system.

Which decade saw physicians begin combining inhaled anesthetics with intravenous ones?

Combinations gave a better risk profile and quicker recovery, and lower odds of dying in the first seven days.

Which US body sets minimum monitoring standards such as ECG during anesthesia?

In the UK the Association of Anaesthetists sets the equivalent guidelines.

What is sedation with benzodiazepines commonly nicknamed?

Benzodiazepines are usually given with painkillers because they do not relieve pain themselves.

Where is a spinal anesthetic injected?

Epidural anesthesia is injected outside the subarachnoid space and typically does not affect muscle control.

Why does a spinal or epidural block commonly cause a drop in blood pressure?

The venous side of the circulation holds 75% of circulating blood volume, so the effect is large.

An ASA physical status score of 3, 4 or 5 raises the risk of death how much compared with a score of 1 or 2?

Being aged 60 to 79 raises risk 2.3 times compared with under-60s.

What is the immediate period after anesthesia, when the patient wakes, called?

Nausea and vomiting occur in about 9.8% of cases at this stage.

What is the main cause of postoperative cognitive dysfunction after cardiac surgery?

Long-term POCD can last weeks or months and often shows as loss of interest in crosswords and hobbies.

Which ancient people are said to have cultivated the opium poppy as early as 3400 BCE?

Alcohol is one of the oldest known sedatives, used in ancient Mesopotamia.

Which Chinese physician is considered the first verifiable historical figure to develop an anaesthetic?

His recipe has never been fully rediscovered.

What did Inca shamans chew and spit into skull wounds to numb them?

Cocaine, isolated later, became the first effective local anesthetic.

What was the medieval soporific sponge soaked in?

Dried and stored, it was moistened before surgery and held under the patient's nose.

Which 16th-century physician noted that chickens breathing ether fell asleep and felt no pain?

Ether may have been synthesised as early as the 8th century, but was long used only recreationally.

Who discovered nitrous oxide in 1772?

People initially thought the gas was lethal even in small doses.

Which chemist experimented on himself with Priestley's gas and nicknamed it in 1799?

In 1800 he wrote about its potential to relieve surgical pain, but nobody followed up.

Who performed the first successful surgery under general anesthesia, in Japan on 14 November 1804?

His herbal formula tsusensan combined Korean morning glory with other herbs, but Japan's isolation kept it unknown abroad.

What operation did the Japanese anesthesia pioneer perform over 150 times before dying in 1835?

Sawako Ariyoshi's novel The Doctor's Wife dramatises his life.

Which Georgia doctor removed a tumor under ether on 30 March 1842 but did not publish until 1849?

His patient James Venable had attended one of the era's ether frolics; US Doctors' Day is 30 March in his honour.

Which dentist's 1845 demonstration at Massachusetts General Hospital failed when the patient cried out?

He had first seen laughing gas at a Grand Exhibition by Gardner Quincy Colton in Hartford in December 1844.

Who gave the first successful public demonstration of ether anesthesia on 16 October 1846?

He was a Boston dentist unaware of Long's earlier work.

What did surgeon John Collins Warren reportedly say after the first ether operation?

He had removed a tumor from the neck of printer Edward Gilbert Abbott.

What name did Morton use to disguise his anesthetic when he patented it?

News of the successful anesthetic spread quickly anyway by late 1846.

What is the Massachusetts General Hospital operating theatre where the 1846 demonstration took place called?

It is in the hospital's Bulfinch Building in Boston.

Who proposed the words anesthesia and anesthetic in an 1846 letter?

He suggested anesthesia for the state and anesthetic for the agent.

Which Scottish obstetrician first demonstrated the anesthetic properties of chloroform on humans in 1847?

By 1895 Britain was using 750,000 doses a week.

Which monarch received chloroform from John Snow in childbirth in 1853?

She was in labour with Prince Leopold.

Besides pioneering anesthesia, John Snow is famous for tracing an 1854 cholera outbreak to what?

He worked with local curate Henry Whitehead to identify the source.

Who first discovered chloroform in 1831, months before Soubeiran and Liebig?

Dumas named and characterised it in 1834; Glover discovered its anesthetic qualities in 1842.

Which nurse anesthetist to the Mayo brothers is often called the Mother of Anesthesia?

She reviewed more than 14,000 surgical anesthetics without a single death attributable to anesthesia.

Which was the first effective local anesthetic?

It was later replaced by drugs with less abuse potential.

Which famous psychoanalyst was part of the Vienna School credited with local anesthesia?

Carl Koller and Leopold Konigstein were the others credited.

Under what name was lidocaine first synthesised by Nils Lofgren's team in 1943?

It was the first amino amide-type local anesthetic; earlier ones were amino esters.

Which Amazonian arrow poison was first given as a standardised muscle relaxant during a 1942 appendectomy?

Harold Griffith and Enid Johnson administered it in Montreal.

Which milky-white IV anesthetic, first sold as Diprivan, is an emulsion of soybean oil and lecithin?

Recovery from it is quick and rarely brings drowsiness or nausea.

Which musician's 2009 death from an anesthetic plus benzodiazepines drew attention to the drug's off-label use?

The coroner found lorazepam, midazolam and diazepam alongside the milky-white intravenous anesthetic.

Which anesthetic induces a dissociative trance while preserving breathing and airway reflexes?

It is used especially in trauma, emergency and paediatric cases and, at low doses, for depression.

Which receptor does the dissociative anesthetic block, an action linked to its antidepressant effect?

Its two enantiomers, esketamine and arketamine, both show antidepressant action.

Which inhaled anesthetic, sold as Fluothane, has largely been replaced by sevoflurane?

Its side effects include irregular heartbeat and liver toxicity.

Which drug is the specific treatment for malignant hyperthermia, a rare reaction to volatile anesthetics?

Rapid cooling and supportive measures accompany it.

Which famous 19th-century anesthetic remained in wide clinical use into the 21st century?

Ether and chloroform gave way to safer agents and cocaine to better local anesthetics; nitrous oxide is still used.

Who authored the first comprehensive medical textbook titled Anesthesia in 1914?

It stayed the standard reference for decades and covered inhalation, rectal, intravenous and spinal techniques.

Who first described intravenous regional anesthesia in 1908?

The technique is still known as a Bier block.

What did the FDA warn in December 2016 about repeated or lengthy anesthesia in children under three?

The American College of Obstetricians and Gynecologists criticised the warning as lacking direct evidence.

In how many nations do nurse anesthetists administer anesthesia?

In the UK, Australia, New Zealand, Hong Kong and Japan all anesthetics are given by doctors.

What is the term for anesthetising an isolated body part, such as a whole limb, via its nerves?

Neuraxial blockade, by contrast, works at the level of the central nervous system itself.

How long after ether's introduction was the first death directly related to anesthesia reported?

Before anesthesia, speed was everything, leading to reports of very quick amputations.

Which company's chemists Volwiler and Tabern synthesised sodium thiopental, the first IV anesthetic, in 1934?

Ralph Waters first used it in humans on 8 March 1934, finding short-term anesthesia but surprisingly little pain relief.

Who introduced the cuffed endotracheal tube in 1928, allowing anesthetists to control breathing?

The cuff let anesthesia go deep enough to stop spontaneous breathing while gas and oxygen were delivered by positive pressure.

Which curved laryngoscope design of 1943 is still the most widely used for oral intubation?

Sir Robert Macintosh also inspired the Eschmann introducer after describing a gum elastic urinary catheter used to guide a difficult intubation.

Which Belgian pharmacologist's team synthesised fentanyl in 1960?

Janssen is credited with more than 80 compounds, including haloperidol, etomidate and the later opioids sufentanil and carfentanil.

Halothane, introduced in 1956, had what major safety advantage over ether and cyclopropane?

Rare cardiac arrhythmias and liver toxicity later saw it superseded by halogenated ethers, though it remains common in the developing world.

Where did Henry K. Beecher lead the first dedicated anesthesia department, from 1936?

Beecher had trained as a surgeon and had no previous experience in anesthesia when he took charge.

A 1952 polio outbreak in which country led to critical care medicine emerging out of anesthesia?

Mechanical ventilation became commonplace during the polio epidemics, and by the 1960s the ventilator was standard operating room equipment.

Which non-greenhouse noble gas won approval as an anesthetic in Europe in the 2000s?

Xenon was approved in Germany in 2005 and more widely in Europe in 2007. The 21st century also brought video laryngoscopes such as the Glidescope, which use digital sensors to view the glottis.

Under what trade name did Bayer market barbital, the first commercial barbiturate, from 1903?

Discovered by Emil Fischer and Joseph von Mering in 1902, it was sold as an insomnia treatment until the mid-1950s.