Before Anesthesia: A Historical Overview of Surgery and Pain Management

The idea of anesthesia, a medical practice that enables a patient to undergo surgery while unconscious, has long been a subject of fascination and wonder. The prospect of performing surgical procedures without the pain and stress that patients had to endure in the past was a major breakthrough in medical science. However, before the widespread use of anesthesia, patients had to bear the excruciating pain and fear associated with surgery. Surgeons were required to perform operations quickly and efficiently, and there was a real need for anesthesia advancements that could induce unconsciousness and enable more meticulous surgeries.

The first documented medical use of an anesthetic dates back to around 200 CE, when Chinese physician Hua Tuo described a concoction made from a powder mixed with alcohol to anesthetize patients. In the 13th century, Arab surgeon Ibn al-Quff also described patients inhaling drug-soaked sponges, which likely contained substances such as cannabis, opium, and mandrake, to alleviate pain during surgery. Despite these early innovations, the use of anesthetics did not become widespread until much later.

During the late 1700s, many scientists began studying chemistry with medical applications in mind, which led to a profusion of anesthetic advancements involving three main players: nitrous oxide (laughing gas), ether, and chloroform. English chemist Humphry Davy began experimenting with nitrous oxide in 1799, but it would not be until decades later that its pain-relieving abilities were recognized as useful for surgical operations. By the early 1800s, ether came to be used medically, but was initially formulated centuries before for recreational purposes.

In 1842, ether was used successfully to remove a neck tumor, and dentists began using ether for tooth extractions. In October 1846, the first public surgery using ether was performed in the United States, and by the late 19th century, more people were able to access anesthetics for increasingly complex operations. Chloroform was also popular in the mid-19th century, but concerns about its toxicity and side effects led to its decline in use.

The discovery of anesthetics was not without controversy. Many doctors held sexist and racist beliefs that dictated the amount of anesthesia they would provide, if any at all. American obstetrician Charles Meigs argued that the pain of childbirth was a form of divine suffering and should not be interfered with. In addition, experimental gynecological surgeries without pain relief were conducted upon enslaved Black women by American physician James Marion Sims during the 1840s.

Despite advances in anesthesiology, the overuse or reliance on it can be hazardous to patient safety as well. In a number of situations, patients have been over dosed or provided with inappropriate amounts of opioids. As a result, they have become addicted to them while trying to relieve their pain post treatment. Though anesthetics have significantly improved the safety of patients and permitted more complex surgeries, they are not without risks and must be monitored closely to ensure patient safety.

Today, anesthesia is widely available and has greatly improved the safety and success rates of surgical procedures. Modern formulations of anesthetic drugs are safer and produce fewer side effects. The continued development of anesthesia technology and practice remains an important goal of medical research. With the availability of anesthesia, surgery today is a far cry from the painful experiences of the past. Not only has the relief of pain during surgical procedures made surgery more bearable, but it has also led to improved health outcomes and a greater quality of life for individuals worldwide.

Based on: What did people do before anesthesia? - Sally Frampton