Anesthetics Essay

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Anesthesia is a partial or complete loss of sensation or feeling induced by the

administration of various substances. For many decade, people have used one form

of an anesthetic during surgical procedures. Some people also use some of these

anesthetics as recreational drugs, e.g. laughing gas (a.k.a. Nitrous Oxide). The

term anesthetic literally means "without feeling". There are many

different types of anesthesia, but they are usually put into three groups. These

groups are gene- ral anesthetics, local anesthetics, and spinal anesthetics. A

general anesthetic causes a complete loss of consciousness. They are used when

having a serious operation or in the case of an emergency operation. It works to

the surgeon's advantage because the anesthesia reacts with the body in a matter

of seconds. There are two different ways in which general anesthetics are

administered, they are intravenous and inhalation. The most popular procedure is

intravenous. This is where the anesthetic is put into the body by way of a

needle in the vein, which is usually located in the hand or elbow. Although

intravenous is more popular, it is usually used by itself during short

procedures. In the case of longer procedures, intravenous anesthesia is also

accompanied by inhalation anesthesia. Inhalation anesthesia is administered by

way of a mask and in the form of gas. Usually during long procedures, the mask

will remain on while the fluids from the intravenous anesthesia work through

your body. The second group of anesthesia is local anesthesia. Local anesthesia

is used when a doctor wants to numb a certain part of the body while you

maintain total consciousness. Local anesthetics are usually administered through

a gel or cream on the surface of the skin, but can also be injected underneath

the skin, e.g. lidocane. If the anesthetic is placed on the surface of the skin

than the numbing effect should take place within a few seconds. If injected

underneath the skin, it can take up to a few minutes to take effect. Both forms

of local anesthesia are used when dealing with minor surgery such as dentistry,

etc. The third and last group of anesthetics is the topical group. This group is

associated with childbirth, gynecological procedures, and spinal operations. A

spinal injection gives relief to pain, but at the same time allows for total

consciousness. Usually the syringe is injected into the epidural layer of the

spine. The effects of the spinal injection can be felt within minutes of the

injection. As I have already discussed, there are three different methods of

distribution among anesthetics, inhalant, intravenous, and infusion. An inhalant

is an anesthetic in the form of a gas which is administered by way of a gas

mask. Intravenous anesthesia is administered by way of a needle into the vein.

Infusion anesthetics are administered by way of a catheter. These three methods

operate in four steps. The first of these steps is premedication or induction

stage. This step involves the nurse or practitioner to administer a form of a

sedative or muscle relaxant. This step is not always required, only when having

major surgery. The second stage is when the actual anesthesia is administered.

The patient falls into a deep, pleasant state of unconsciousness. The third

stage is when the drug is in full effect. The patient now experiences a loss of

consciousness, although the patients reflexes still remain active and breathing

is a little irregular. In the last stage, the fourth stage, the patient is

totally unconscious. Muscels are fully relaxed and breathing becomes regular and

quiet. Anesthesia has a long history which started in the middle 1700's. In

1769, an English chemist, Joseph Priestley discovered the first recognized

anesthetic, nitrous oxide. Nitrous oxide is more commonly known as laughing gas.

Although the gas was discovered in 1769, it wasn't until 1844 when an American

dentist by the name of Horace Wells, first put the nitrous oxide to use during a

dentistry procedure. The wonderful world of anesthesia was growing and becoming

more and more popular throughout the United States as well as in England. The

next important discovery took place in 1829. In 1829, an American, Micheal

Faraday reported that the inhalation of ether caused a person to go into a state

of unconsciousness. Using ether as an anesthetic was not very popular, though.

It was first used in 1842 when, an American doctor, Crawford W. Long removed a

tumor off of the neck of one of his patients. The second recorded use of ether

was by the American dentist, Thomas Green Morton in 1846. Morton along with the

help of Charles Thomas Jackson, an American chemist, devel- oped a technique for

painless tooth extraction with the assistance of diethyl ether. In 1831, an

American physician and chemist, Samuel Guthrie was the first to discover

chloroform and its uses. The first to use chloroform during a surgical procedure

was Sir James Y. Simpson. Simpson was a Scottish obstetrician whom was not

satisfied with the action and reaction of ether. Simpson was the first to adopt

chloroform as a useful anesthetic in surgical procedures. In 1884, Sigmund Freud

was the first to report cocaine's anesthetic properties. An Austrailian

physician, Karl Koller, took this report of cocaine as an anesthetic and applied

it to surgical procedures. Koller's surgical procedure was even more important

because it was the first procedure to take place while using what we now call

"local anesthesia". Cocaine was the first local anesthesia to be

discovered and used in a surgical procedure. William Stewart Halsted, a profesor

of surgery at John Hopkins University in Baltimore, was the first to use cocaine

to anesthetize whole areas of the body by directly injecting the cocaine into

the nerve. In 1898, Karl Gustav Bier injected cocaine into vertebral canal and

obtained paralysis of the lower extremities of the body. He used this method in

surgical procedures. Since then this procedure that he discovered is know as

spinal anesthesia and is widely used today. At around 1901, J.L. Corning used

cocaine to produce a useful spinal anesthetic, which in turn produced two

important cocaine derivatives, novocaine and procaine. Many other important

analgesics and their uses came about between 1800 to 1900. Ethyl chloride which

was introduced to us in 1848, was too short lived. Surgeons needed an anesth-

etic that was non-toxic and non-inflammable. So in 1929, cyclopropane was

introduced to the medical world, but soon enough the medical world found out

that the drug was inflammable. In 1934, trichloreth- ylene was first used. This

drug on the other hand came along with two advantages. It reduced the awareness

of pain while maintaining full consciousness, which made the drug ideal for

childbirth use. In 1874, Ore of Bordeaux, was the first to achieve an

intravenous anesthesia. He used Chloral to achieve this intravenous anesthesia.

In 1902, Emil Fischer performed a synthesis of Veronal. The synthesis caused the

use of intravenous anesthesia to be widely excepted and performed. After Veronal

many other analgesics were produced and discovered. After 1945, two specific

drugs came into use with anesthesia. These two drugs are curare and

succinylcholine. Both of these drugs are used in anesthetics as a muscle relaxer.

Curare prevents the nervous impulses fromreaching the muscels. Thus blocking the

it at the neuromuscular junction where the nerve transmitter substance,

acetylcholine, is stored. The curare that is used in anesthesia is refered to as

tubocurarine. Succinylcholine is used to neutralize the action of acetylcholine

in the neuromuscular junction. These anesthetics and their derivatives are still

used today. Another form of anesthetic used on the body is hypothermia. This is

where the body temperature is lowered by about ten degrees. Hypothermia is

achieved by cooling the patient with ice, wet sheets, and fans. Although this

helps in cooling the body it does not stop the body's natural responses to the

cold. These responses are centered around the part of the brain called the

hypothalamus. Some of these responses are shivering, etc. The body has these

responses because it is trying to keep the body's heart, temperature, and blood

pumping at a constant rate. In order to stop these responses doctors use a drug

called chlorpromazine or they use promethazine, which also has a tranquilizing

effect. This whole process is used because it lowers the amount of oxygen

consumed by the tissues in the body. This also causes vital organs in the body

to consume a lower amount of oxygen. The less oxygen the smaller amount of blood

that is rushed to the brain and other vital organs within the body during

surgery. In turn the brain and other vital organs will still function just at a

slower pace. This is...

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Daytona . January 1990 Vol. 47, Iss. 1, Pg.17. Best Medicine: Under and Out.
Saline, Carol. Philadelphia Magazine. Philadelphia. November 1988 Vol. 79, Iss.
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Jang-Shin. Science. Washington. May 4, 1990. Vol. 248, Iss. 4955, Pg. 583-586.
Tropospheric Lifetimes of Halogenated Anesthetics. Brown, A.C. Nature. London.
October 19, 1989 Vol. 341, Iss.6243, Pg. 635-638. Anesthesiology-First of two
parts. Wiklund, A. Richard. The New England Journal of Medicine. Boston October
16,1997. Vol. 337, Iss. 16, Pg. 1132-1142. An Anesthesia Mask Gas-Scavenging
System. Schapera, Anthony. Journal of Occupational Medicine. Baltimore. November
1993. Vol.35, Iss.11, Pg. 1138. Ludovici, L.J. The Discovery of Anesthesia. New
York. Cone of Oblivion. 1961. United States Pharmacopeia. Complete Drug
Reference. Yonkers, New York. United States Pharmacopeial Convention Inc. 1992.
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