Definition
Anaesthesia originates from the Greek “without sensation.” Most definitions include the loss of sensations in a part of or the whole body. Next week we will learn about different types of anaesthesia such as local, regional & general anaesthesia. These types of anaesthesia lead from the definitions i.e. local anaesthesia is the loss of sensation in a very small area of the body such as a finger; regional anaesthesia is the loss of sensation is a larger area of the body such as an entire arm or leg & can even extend out to half of the body (spinal or epidural); general anaesthesia is the loss of sensation to the entire body & this what we mostly recognise as anaesthesia for surgery.
A short history
We are very lucky to have been born in a time where anaesthesia for surgical procedures is a no questions asked situation. You may have heard of harrowing accounts from the time before anaesthesia – individuals feeling every agonising moment of their procedure. For us, undergoing a mastectomy or brain surgery without anaesthesia would be unheard of – madness even!
Inhaled ether was the first anaesthetic agent available & was discovered by the US dentist, Samuel Morton, in the mid-1800s. This advancement has been likened to the creation of the lightbulb or telephone.
Not long after this, inhaled chloroform was discovered by James Simpson in England. Unfortunately, both of these agents carried very nasty & potentially fatal side effects such as cardiac arrest from chloroform & the highly flammable nature of ether. And whilst being fully aware during a procedure was extremely unpleasant & in some cases terrifying, the high risks of anaesthesia worried patients more.
Thankfully, newer agents were discovered over time such as sevoflurane & propofol & anaesthesia is now safer than driving your car each morning on your commute to work. In particular, deaths under anaesthesia in Australia is more rare than being struck by lightning! The modern anaesthetic & those administering that anaesthetic are extensively researched & regulated & there are a plethora of anaesthesia options for any given patient & procedure.
So, who administers anaesthesia in Australia?
Last week, we explored advanced practice positions in perianaesthesia nursing. We learnt that there are Nurse Sedationists administering anaesthesia here in Australia. The anaesthesia they administer is limited to sedation. A highly skilled medical practitioner (an Anaesthetist) administers general & major regional anaesthesia. These individuals have initial training in medicine & then specialise in anaesthesia which involves extensive training & assessment (approximately 12 – 15 years worth of training!). You may have heard of the term ‘Anesthesiologist.’ This is mostly an American term however there are some European countries that have adopted this Pronoun to identify their anaesthesia practitioners.
What does the future hold?
As we discussed last week, there may be an additional advanced nursing practice position created in the not-too-distant future to enhance the anaesthesia profession. As technology advances, there may even safer anaesthetic agents on the market along with ‘easier’ ways to administer them. Whatever does eventuate, the basics of anaesthesia have not changed much over the past 50 years. One of those basic features includes the types of anaesthesia which will be discussed next week.