Anesthesia and Painless Surgery

Painless surgery is taken for granted by most of us who are in the business of doing surgery. But the history of painless surgery started 153 years ago.

On October 16, 1846, Dr. William Morton, a young Boston dentist, administers ether to Edward Gilbert Abbott, so that Dr. John Collins Warren can do painless surgery.

This is an important day for patients and surgeons. Prior to that the operating room was seen as a torture chamber. Patients would scream with pain until they fainted. Surgeon and his assistant had only a minute or two to complete their procedure. Amputation took less than two minutes.

“Very few operations were done and they were dreaded by all,” says Dr. Robb Rutledge, attending surgeon at Fort Worth, Texas, in an article in Bulletin of the American College of Surgeons.

Before 1846, there were some isolated attempts to make surgery painless. In 1800, nitrous oxide (laughing gas) was used by Humpry Davy to relieve pain of surgical operation. There were some unpublished reports of ether use as well. But it was Morton’s success at Massachusetts General Hospital that changed the practice of surgery.

Both ether and nitrous oxide became well known in social circles. There were “ether frolics” and “laughing gas parties.”

During one of these laughing gas parties, Horace Wells, a successful young dentist, observed that one of the guests had bruised his leg but felt no pain. Next morning, Wells had his colleague use nitrous oxide to pull Wells’ own wisdom tooth. Wells was impressed.

Dentists and surgeons used nitrous oxide and ether to do more cases. It was Oliver Wendell Holmes who suggested etherisation be called anaesthesia, which means insensitive to objects of touch. “This name caught on and was adopted around the world,” says Dr. Rutledge.

But there is a sad end to this wonderful story. Some of the individuals involved in the discovery of anaesthesia started to fight over priority and financial gain. The battle raged in front of the U.S. Congress. But nobody won. “No one ever received any financial governmental award for the discovery,” says Dr. Rutledge.

Horace Wells was so disappointed that he left his wife and son and moved to New York City. He became addicted to chloroform. Was jailed on his 33rd birthday for throwing sulfuric acid on prostitutes. In 1848, while in prison, he committed suicide.

William Morton destroyed himself trying to get recognition for his role in the discovery of anaesthesia. He was censured by the American Medical Association for unworthy conduct. He died of apoplexy at the age of 48.

Sad endings. But things have not changed in the last 153 years. Money and recognition continues to be at the heart of many battles – big or small. Some things in life never change!

Same as the fear of pain. Every individual I have “surgerised” has had fear of pain and needles. Needles are painful. When we discuss surgery with patients, their first question is: Is this going to hurt? Rarely a patient wants to know about complications, risk of permanent damage from the procedure or the worst of all complications – death.

Pain is scary. Pain is a complex experience. Response to pain is physical as well as emotional. Response to pain varies among individuals because the emotional component is variable. Nobody likes to be in pain.

So, next time you have painless surgery, remember it was pioneers like Wells and Morton who made this possible.

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