Anesthesia Medical Quotes

Every human soul is different. We are all shaped by both experience and design, by callings and the way our gifts mold our inner lives. Every soul has a bent, a drift, a way it wants to go. And when hard times come and the inner person writhes in torment, the soul reaches for what it thinks is anesthesia, for something to medicate the pain.

The Hippocratic oath prevents doctors and medical personnel from participating in executions, so Alabama officials planned for untrained correctional staff to take a knife and make a two-inch incision in Mr. Nelson’s arm or groin so that they could find a vein in which to inject him with toxins and kill him. We argued that without anesthesia, the procedure would be needlessly painful and cruel.

As a result of its investigation, the NIH said that to qualify for funding, all proposals for research on human subjects had to be approved by review boards—independent bodies made up of professionals and laypeople of diverse races, classes, and backgrounds—to ensure that they met the NIH’s ethics requirements, including detailed informed consent. Scientists said medical research was doomed. In a letter to the editor of Science, one of them warned, “When we are prevented from attempting seemingly innocuous studies of cancer behavior in humans … we may mark 1966 as the year in which all medical progress ceased.” Later that year, a Harvard anesthesiologist named Henry Beecher published a study in the New England Journal of Medicine showing that Southam’s research was only one of hundreds of similarly unethical studies. Beecher published a detailed list of the twenty-two worst offenders, including researchers who’d injected children with hepatitis and others who’d poisoned patients under anesthesia using carbon dioxide. Southam’s study was included as example number 17. Despite scientists’ fears, the ethical crackdown didn’t slow scientific progress. In fact, research flourished. And much of it involved HeLa. 18

Kuslich SD, Ulstrom CL, Michael CJ. The tissue origin of low back pain and sciatica: a report of pain response to tissue stimulation during operations on the lumbar spine using local anesthesia. Orthop Clin North Am. 1991;22(2):181

Almost no effective treatments existed for prevalent diseases until the eighteenth century. Until the late 1830s, the lack of effective anesthesia made the few common surgical procedures horribly painful and all others impossible. Between

I ask you to consider three medical miracles we take for granted: X-rays, cardiac catheterization, and general anesthesia. I contend all three would be stillborn if we tried to deliver them in 2005.”43 (The same observation has been made about insulin, burn treatments, and other lifesavers.)

Nineteenth-century operating “theaters” had more to do with medical instruction than with saving patients’ lives. If you could, you stayed out of them at all cost. For one thing, you were being operated on without anesthesia. (The first operations under ether didn’t take place until 1846.) Surgical patients in the late 1700s and early 1800s could feel every cut, stitch, and probing finger. They were often blindfolded—this may have been optional, not unlike the firing squad hood—and invariably bound to the operating table to keep them from writhing and flinching or, quite possibly, leaping from the table and fleeing into the street. (Perhaps owing to the presence of an audience, patients underwent surgery with most of their clothes on.)

British Medical Journal asked its readers to vote on the most important medical milestone that had occurred since 1840, when the BMJ was first published. Third place went to anesthesia, second place to antibiotics. The winner was one you might not have expected: the “sanitary revolution,” encompassing sewage disposal and methods for securing clean water. Much of the world, though, is still waiting for that revolution to come.

The aggressive use of new medical tools went beyond castration. Dr. Marion Sims discovered a condition called “vaginismus,” in which a woman felt such pain from intercourse she was unable to bear penetration. He prescribed surgery, but another treatment was to put the woman under anesthesia so her husband was able to have sex with her. Sims described one case in which a physician had to visit the couple two or three times a week to anesthetize the woman before lovemaking.

The development of general anesthesia has transformed surgery from a horrific ordeal into a gentle slumber. It is one of the commonest medical procedures in the world, yet we still don’t know how the drugs work.

Pain is a Medical Orphan. Perhaps because it has traditionally been considered the consequence of disease or injury, not an illness in itself, and not specific to a body organ or site, no single specialty has accepted, as a pressing goal or major responsibility, a commitment to the elimination of pain. Perhaps there’s a little too much “man up” sentiment out there, embracing the words of Nietzsche: “That which does not kill us makes us stronger.

critical thinking Scenario 1 Mrs. Hernandez is an 85-yearold female admitted to surgery for insertion of a hip prosthesis to treat a hip fracture. The surgical technologist assigned to transport the patient to the preoperative holding area performed a routine review of the patient’s medical chart in the emergency department. The medical chart indicates that Mrs. Hernandez is being treated forchronic hypertension. 1. Knowing that she has a concurrent diagnosis of hypertension, which additional related items should be checked on her chart? 2. How might this situation affect the preparations going on in the surgery department? 3. What action or actions should the surgical technologist take prior to bringing the patient to preoperative holding? Scenario 2 Mr. Van Nguyen is a 47-yearold male admitted to surgery for repair of a retinal detachment under general anesthesia. 1. Which diuretic may be administered intraoperatively? 2. The circulator should check the preference card for a standing order for what preoperative preparation of the patient specific to this situation? 124

The Circumcision Decision If you have a baby boy, chances are you’ll be asked whether or not you want to circumcise him in the hospital. Most of us have inherited a vague sense that circumcision is somehow cleaner or healthier. But these are myths. We’ll share a few facts to jumpstart your research. - The significance of the infant’s pain is often overlooked in circumcision. Hospitals use painful Gomco clamps that sever nerve endings, and most docs make the cut without anesthesia. - Many infants go into shock as a result of the pain they experience in circumcision, and the breastfeeding relationship may be compromised as a result. - The circumcised penis is no cleaner than an intact penis, and requires far more care during the healing process. - “...[P]rofessional societies representing Australian, Canadian, and American pediatricians do not recommend routine circumcision of male newborns.” ~American Medical Association What if you plan to circumcise for reasons of Jewish faith? In Jewish circumcisions, - Boys are circumcised eight days after birth, when natural levels of Vitamin K are the highest. - Anesthetic is traditionally given (in the form of a tiny amount of wine and/or numbing agents). - Mohels (traditional circumcisers) don’t use painful skin clamps. Overheard… After reading up on circumcision, I knew I didn’t want to go through with it. The first reason was medical: the AAP doesn’t recommend routine circumcision. My second reason was emotional. It went against my mama bear instinct to protect my baby. Convincing dad was more difficult. He wanted to have his son like him. (I asked him if he and his dad compared their penises; the answer was no.) My husband watched videos of the procedure being done but had to stop them before they were over. He’d thought it was a simple snip of the ‘extra’ skin, but it’s not. The foreskin is actually fused to the head of the penis, like a fingernail to a nail bed. We took our baby home from the hospital the way he was born, and we haven’t regretted it. ~Lani, mom to Bentley Want to learn more? Check out the Circumcision Resource Center online, a helpful resource filled with medical and psychological literature for those questioning the practice.

Where the techno-medical model of birth reigns, women who give birth vaginally generally labor in bed hooked up to electronic fetal monitors, intravenous tubes, and pressure-reading devices. Eating and drinking in labor are usually not permitted. Labor pain within this model is seen as unacceptable, so analgesia, and anesthesia are encouraged. Episiotomies (the surgical cut to enlarge the vaginal opening) are routinely performed, out of a belief that birth over an intact perineum would be impossible or that, if possible, it might be harmful to mother or baby. Instead of being the central actor of the birth drama, the woman becomes a passive, almost inert object - representing a barrier to the baby's eventual passage to the outside world. Women are treated as a homogenous group within the medical model, with individual variations receding in importance.

Before anesthesia, surgeons removed bladder stones, drained ovarian cysts, and amputated legs, but little else; they were rewarded for their speed more than their skill. A surgeon named Robert Liston, in an attempt to best his own speed record for amputating a leg, accidentally cut off one of his patient’s testicles and two of his assistant’s fingers.

James Young Simpson studied medicine in Edinburgh, Scotland, graduating in 1832. By the mid-1840s, Simpson had climbed the ranks to become a professor of midwifery in Edinburgh, relieving the pain of childbirth with ether, like his American colleagues. But Simpson wasn’t satisfied. He wanted a more potent agent, one that was pleasant to inhale, worked quicker, and didn’t cause vomiting upon awakening. He settled on chloroform, a combination of hydrogen, carbon, and chlorine. On November 4, 1847, Simpson invited two of his assistants, James Duncan and George Keith, and some of his friends, including a Ms. Petrie, to a dinner party. When the dinner was over, he asked his guests to sniff a variety of volatile gases, including chloroform. Duncan and Keith immediately lost consciousness, falling under the table. Ms. Petrie also lost consciousness, but not before declaring, “I’m an angel! I’m an angel! Oh, I’m an angel!” The next day, without animal studies, clinical trials, or federal approval, Simpson administered chloroform to a woman during a particularly painful delivery. “I placed her under the influence of chloroform,” recalled Simpson, “by moistening half a teaspoon of the liquid onto a pocket handkerchief [and placing it] over her mouth and nostrils. The child was expelled in about twenty minutes. When she awoke, [the mother] observed to me that she had enjoyed a very comfortable sleep.” The parents were so elated that they named their daughter Anesthesia. On November 10, 1847, Simpson told a group of colleagues what he had done. Ten days later, he described his experience in a medical journal, claiming that chloroform was more potent and easier to administer than nitrous oxide, and quicker to induce unconsciousness and less flammable than ether. Now the entire medical world knew about it.

[Queen Victoria had been denouncing the Women's Rights movement] ... And after chloroform was introduced to ease the pains of childbirth, she demanded that it be used on her. Religious and medical conservatives were shocked. They said God had decreed that women must suffer in childbirth as atonement for the sins of Eve. But queen Victoria wouldn't accept this particular anti-woman's-rights dictum. She became one of the first women to use anesthesia during childbirth , and knighted Dr. James Simpson, the Scottish physician who developed this use of chloroform, though he was excommunicated by his church for doing so.

So certain were experts that neonates felt no pain that through the mid-1980s major surgeries on newborn babies were sometimes performed without anesthesia. These included major cardiovascular procedures requiring prying open rib cages, puncturing lungs, and tying off major arteries. Though provided with no pharmacologic agents to blunt the pain that cracking ribs or cutting through the sternum might have induced, babies were given powerful agents to induce paralysis—ensuring an immobile (and undoubtedly terrified) patient on whom to operate. Jill Lawson’s remarkable story of her premature son, Jeffrey, and his unanesthetized heart surgery provides a heartbreaking account of such a procedure. After Jeffrey’s death in 1985, Lawson’s campaign to educate the medical profession about the need to treat pain in the young literally changed the field. And likely led to improved awareness of pain in animals, too. bA technique called clicker training pairs a metallic tick-tock! with a food treat every time the animal performs a desired behavior. Eventually the animal comes to associate the sound of the clicker with the feel-good neurochemical rewards of the food. When the treat is discontinued, the animal will continue doing the behavior, because

had general anesthesia (and how many times). General anesthesia combines some toxicity of the anesthetics with what is often imperfect oxygenation, and this can affect brain function. have dental amalgams. These expose you to inorganic mercury. eat high-mercury fish. This exposes you to organic mercury. take certain medications (especially any with brain effects, such as benzodiazepines like Valium, antidepressants, blood pressure pills, statins, proton pump inhibitors, or antihistamines). used street drugs. drink alcohol (and how much). smoke cigarettes. practice good oral hygiene. Poor oral hygiene can contribute to inflammation. have surgical implants (artificial hips or breast implants, for instance). have liver, kidney, lung, or heart disease. snore.

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