麻醉学的发展历程及未来.ppt

Anesthesiology, Yesterday, Today and Tomorrow Adolph H. Giesecke MD. Retired Jenkins Professor and Former Chairman, Anesthesiology and Pain Management, UTX Southwestern Medical Center, Dallas TX. The First Anesthesiologist. 1 Seishu Hanaoka, 1760-1835. 2 “Angel of Medicine.” Duty to relieve pain. “Tsusensan” 1805. Mother and wife volunteered. Breast cancer removed with tsusensan 10/13/1805. Hanaoka 1805 Golden Epochs of Anesthesiology I. Inhalation anesthesia,1846. II. Regional anesthesia, 1884. III. Intravenous anesthesia, 1932. IV. Neuromuscular blockers, 1942. V. Precision anesthesia, 1986. Golden Epochs of Anesthesiology ETHER DAY. 3 Successful public demonstration 10/16/1846 at MGH. Ether Dome, now a national shrine. William Thomas Morton 1819-68. 3 Clothing merchant, swindler, dentist, medical student. Attended Wells’ demonstration of N2O in 1845. Idea of more potent agent, ether from Jackson. Patented “Letheon.” Ether “Sweet vitriol” discovered 1275 by Spanish chemist Raymundus Lullius. 1540, synthesis of ether described by German scientist, Valerius Cordus. Swiss physician and alchemist Paracelsus discovered the hypnotic effects of ether. Crawford Williamson Long (1815-1878). 4 Sir Humphrey Davy (1778 -1829) Superintendent of Thomas Beddoess Pneumatic Institute.  Rx pulmonary tuberculosis by inhaling various gases, N2O, H2, O2, and CO2.  Humphrey Davy. 4 1800 Researches, Chemical and Philosophical: Chiefly Concerning Nitrous Oxide. He described inhaling N2O himself and obtaining relief from a painful condition. He suggested N2O might be used for surgery, 44 years before Horace Wells. Drawing from the 18th century depicting the recreational use of nitrous oxide - laughing gas Horace Wells (1815 - 1848). 5 Attended a demonstration of N2O conducted by Quincy Colton, 12/10/1844. Noticed that a man intoxicated by N2O lacerated his leg, and felt no pain or recall. Horace Wells. Inhalation landmarks John Snow (1813-5