麻醉学的发展历程及未来.pptxVIP

麻醉学的发展历程及未来第1页/共44页 Anesthesiology, Yesterday, Today and Tomorrow第2页/共44页 The First Anesthesiologist. 1第3页/共44页 And the Lord God caused a deep sleep to fall upon Adam, and he slept. Genesis 2:21 . 第4页/共44页 Managing Pain Before AnesthesiaLocal application of cold water, ice or pressure.Plants and extracts. Coca leaves chewed and saliva dripped into injured areas or open wounds - Inca Shamans. Alcohol or/with opium or hemp – “soporific sponge.”Hypnosis第5页/共44页 Most common,Opium poppy, Papaver somniferum, Mandragora or mandrake from Atropa mandragora, belladonna from the Morning Glory,marijuana or Cannabis indica. Opium第6页/共44页 In those “dark” days many patients approached surgery as through facing execution, an often appropriate assessment of uncontained risks, including pain, hemorrhage, shock and postoperative infection.第7页/共44页 The easiest pain to bear is someone else’s.第8页/共44页 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. 第9页/共44页 Hanaoka 1805第10页/共44页 Golden Epochs of AnesthesiologyI. Inhalation anesthesia,1846.II. Regional anesthesia, 1884.III. Intravenous anesthesia, 1932.IV. Neuromuscular blockers, 1942.V. Precision anesthesia, 1986.第11页/共44页 Golden Epochs of AnesthesiologyI. Epoch of inhalation anesthesia, 1846.第12页/共44页 ETHER DAY. 3Successful public demonstration 10/16/1846 at MGH. Ether Dome, now a national shrine.第13页/共44页 William Thomas Morton 1819-68. 3Clothing merchant, swindler, dentist, medical student. Attended Wells’ demonstration of N2O in 1845.Idea of more potent agent, ether from Jackson.Patented “Letheon.”第14页/共44页 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.