The first intravenous anaesthetic: how well was it managed and its potential realized?

Br J Anaesth. 2013 Jan;110(1):7-12. doi: 10.1093/bja/aes388. Epub 2012 Nov 15.

Abstract

Our speciality commonly traces its origin to a demonstration of the inhalation of ether by a patient undergoing surgery in Boston in 1846. Less well known is the demonstration of the i.v. injection of opium with alcohol into a dog in Oxford in 1656, leading to anaesthesia followed by full long-term recovery. After gaining i.v. access, a mixture of opium and alcohol was injected, resulting in a brief period of anaesthesia. After a period during which the dog was kept moving to assist recovery, a full recovery was made. Details from this momentous experiment allow us to compare the technique used with modern management. It is important to consider why there was a failure to translate the results into clinical practice and nearly 200 yr of potentially pain-free surgery. Possible factors include lack of equipment for i.v. access, lack of understanding of dose-response effects, and a climate of scientific discovery rather than clinical application. Given the current interest in total i.v. anaesthesia, it seems appropriate to identify its origins well before those of inhalation anaesthesia.

Publication types

  • Historical Article
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Analgesics, Opioid
  • Anesthesia Recovery Period
  • Anesthesia, Intravenous / history*
  • Anesthesiology / history*
  • Anesthetics, Intravenous / history*
  • Animals
  • Central Nervous System Depressants
  • Dogs
  • Ethanol
  • History, 17th Century
  • Injections, Intravenous
  • Opium

Substances

  • Analgesics, Opioid
  • Anesthetics, Intravenous
  • Central Nervous System Depressants
  • Ethanol
  • Opium