Every human being ever born on earth has, at one time or another, experienced some sort of injury, and accompanying discomfort. Yet modern medical and dental anesthesia as we know it today hasn’t been around for very long. In earlier times, many people people gladly took their chances rather than go under the knife with surgery because there was little chance of success and the lack of anesthetics made it an excruciating experience. It wouldn’t be until 1846 that one of mankind’s greatest fears, the pain of surgery, was eliminated. Luckily, we live in a modern age where the benefits of advanced anesthesia is available to all people and for all medical and dental procedures, and major surgeries can be performed practically with little to no discomfort
The oldest recorded substance used for relief during surgical procedures is alcohol. Herbal medicines were probably in use at this time as well. The ancient Sumerians recorded cultivating and harvesting the opium poppy as early as 3400 BC. It is most probable that their knowledge of the poppy was past down to civilizations of the Babylonians and the Persians, also finding its way to the Egyptians.
In 2250 BC a Babylonian clay tablet records a relief remedy for cavities. Also, the Egyptians wrote in a medical papyrus from the Eighteenth dynasty the use of crude analgesics and sedatives prepared from the mandrake fruit.
Before ancient India and China were introduced to opium by the Arabs in the 8th century, these civilizations pioneered the use of cannabis incense administered along with wine for anesthesia. Legendary Chinese surgeon Hua Tuo of the 2nd century AD is of particular note. It is said he performed major operations such as resection of intestines and gastrostomy after administering an oral anesthetic potion to his patients. The exact ingredients are lost to us because he burned any records before his death. Confucian teachings regarded surgery a form of body mutilation and thus it was a taboo practice.
Local anesthetics were used in Inca civilization where shamans chewed coca leaves and performed operations on the skull while spitting into the wounds they had inflicted to anesthetize. Cocaine would later be isolated and became the first effective local anesthetic,
initially used for eye surgery in 1884 by Karl Koller.
The first mention of inhaled anesthesia is found in early Arab writings in the late twelfth century. The “sleep sponge” was soaked in a dissolved solution of opium, mandragora, hemlock juice, and other substances. When held under the patient’s nose the fumes rendered the patient unconscious.
Somewhere between 1540-1842 anesthetics were little used, and practically forgotten about, at least not used publicly. Certainly there were different types of anesthetics that that were experimented with and used privately, but for all intents and purposes, this was the dark ages of anesthetics.
Although Ether was synthesized by Valerius Cordus of Germany in 1540, it wouldn’t be until the mid-1800s before it became a popular anesthetic prevalent for surgery. Ether is flammable and highly volatile, but showed great promise for medical/dental use as an inhalant. Around the same time period, Chloroform and Nitrous Oxide were being experimented with, but Ether became the earliest acceptable anesthesia of choice because of a successful demonstration to the medical/dental community.
Nitrous oxide was prepared by Joseph Priestly in 1776, and its anesthetic properties were announced as early as 1779 by Humphry Davy who coined the term “laughing gas.” A botched tooth extraction demonstration in 1846 performed by Dr. Horace Wells, delayed the popular use of it when the patient exclaimed he could still feel the pain, and ether became the inhalant of choice for several years until more evidence proved nitrous oxide to be the safer, more convenient alternative.
In 1853 chloroform was first used as an anesthetic, but the morbidity rate was found to be higher than ether, and so the dominance of ether in the medical community continued.
Also in 1853 the hollow needle and hypodermic syringe are invented, making it easier to administer local anesthetic. This allowed for the use of cocaine for this purpose after it was synthesized around 1855.
In 1894 a man by the name of H.J. Carlson discovers that ethyl chloride caused sound sleep in some dental patients. Procaine (novocaine) is discovered in 1904, and a carbon dioxide absorber is first used for general anesthesia in 1915. With the use of curare in 1942, the golden age of anesthesia had finally begun.
1943 brought lidocaine, which is used as a local and topical anesthetic that relieves itching and burning of the skin. It can also be sued as a dental anesthetic and for minor surgery. Synthesized by Nils Lofgren it is first marketed for use in 1949.
Since this time we have had continuing discoveries and improvements in inhalants and injectables with varying degrees of popular use: Halothane (1956), Enflurane (1963), Isoflurane (1965), Pancuronium (1967), Forane (1981), Propofol (1990), and Desflurane (1992)
If you would like more information about the history of dental anesthesia, call Dr. Thomas Anglemire and our helpful team at Granger Family Dentistry PC in Granger, Indiana. Phone: 574-277-5406.