ENGL 302 N04
AMRIN CHOWDHURY
English 302 N04
Narration
DISCRETE PAIN
Pain is an unpleasant sensation or
feeling
that is
usually
associated with some internal damage such as tissue
damage. Pain
can have
an effect physically and emotionally, based on the level of pain. Luckily,
to get through this intolerable sensation, the process of anesthesia was
developed. This process worked to block the perception of pain usually
during any surgical procedures or other procedures where patients are
likely to experience severe or unbearable pain.
The development of anesthesia was rather meant to create a
cultural change. The concept of pain was mostly linked to the obstetric
pain during the eighteenth century. One was regarded highly if he or she
was able to endure the pain and men who disregarded pain were favored the
most. Gradually, a change took place when the idea of anesthetics was
favored, which would change the cultural environment of a number of
individuals in Western Europe and the Americas.
They were dentists, not doctors, who are credited for
discovering
anesthesia because they had better everyday contacts with patients dealing
with tremendous amounts of pain. On the other hand doctors were more
attentive on the rising of new infectious diseases and such, rather than
pain from treatments or procedures. Horace Well and William Thomas Green
Morton were the two dentists known to develop anesthesia, or better known
as local anesthesia, from a very peculiar Spanish discovered crop, the
coca leaf.
Coca leaf is best known today for its extraction to make
the drug
cocaine, which is used in various ways in modern times. It was from coca
leaf that several chemists in Germany synthesized cocaine, with which the
first motives of anesthesia were encountered. Friedrich Gaedeke was the
German chemist, who discovered that coca leaves contained a molecule known
as alkaloid. Then, Albert Niemann isolated the substance and called it
cocaine. Cocaine was used and studied first by Thomas Moreno y Maiz, a
Peruvian surgeon, who found out that injecting this drug in rats, pigs,
and frogs caused sensitivity in them; hence, caused some local anesthetic
effects. Another observance with cocaine was led by a Russian physician,
Basil Von Anrep. He injected a small quantity of cocaine under his skin
and felt nothing when jabbing took place at that very site of the skin.
Consequently, he did the same to his tongue and felt no sensation when the
tongue was jabbed the same way. Therefore, he concluded that cocaine was a
good candidate for surgical anesthetics. Finally, it was only after the
experiments and researched work of ophthalmologist Carl Koller from Vienna
that cocaine would definitely be named to use as regional and local
anesthesia. Dr. Koller’s work and research was based on a patient who had
glaucoma, who would be the first person to have a local anesthetic on an
operating table. The development of cocaine as anesthesia spread across
United States and Canada during the late nineteenth century.
Soon thereafter, Dr. Richard John Hall reported on the
first
successful nerve block of a patient who was under the supplement of
cocaine hydrochloride. It was him, Dr. Hall and Dr. William Stewart
Halsted who are credited for using the hypodermic syringe to infiltrate
cocaine to the sensory nerve. The development of the hypodermic syringe
would further enhance local anesthesia. It was an instrument carefully
described to administer substances into the human body, subcutaneously.
More and more elaborate designs of the syringe were being brought by new
innovators. It is Alexander Wood, a surgeon from Edinburg, who we credit
today for “employing the needle and the syringe as a medical instrument.”
Eventually, medical professionals witnessed the development of Pravaz’s
syringe, named after Charles Gabriel Pravaz, known as the “father of
orthopedics.” Pravaz’s syringe was the most advanced syringe, which drove
more health professionals to the use of local anesthesia due to its
mechanism with the fine needle and the screw motion that allows a
convenient way to apply substances into the body.
After cocaine was well renowned, more drugs were being
developed
to be used for local anesthesia. The most successful was novocaine, also
known as para-amniobenzoic substances, discovered by Alfred Einhorn, a
German chemist. It was the safest, compared to other drugs, such as
alypine and stovaine, two other drugs that were in the market, and became
the most popular anesthetic drug, although it appeared to cause allergic
reactions to some patients. In essence, more approaches were taken to
search for alternate drugs. These drugs included lidocaine, developed by
Nils Lofgren and Bengt Lundquist, mepivacaine, bupivacane, pribocaine, and
etidocaine. Today, the most commonly used is the mepivacaine. In
dentistry,
lidocaine is the most common. Most of these solutions contain adrenaline.
It is a vasoconstrictor, which basically means it can constrict vessels
and can prolong the effects of the anesthetic. Currently there is ongoing
and continuous research in developing newer drugs that are more safe and
effective. Although anesthesia can have adverse effects such as toxicity
to the heart, where it can cause arrhythmia or to the brain, causing
seizures, health professionals still find anesthetics to be a valuable and
required part of any surgical procedures for the dissipation of severe
pain. It is for the benefit of both the patients and the medical and
health professionals to take advantage of such a powerful process because
it only allows the completion of a procedure without any complaints of
pain.
I used EndNote.
Calatayud, J. & Gonzalez, A. (2003). History of the
Development and
Evolution of Local Anesthesia since the Coca Leaf.
Anesthesiology, 98,
1503-1508.
Duce, M.A. & Hernandez, L. F. (1999). Origins of the
Hypodermic
Syringe and
Local Anesthesia. Their Influence on Hernia Surgery. Hernia,
3,
103-106.