01 history of anaesthesia

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HISTORY OF ANAESTHESIA, OPEN DROP METHODS, OLD EQUIPMENTS & RELATED

PHYSICSBy: Dr. T.C.KRIPLANI

James Charles Stuart(19-06-1566 : 27-03-1625)

“A BLACK DAY IN THE HISTORY OF MANKIND”

1591 EdinburghA young woman named

Euphanie Macalyane got the punishment for seeking pain relief during labor. She was burnt alive on direct order

from King of Scotland James VI

King James of Scotland

JULY 1868 BOSTON(Mount Auburn Cemetery)

-Mrs..E. MORTON

(GRAVE SIDE)

“My Husband’s greatest gift which he devoted to the service of mankind proved a curse to himself and to his family”.

Prof. A K Sethi’s EORCAPS 2008

Queen’s University Belfast1920-21

“Magill is Mad”

Sir I.W.MAGILL(1888-1986)

Remarks written by the referee on the manuscript submitted by Sir I. W. Magill for the award of MD degree from Queen’s University, Belfast


Q1. Tell about the history of origin of word Anaesthesia.

Philospher Plato Pedanius Dioscoride

(428 - 348 B.C.) (100 A.D.)


Oliver Wendell Holmes (1846)

Bailey’s English Dictionary (1721/1751)

Encyclopedia Britannica (1771)

John Eliotson (1791-1868)


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Q.2. Who synthesised Ether ?

Raymundus Lullius (1275)(Spanish Chemist)

Paracelsus (1540)(Swiss Physician & alchemist)

Valerius Cordus (1540)(Italian-pupil of Paracelsus)


Q.3. Who gave first Anaesthesia ?

Genesis 2: 21 Creation of Eve


Q. 4. In U.S.A. Physician's Day is celebrated on which Date & why ?

• 30th of March every year.

• On 30-03-1842 C.W.Long

administered ether

anaesthesia.

1815-1878


Q.5. First Public demonstration of anaesthesia was given by whom ? Tell Time/Day/Date and Place.

• William Thomas Green Morton

• 10.15 A.M. Friday, 16th of Oct’ 1846

• Bullfinch Amphi Theatre M.G.H.

Boston U.S.A.


Bullfinch Amphi Theatre M.G.H.,Boston U.S.A.


Q.6. Who introduced Chloroform in clinical practice ? Tell the date.

Prof. J.Y.Simpson 8-11-1847


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Q.7. When was the first death under

chloroform anaesthesia ?

• 28th of Jan. 1848.

• Hennah Greener, 15 yrs. Old girl operated for removal of toe nail at Winlaton (Near New Castle, U.K.) Anaesthesia was given by Dr. Meggison in his office


Q.8. How many commissions / committees were there to investigate the cause of deaths under chloroform anaesthesia.

YearFive 1864

1888188919041911


Q.9. Identify the Gentleman and tell about

his contribution towards anaesthesia.

Prof. A K Sethi’s EORCAPS 2008 Ans.

(H.E.H. Mir Mehboob Ali Khan, 6th

Nizam of Hyderabad) Born 17th August

1866 Ruled 1869 to 1911)

Died : 31st August 1911Sponsored

1st Hyderabad Chloroform Commission – 1888 (experiment done on 128 dogs).

2nd Hyderabad Chloroform Commission -1889 (on 490 animals dogs, horses, monkeys, rabbits, goats & cats).


Q.10. The seven foundation stones of anaesthesia (rated by W.S.Sykes) in order of merit are:-


2. HORACE WELLS3. W. T. G. MORTON

4. HUMPHRY DAVY5. C. W. LONG 6. J. Y. SIMPSON7. C. T. JACKSON

SEVEN FOUNDATION

ANAESTHESIA

1. HENRY HILL HICKMAN

STONES OFANAESTHESIA


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1. Dr. HENRY HILL HICKMAN

(1800 -1830)


2. DR. HORACE WELLS

(1815 -1848)


3. DR. WILLIAM THOMAS GREEN MORTONProf. A K Sethi’s EORCAPS 2008

4. SIR HUMPHRY DAVYProf. A K Sethi’s EORCAPS 2008

5. DR. CRAWFORD W. LONGProf. A K Sethi’s EORCAPS 2008

6. DR. J. Y. SIMPSON

(1811 - 1870)


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7. MR. CHARLES T. JACKSON

(1805 - 1880)


Q.11. Who is known as father of General Anaesthesia ?

John Snow

(1813-1858)


John Snow gave anaesthesia to her at the birth of Prince Leopold (8th

child)in 1853 and in 1857 at the birth of Princess Beatrice (9th

child)Queen Victoria (1819-1839-1901)


Q.12. Who is known as father of Intravenous anaesthesia ?

Prof. Helmut Weese(1932 introduced Hexobarbital (Evipan)


Q.13. Who is known as father of spinal anaesthesia ?

August Karl Gustav Bier(1861-1949)

16th of August 1898(Keil Germany)

Prof. A K Sethi’s EORCAPS 2008 Q.14. Who is known as father of local anaesthesia ?

Dr. Heinrich Friedrich Wilhelm Braun(1862-1934)

-Introduced Adrenaline (chemical tourniquet) with local in 1902-Pioneer of new drug Procaine, Textbook of local Anaesthesia


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Q.15. Who is known as father of injectors ? What is Venturi’s principle?

* James Thompson (1852)(Brother of Lord Kelvin)

* U = 1/2 D x V2

U - Pressure drop

D - Density

V - VelocityGiovanni Batista Venturi

(1746-1822)


Q.16.What is coanda effect ?

• In 1932 Henri Coandadescribed the phenemenon of wall attachement.

• Jet being diverted towards wall and being attached.(Digitallogics)


• Small puff of gas injected at the site of bubble will deflect the main jet to opposite wall.

• Used in ventilators. (Fluidics)


MR. HENRY COANDA (1910)

AT 25 YRSMR. HENRY COANDA

AT 71 YRS


THE JET PLANE MADE BY HENRY COANDA


Q.17. Who is known as father of oximetry?

Carl Matthes1935 U.S.A.


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Q.18. Who is known as father of C.P.R.?

Dr. Peter Safar(12-04-1924 - 03-08-2003)


Q19. Who is known as father in-law of anaesthesia ?

Alexander Wood(1817-1884)

In 1855 he injected solution of morphia near the nerve for pain relief for the first time.


Q.20. When was the 1st local anaesthetic (Cocaine) introduced clinically.

15th of September, 1884

Opthalmic Congress

Heidelberg, Germany

Carl Koller(1857-1944)

Intern at AllegemeineKrankenhaus (Vienna)


Q.21. Which fluorinated Hydrocarbon was first to be introduced for anaesthesia?

Fluroxine (Trifluoro ethyl Vinyl Ether)

10-04-1953, synthesided by John C. Kranz (Jr) University of Maryland

Gave open drops to – Dr. Max S. Sadove, Anaesthesiologist at the University of Illinois (Member of Walter Reed Society)


Q.22. Who introduced relaxant (curare) into anaesthesia practice (Date, Place & Year) ?

23rd January 1942

Montreal (Canada)

By Harold R Griffith

& Enid JohnsonDr. Harold Griffith

1894-1985


Q.23. What do you know about Pearl Harbor disaster in relation to anaesthesia ?

• Many deaths due to use of Thiopentone in shocked patients (1941). Cyanosis – Respiratory failure – death of young patients.• 1943 (Anaesthesiology) - Halford quoted Intravenous Anaesthesia is an ideal method for “euthanasia” in war surgery.• 1943 (Anaesthesiology) Adam & Gray reported successful administration of drug in deep shock• 1943 – Anaesthesiology – editorial “possibly the fault lay with the administration rather than with the drug.


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Q.24 When was father of our nation Mahatma Gandhiji operated for emergency appendicectomy? Who gave anaethesia ?

* 12th of Jan, 1924, Sasoon Hospital, Poona.

* Dr. Date gave anaesthesia

* Col. Maddock operated.


Q.25. In which year association of anaesthetists of G.B. & Ireland was formed (became national) ?

• 1932


Q.26. In U.S.A. “Long Island Society of

Anaesthesia” became national in

which year?

• 1935


Q.27. When Indian Society of Anaesthetists was formed ?

• 1947


Q.28. When World Federation of Societies of Anaesthesiologists (W.F.S.A.) was formed?

• 1951 Sept.

• 1st Conference 1955 Scheveningen, Netherlands.

Dr. Harold Griffith (First President)


Q.29. When was Asian &

Australasian Regional section of W.F.S.A. formed?

• 1960 Toranto, during second world congress

• First Conference at Manila, (Phillipines) 1962.


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Q.30. When was South Asian Confederation of Anaesthesiologists (SACA)formed ?

• 1991 at Delhi• First congress, Dhaka, Bangladesh

1993

Prof. A K Sethi’s EORCAPS 2008 Q.31.When was the publication of following journals started ?

A). Anesthesia Analgesia(now Anesthesia Analgesia Curr.Res.)

B). Brit.J.Anaesth.

C). Anesthesiology

D). Anaesthesia

E). Ind.J.Anaesth.

• 1922

• 1923

• 1940

• 1946

• 1953


Q.32. In U.K. which year the following courses were started ?

- D.A. -

- F.F.A.R.C.S. -(Now F.R.C.A.)

*1935

* 1947(1st exam in 1953 (three Indians passed)


Q.33. In India following courses were started in which year ?

- D.A. -

- M.S.(Anaesth.) -

- PhD. (Anaesth.) -

* 1946(Bombay Unv.)

* 1955(Muzaffarpur Unv.Darbangha Med. Coll., Bihar)

* 1958


Q.34. Who was Dr. T.N. Jha ?* Prof. Of Anaesthesiology Medical College, Darbhanga (Bihar)

* 1983 - Best PG paper Award started

* Played key role in starting M.S.(Anaesth.) in 1955, Darbhanga Medical College (Muzzafarpur University) 01-03-1923 - 30-07-1979


Q.35. Identify this. How much % of vapour maximally it gave ?

*Morton’s Inhaler

* 24%


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Q.36. Identify these masks and droper.

Schiemmelbusch(1890)

Yauncher’s

Bellamy Gardner Droper


Q.37.How many layers of Gauge/Lint are put over the mask for open drop technique.

* 12-16 layers of gauge

* 1 layer of lint


Q.38. What were the common inhalation anaesthetic agents used for open drop technique. Should one trickle oxygen under the mask ?

* Ethyl Chloride

* Ether

* Chloroform

* Yes always because the partial pressure of O2 goes down under the mask.


Q.39. Tell about Ethyl chloride :-

-Boiling point-S.V.P. at 20° C-Blood : Gas part. coeff.-Vol % required for induction.

* 12.5°c* 988mmof Hg* 2* 3-4.5 vol%


Q.40. Tell about Chloroform :-

-B.P.-S.V.P.(at 20°c)-Blood : Gas part.coeff.-M.A.C.

* 61°c* 150mm of Hg* 8.4* 0.7


Q.41. Tell about Ether (Diethyl) :-

-B.P.-S.V.P.-Blood : Gas part. coeff.-M.A.C.-Vol % required for Induction-Vol % required for maintenance

* 35°c* 425mm of Hg* 12* 1.92% * 18-20%* 4-6%


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Q.42. How much is the latent heat of vaporisation of Ether (Diethyl) ?

65 Cal/ml3


Q.43. How much is the heat loss during following techniques of anaesthesia:-

- Open drop- Semiclosed- Oxford & E.M.O.- Circle system- To & Fro (Water's)

* 300 Cal/ml* 250 Cal/ml* 220 Cal/ml* 180 Cal/ml* Negligible


Q.44. Identify the Equipment. What is the mechanism of Heat conservation in this equipment.

OXFORD VAPORISER

1941 designed by Macintosh


Q.45.Identify this equipment.


E.M.O(Epstein,Macintosh,OxfordVaporiser)

• Made in 1952.• Wt=6.5kg.• Total ether = 450ml(150ml

+ 300ml)• Ether 1-20%• Thermocompenstion (15-

30 degree celsius)(sealedether capsule)

• 1200ml water.

Prof. A K Sethi’s EORCAPS 2008Q.46. Identify the equipment. How warm ether

or chloroform was delivered through this ?

* Shipway apparatus (Sir Francis Shipway 1916)

* Vapour was pass through thermos flask filled with hot water.


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Q.47 Identify this equipment made for giving chloroform. How at times fatal complications occurred with this equipment.

1867. Junker’s BottleFatal complications due to wrong connections

Prof. A K Sethi’s EORCAPS 2008 Q.48. Identify the machine. Which type of Machine this is ? When and why this machine was discontinued

Minnitt’s gas air machine (R.J.Minnitt, 1933 discontinued in 1970)

Maximum upto 50% of N2O with air

Q.49. Identify this machine. Which type of machine this is .This machine was used for.........anaesthesia ?

Walton fiveIntermittent typeDental Anaesthesia

1st appeared in 19255th appeared in 1958


Q.50 Which system is not there in this machine? When was that system incorporated in Boyle's Machine?

* Pin Index System* Incorporated in 1952 in Boyle’s Machine(suggested by Prof. Woodbridge in 1939)


Q.51. Identify the cylinders. What is the Pin-Index No. of these cylinders ?

Cyclopropane – 3 6

CO2 – 1 6


Q.52. In which year the Oxygen & Nitrous

Oxide cylinders were made ? Tell the

composition of modern cylinders ?1865- Brass bound with Copper cylinders (Barth & Coxeter

London)

1870- Cast Iron Cylinders (S.S. White & Philadelphia)

1946- Mangnese Steel - Now Molybdenum steel & Aluminium Alloy.

Iron remaining Silicon 0.3% Chromium 0.8-1.1%

Carbon 0.3-0.4% . Sulpher 0.35% Molybdenum 0.15-0.25%

Maganese 0.4-0.9% Phosphorus 0.35%


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01 history of anaesthesia