|COMMENTS ON PUBLISHED ARTICLE
|Year : 2020 | Volume
| Issue : 3 | Page : 252-253
Evolution of anaesthesia
Dipankar D DasGupta
Department of Anaesthesia, Jaslok Hospital and Research Center, Mumbai, Maharashtra, India
|Date of Submission||27-Dec-2019|
|Date of Acceptance||09-Feb-2020|
|Date of Web Publication||11-Mar-2020|
Dr. Dipankar D DasGupta
Department of Anaesthesia, Jaslok Hospital and Research Center, Mumbai - 400 026, Maharashtra
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
DasGupta DD. Evolution of anaesthesia. Indian J Anaesth 2020;64:252-3
On 16 October 1846, Dr. William T. G. Morton gave the first public demonstration of general anaesthesia at Massachusetts General Hospital, Boston.
From this dramatic moment of birth, the science of anaesthesiology has undergone spectacular developments. Over the past half-century, it has become necessary for anaesthesiologists to focus their interests on narrower fields to continue to gain adequate expertise and provide excellent service to patients suffering from diseases such as those involving the cardiovascular and neurological systems. It also became necessary to separate out the anaesthesia of neonates, infants and children, geriatric, bariatric and so on.
Developments in organ transplant and newer techniques involving robots have necessitated the development of special capabilities and further specialisation. Keeping up with advances in the developments of newer drugs, machines and gadgets and accurate care in resuscitating moribund patients and those in the intensive care units have also made a deep study and experience crucial.
It is important to recognise what it takes to be a competent and reliable anaesthesiologist. First and foremost is the need to be an excellent physician with strong clinical abilities. More than a nodding acquaintance with pharmacology and an ability to innovate, understand, develop and use increasingly effective machines, monitoring and resuscitative devices are crucial. Most important of all, the anaesthesiologist must have the ability to recognise at an early stage when something is going wrong and speedily avert a crisis – be the cause drugs, faulty equipment, an unexpected complication or a surgical catastrophe.
In an uncontrolled population and limited economy creating the cadres to meet the growing demand for such dedicated anaesthesiologists has not been easy. We have yet to determine what is ideal in a country as large and varied as ours with its manifold problems – burgeoning population, economic instability, political vagaries and deterioration of character. That we have succeeded in training anaesthetisiologists, whose abilities are recognised internationally despite these handicaps, is indeed creditable.
It is tempting to consider meeting shortages by following the example in some countries, where nurses have been inducted into anaesthesia to create the cadre of nurse-anaesthetists.
Perish the thought. We live and work in India. Nurses already have their hands full attending to the tasks they have trained themselves for and perform so well. With all the effort put in by them, we remain short of trained and experienced nurses capable of helping patients in our healthcare centres, clinics, wards and intensive care departments.
Inducting them to anaesthesia will make it necessary for them to jettison several of their strengths and spend inordinate time and effort in the attempt to acquire the skills needed for an anaesthesiologist.
Persistence in such an effort may result in a hybrid that, under our circumstances, will deprive our patients both of excellent nurses and skilled anaesthesiologists.
In a country like ours, the concept of creating a nurse anaesthetists - technician is absurd. No medical speciality can have replacement by nurse or paramedics. Moreover, as medical jurisprudence guidelines are rigid no one will take the responsibility of any catastrophe for nurse anaesthetists technicians.
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There are no conflicts of interest.