By Angeline Kado
Medicine has come a long way but perhaps the most significant milestone and gain in this practice that has possibly affected all of us in one way or the other, is conquering pain.
While conquering pain through the use of opium and other herbal remedies dates back to early civilizations, the first public demonstration of modern anaesthesia took place on October 16th, 1846.
The historic milestone made by William T. G. Morton-a young dentist and John Collins Warren-a surgeon at Massachusetts General Hospital, saw the use of diethyl ether “anaesthesia” to prevent pain during surgery. This discovery brought about the elimination of one of mankind’s biggest fears; the excruciating pain of surgery.
Before this milestone, surgery and pain were synonymous, but not anymore.
Today, anesthesia used in both invasive surgeries (such as an open heart surgery) and minor procedures (such as tooth extraction), allows medical procedures to be carried out without pain and in some cases, without the patient being aware.
According to Jennifer Whitlock, a board certified family practice nurse practitioner working with patients recovering from surgery, anaesthesia can be categorized into four main types including; General anaesthesia, Regional anaesthesia, Monitored anaesthesia and Local anaesthesia.
While the type of anaesthesia used for a surgery will always greatly depends on the type of surgery being administered, other factors that are taken into account include; the state of health, length of surgery as well as the preferences of the anaesthesia provider and surgeon.
While technology has been embraced in most medical areas, anaesthesiologists have not been left behind.
According to Dr. Amer Majeed, a Consultant Anesthesiologist at King Faisal Specialist Hospital and Research Centre in Riyadh (Saudi Arabia), technological advances are leading to the possibility of remotely controlled or even completely autonomous delivery of anesthesia.
As Dr. Amer observes in an article published in the Anaesthesia, Pain & Intensive Care (APICARE) journal, during the last decade, the risks associated with aesthetic care have been dramatically reduced.
According to the anaesthesiologist, technological advancement and automation has played a significant role in improving patient safety, as well as the working environment of anaesthesiologists.
“Anaesthesiologists world-wide have developed standards for continuous real-time monitoring of hemodynamic, oxygenation, ventilation, neurological status, urine output, core temperature, degree of neuromuscular blockade, as well as other items, all of which have also contributed significantly to patient safety,” he adds.
These technological advancements include Anesthesia Information and Management Systems (AIMS) with integrated decision support, target-controlled infusion systems, better design of anaesthesia machines, closed-loop delivery of anaesthesia, and point of care ultrasound guided procedures.
More recently, the technological trend in anaesthesiology went a step further and saw the introduction of robots.
These are designed to establish peripheral and central venous access, perform endotracheal intubations (a medical procedure in which a tube is placed into the windpipe through the mouth or nose).
Additionally, robots are designed to assist in the administration of regional anaesthesia, which is the use of local anaesthetics to block sensations of pain from a large area of the body, resuscitation and automated drug delivery systems.
Tele-anesthesia is yet another advancement in the field of anesthesiology.
According to a research carried out by Dr Bettina Smallman of State University of New York Upstate, Syracuse, and colleagues and published by Anesthesia & Analgesia, official journal of the International Anesthesia Research Society (IARS); the monitoring and communication systems used in tele-anesthesia have the potential to help ORs work more productively and efficiently.
According to a review on Perioperative cardiovascular monitoring of high-risk patients published on the US national Library of Medicine and National Institutes of Health Journal; insufficient tissue perfusion and cellular oxygenation due to hypovolemia, heart dysfunction or both, is one of the leading causes of perioperative complications.
According to Dr. Amer,the concept of Artificial Intelligence, commonly referred to as AI, stems from the superiority of computers to perform tasks.
“There is an exponential superflux in affordable computational power, and mass accrual of big data has made it possible to develop and propagate deep machine learning algorithms. These algorithms, when applied through reasonable computational power, can perform analyses and tasks at a small fraction of time taken by conventional methods,” he adds.
As a result of the technological advances as well as the paradigm shift towards functional medicine, the overall state of health is steadily improving.
While this takes place, the required numbers and types of surgical procedures are reducing. Also on the downward trend is the required number of relevant workforce including anesthetists in future.
