Improved pain control is arguably one of the most significant advances of modern medicine. The modern use of anesthetics have allowed surgery to become a relatively simple procedure for mitigating illness and disease.

Before the widespread use of ether and chloroform in medical procedures in the early 1900s, a patient undergoing a tooth extraction or amputation had very limited options for dulling the senses during the painful procedure-- opium and alcohol.

Consider a patient with a cancerous tumor in 1750. With most likely alcohol as the only anesthetic during surgery, his options were limited: he faced a horribly painful, traumatic surgery or the grim outlook of spreading cancer. Patients often delayed or refused needed operations because of the fear of pain or even death resulting from the surgery itself. Many patients who underwent surgery without adequate anesthesia died from shock.

Today's patient, with the same surgery, will have an anesthesiologist dedicated to his care during surgery, and a skilled nurse with a Master of Science in nursing charged with taking a detailed history before the surgery to ensure the best anesthetic care is given. He will be monitored closely during and after to ensure the anesthetic is effective and has as little risk as possible.

Beyond Ether and Chloroform

Ether was the first widely used anesthetic, but it was highly flammable, leading to the popularity of chloroform. Both anesthetics had their risks, though. It was difficult to ensure a safe dose, and many patients died from overdose. As surgeons improved their techniques and researched new and better ways to achieve pain-free procedures, they found more effective drugs, new methods for administration, and better monitoring techniques.

Anesthetics Now

The anesthetic used for a particular procedure can vary widely. There are options for local numbing--those are all the drug names ending in -aine, like lidocaine and novocaine--nerve blocks, such as an epidural; intravenous drugs that put the patient to sleep; and inhaled drugs, like nitrous oxide, or laughing gas. Each anesthetic has its own positives, and many procedures use more than one anesthetic. There are also drugs that can better manage the after-effects, such as ondansetron for nausea.

Balancing the Risks: Risks of Pain Vs. Risks of Anesthesia

The modern world has a very different view of pain that they did in the past. Pain was seen as inevitable, and enduring pain well was a mark of honor. Today, we realize that pain has very little, if any, benefit, other than alerting individuals to something that should be avoided! Nerves can become sensitized to pain, leading to chronic pain. Therefore, pain management now often involves preemptive management. As anesthetics have become more specialized and precise, physicians are better able to manage the risks, so now the risks of uncontrolled pain can be greater than the risks of anesthetics.

Easing pain and suffering is arguably one of the biggest goals of medicine, second only to prolonging life. After all, avoiding pain and the desire to live are two of the most basic human instincts. With advancements in medicine, life expectancy rates have increased and the understanding of the human body and it’s conditions has grown.