High-Impact Clinical Studies That Fomented New Developments in Anesthesia: History of Achievements, 1966-2015.

The aim of this work is to identify the most influential initial clinical studies that fomented important developments in anesthesiology over the past 50 years. Studies fomenting new development can be selected using vastly different approaches and, therefore, might provide diverse outcomes. In the present work, two basic aspects of study assessments - the stage of development (eg, generation of idea, preclinical studies, clinical trials) and the method of selection (eg, committee vote, various types of citation analysis, method of finding the invention disclosure) - were chosen according to the following model. The stage of development: the initial clinical studies demonstrating the basic advantage of an innovation for providing anesthesia. The method: a combination of two factors - the study priority in terms of the time of its publication and the degree of its acknowledgement in the form of citation impact; the time of study publication was regarded as a primary factor, but only if the study's citation count was =/>20. The initial high-impact studies were selected for 16 drug-related topics (ketamine, isoflurane, etomidate, propofol, midazolam in anesthesia, vecuronium, alfentanil, atracurium, sevoflurane, sufentanil, rocuronium, desflurane, ropivacaine, remifentanil, dexmedetomidine in anesthesia, and sugammadex), and 9 technique-related topics (ultrasound-guided peripheral nerve block, capnography in anesthesia, target-controlled intravenous anesthesia, pulse oximetry in anesthesia, total intravenous anesthesia, transesophageal echocardiography in anesthesia, combined spinal-epidural anesthesia, and bispectral index). Twenty-five studies were designated the first high-impact studies (one for each topic); 16 are drug-related and 9 are technique-related. Half of the first high-impact studies had a citation count of =/>100, (range: 100 to 555). The citation count of the other half of high-impact studies did not reach the 100-citation threshold (range: 41 to 97). If a selected first high-impact study had a citation count <100, a next-on-timeline, additional study with citation count =/>100 was also selected; (range: 100 to 344). The present results show that an initial high-impact clinical study on a new development in anesthesiology can be determined and that related citations usually vary from one hundred to five hundred.

The history of "modern" anesthesia technology - A critical reappraisal: Part I: Key criteria of "modern" anesthesia: Technology and professionalism definitions, backgrounds and a short introduction to a changing evidence-base.

This paper is the first in a series of publications. These investigate, whether important elements of the historiography of anesthesia require a critical reappraisal. A systematic, combined presentation, contextualization and assessment of recent European research is provided. This includes the author's own findings. These emanate from two extensive projects. They combine very recent findings with results of earlier research, conducted by the author and numerous collaborators over the last 18 years. The findings represent an ever increasing and ever more robust body of evidence. They add an important new element to our international historiography. As an introduction, several definitions will be given for criteria, which designate "modern" anesthesia and its technology. On one of these criteria, the history of professionalization and specialization, a short overview will be given. This will be followed by an overview of general contexts, key features and early achievements of anesthesia-related technology. All results will be compared with a currently dominating narrative: This alleges "dominance" of US-American and British pioneers and developments. Apparent biases and inconsistencies are identified. These suggest that our current, international historiography of anesthesia may require a critical reassessment. Three subsequent articles will focus on specific aspects of anesthesia technique and technology. Their results likewise suggest a history of internationalism and trans-disciplinary reciprocity, rather than of national dominances. Further investigations will aim to ascertain the nature and extent of potential interactions, which may nowadays be underrecognized.

Anaesthetic or "Antiaesthetic" or "Antaesthetic"? Correspondence From Andrew Buchanan, MD, to James Simpson, MD, Concerning a Name for the Agents Producing Insensibility.

In November 1847, James Young Simpson, MD, of Edinburgh, Scotland, applied the word anaesthesia to the state of narcotism and insensibility produced by the inhaled vapors of sulfuric ether and chloroform, along with the word anaesthetic as an adjective to denote that state and as a generic term for agents capable of inducing the state of insensibility. In March 1848, Andrew Buchanan, MD, of Glasgow, Scotland, penned a letter to Simpson to suggest a more semantically precise word, the spelling of which is not clear in Buchanan's letter. We do not know whether Simpson replied to Buchanan. Simpson continued using the words anaesthesia and anaesthetic in his publications.

Academic Journals Assessed as Springboards for New Developments: A Study of Leading Anesthesia Journals Over Past 50 Years.

PURPOSE: The impact of academic journals on scientific activity can be measured using different approaches. The aim of this study was to assess the leading anesthesia journals as springboards for new developments in the field of anesthesia. METHODS: The selection of the topics for analysis was based on the degree of increase in the number of articles on a topic that was at the center of specialty interest during 1966-2015. The assessment of a journal's response to a new development was made by measuring the number of initial articles on a related topic. Six leading anesthesia journals were assessed collectively and individually as to whether their responses to new developments were prompt and prominent. RESULTS: The role of the leading specialty journals in presentation of 28 topics related to prominent new developments in anesthesia was found to depend on the nature of topics and the type of articles. Compared with all PubMed journals publishing articles associated with anesthesia in 1966-2015, the six leading anesthesia journals published 43% of drug-related research articles, 30% of technique-related research articles, and 16% of both drug- and technique-related review articles. Regarding initial publications (on new topics), this group of six journals contributed comparably more articles: from 43% to 84% of drug-related research articles, from 30% to 49% of technique-related research articles, from 16% to 33% of drug-related review articles, and from 16% to 25% of technique-related review articles. The approximate doubling of the shares demonstrates the dominance of this group of journals in the swiftness response to new anesthesia developments. The promptness of reaction to new developments in anesthesia of each of the six leading anesthesia journals was assessed (the combination of drug- and technique-related articles) based on the number of articles published among the first (first 5 plus next 30) on all 28 topics. The ranking order of four journals (with the highest number of all 1966-2015 articles) regarding early publications was (from high to low): Anesthesia & Analgesia, British Journal of Anaesthesia, Anesthesiology, and Anaesthesia. CONCLUSION: This study assesses six leading anesthesia journals for their function as springboards for new developments in anesthesia over the past 50 years. The dominance of leading journals in initial publications on 28 drug-related and technique-related topics was clearly demonstrated. The results also indicate the possibility of using promptness of response to new advances for quantitative assessment of this aspect of a journal's contribution to the specialty.

Was Mafeisan an Anesthetic in Ancient China?

According to the Chinese historical books, Records of the Three Kingdoms () and Book of the Later Han (), Hua Tuo (, 140 - 208), a Traditional Chinese medicine (TCM) physician invented Mafeisan, an oral herbal general anesthetic, more than 1800 years ago during Eastern Han Dynasty. However, no written record of ingredients of the original Mafeisan has been found anywhere so far although there have been several similar anesthetic prescriptions published in TCM books later. There has been controversy over the existence of Mafeisan and even Hua Tuo in Chinese literature. We did extensive literature search and analysis, and believe that there indeed was Mafeisan in Hua Tuo's time.

Shifting understandings of labour pain in Canadian medical history.

While pain in childbirth is a universal, cross-cultural, biological reality, individual experiences and perceptions of this pain are historically and culturally specific. At the turn of the 20th century-a key period in terms of both the medicalisation of birth and the professionalisation of obstetrics in the Canadian context-Canadian physicians understood and conceptualised 'birth pangs' in a number of varying (and at times competing) ways. Throughout the 19th century, doctors emphasised the broader utility of pain as a diagnostic tool and a physiologically necessary part of the birthing process. With the advent of anaesthetics, including chloroform and ether, however, a growing subset of the medical profession simultaneously lauded the professional, physiological, and humanitarian benefits of pain relief. By the first decades of the 20th century, shifting understandings of labour pain-and particularly growing distinctions between 'pain' and 'contraction' in mainstream medical discourses-underscored the increasing use of obstetric anaesthesia. Drawing on a broad range of medical texts and professional literature, and focusing on a key historical moment when the introduction and adoption of a new medical technology opened up possibilities for professional debate, this paper unpacks both the micropolitics and the macropolitics of shifting understandings of labour pain in modern Canadian medical history.

William James, Nitrous Oxide, and the Anaesthetic Revelation.

William James greatly influenced the fields of psychology, philosophy, and religion during the late 19th and early 20th centuries. This was the era of Modernism, a time when many writers rejected the certainty of Enlightenment ideals. Positivism, which rose to prominence in the early 19th century, had emphasized physical phenomena, empirical evidence, and the scientific method. Darwin's On the Origin of Species (1859), with its theory of natural selection, provided an explanation for the evolution of species apart from a divine Creator. Within this context, William James served as a "mediator between scientific agnosticism and the religious view of the world." James' own experience inhaling nitrous oxide played an important role in shaping his views. For James, the use of nitrous oxide served a key role in elucidating some of his most central ideas: 1) the value of religion, and the emphasis on mysticism and revelation (as opposed to theology and doctrine) as religion's foundation; 2) the universe as pluralistic (as opposed to absolutist, constant, eternal), driven by chance, experience, and change.

Joseph Jacobs: Apprentice to Crawford W. Long in Athens, GA; Pharmacist and Retailer of Soda Fountain Beverages in Atlanta, GA.

In the 1870s, Joseph Jacobs was employed as an apprentice in the Longs and Billups pharmacy in Athens, GA. Jacobs later established a chain of pharmacies in Atlanta, GA. Coca-Cola was first sold to the public on May 8, 1886, at Jacobs' Pharmacy in the Five Points district of Atlanta, GA. The soda fountain in Jacobs' Pharmacy was owned by Willis E. Venable, who was related to James M. Venable, the first patient etherized by Crawford Long in Jefferson, GA.

Providing Anesthesia in the Oral and Maxillofacial Surgery Office: A Look Back, Where We Are Now and a Look Ahead.

Throughout its development the practice of oral and maxillofacial surgery has been richly associated with the provision of anesthetic services. Dentists and particularly oral and maxillofacial surgeons have advanced the science associated with anesthesia especially in the outpatient setting. This article will look back on the development of anesthesia as it relates to oral and maxillofacial surgery, discuss the current mode of anesthesia in the oral surgeon's practice and look ahead to what innovations are advancing this field.

Luigi Porta's contribution to anesthesia in Europe in the 1800s.

Luigi Porta (1800-1875), an Italian physician who was well known in the field of surgery, played an important role in spreading ethereal anesthesia in Europe. Moreover, he proposed an original method to administer ethereal anesthesia, the Italian method "of the bladder of pig". This paper reminds us of the important role that this physician played in Anesthesiology.

From "Circe's Root" to "Spongia Soporifera": The Role of the Mandrake as True Anesthetic of Ancient Times.

Several ancient authors cited mandrake as a powerful and well-known narcotic drug: from Homer to Dioscorides, from Plato to Aristotle, passing from Hippocrates, Demosthenes, Theophrastus, Celsus, and Apuleius. Their detailed studies included the concrete appearance of the plant, the related recipes including mandrake as essential ingredient, the right dosages, how to administer the obtained medication, and the possible collateral effects. Even in the Middle Ages, the success of this root continued: Isidore of Seville, Theodoric of Cervia, Gilbertus Anglicus, and William from Varignana extensively reported their researches on sponges soaked with mandrake juice, which were used before surgical interventions as soporific tools. This article represents a travelogue among ancient ages to discover the anesthetic properties of the mandrake.

From Dental to Mental Institutions: Did Hypoxic Anesthetics by "Dental Associations" Add More Brain-Injured Patients to America's Insane Asylums?

Though most patients survived the hypoxic challenge, some patients likely suffered asphyxial brain damage from GQ Colton's nitrous-oxide techniques and were admitted to insane or lunatic asylums.

Adoniram Judson Shurtleff: a Tragic Picture of Anesthetic Drug Abuse.

A previously unpublished carte-de-visit depicts Massachusetts dentist Adoniram Judson Shurtleff, who died at 41 years of age while abusing nitrous oxide in 1885.