Paweł Radkowski, Aleksandra Czajka, Justyna Dawidowska-Fidrych, Małgorzata Braczkowska-Skibińska
Past, present and future of intravenous anesthetics
2024-07-25
The purpose of this article is to present historical background of the expansion of knowledge about the use of intravenous anesthetics.
One of the most important drugs used in modern anesthesiology are intravenous anesthetics. Their history dates back to the 17th century, when science was revolutionized by William Harvey’s discovery, which laid the foundation for the scientific explanation of blood circulation. The human blood circulation system was described by an English physician and anatomist in 1628. Harvey explained the relationship between the venous and arterial blood systems and also described regular contractions of the heart, which changed previous theories. That discovery also led to the first blood transfusions, experiments with intravenous injections, and the invention of the first syringe. Before syringes officially appeared in the 19th century, experiments related to that field were already being conducted. At that time, other techniques, such as variolation, were used. Dried smallpox scabs were blown into the nose of a patient, who then contracted a mild form of the disease. Besides blood, other substances were administered into the human patients’ circulatory systems. Johann Sigismund Elsholtz was the first in history to use opium injections into human veins. Further development of intravenous anesthetics took place in the 19th century, thanks to the invention of the hypodermic syringe. Since 1864, when barbiturates were first synthesized by Adolf von Baeyer, the branch of pharmacology related to intravenous anesthetics has been continuously evolving. Thanks to the nearly 400 year-old history of intravenous administration of drugs, including anesthetics, it is now possible to safely perform both short diagnostic procedures and complex, life saving surgeries. Throughout the years, the main goal of scientists creating new drugs was to increase their safety and effectiveness by minimizing their side effects. The goal has possibly been achieved with propofol, which is still considered a nearly ideal anesthetic that gained widespread recognition ever since it was introduced into clinical practice.
Nowadays, new intravenous anesthetics, like remimazolam, are being constantly developed. Other drugs, like ciprofol and phaxan, currently in clinical trials, are described as promising thanks to their minimized side effects.
Keywords: history of anesthesiology, history of medicine, history of intravenous anesthetics, discovery of blood circulation, drug discovery.
© Farm Pol, 2024, 80(3): 165–171