MORTALITY RELATED TO ANESTHESIA

The first report of the delivery of anesthesia (ether) for an operative procedure was in 1846. Only 2 years later, there was a report of a death attributable to anesthesia.^[41] In that report, Hannah Greener died on induction with chloroform. Since that time, there have been numerous investigations into the cause of anesthesia-related death. The first formal investigation of anesthesia-related deaths was published by John Snow in 1858.^[42] Snow analyzed 50 cases of death during chloroform anesthesia. At that time, mortality occurred principally in healthy patients undergoing minor procedures, suggesting that anesthesia was the principal cause of mortality. Subsequent studies reported deaths of patients with significant comorbidities undergoing major surgical procedures; in these cases, the cause of mortality was frequently multifactorial.

Surgery without Anesthesia

Surgical procedures were carried out before the introduction of anesthetics. The key to success was the speed of the procedure, with successful amputations lasting only 30 seconds. Strong assistants and restraints were frequently required. Alternatively, decreased cerebral perfusion by means of bilateral carotid compression was used to decrease sensation during the procedure. Surgical procedures were associated with significant risk of death and, at a minimum, were associated with severe pain. The development of anesthesia has been heralded as one of the great advances of modern medicine because it allowed surgery to advance.