What did people do before anesthesia? - Sally Frampton

Prevodilac: Ivana Šimšić Lektor: Milenka Okuka

With medical students restraining the patient and onlookers eagerly awaiting,

Dok su studenti medicine držali pacijenta, a posmatrači željno iščekivali,

Scottish surgeon Robert Liston poised himself to begin.

škotski hirurg Robert Liston spremao se da počne.

In quick succession, he cut his patient’s flesh,

Brzim pokretima je testerom sekao nogu svog pacijenta,

sawed through their tibia and fibula and, within just a few minutes,

isekavši goleničnu i lisnu kost, i posle samo nekoliko minuta,

the amputation was complete.

amputacija je bila završena.

It was the 1830s and Liston was renowned for his surgical speed.

To je bilo 1830-ih godina, a Liston se proslavio brzinom kojom je operisao.

This was important because, before anesthesia was widely used,

Ovo je bilo važno, jer pre nego što je anestezija bila u širokoj upotrebi,

patients had to consciously endure every moment of surgery.

pacijenti su u svesnom stanju morali da pretrpe celu operaciju.

The quest for anesthetics that could induce unconsciousness

Potraga za anesteticima koji bi doveli do gubitka svesti

and enable more meticulous surgeries launched long before Liston.

i omogućili preciznije operacije počela je mnogo pre Listona.

Around 200 CE, Chinese physician Hua Tuo described mixing alcohol

Oko 200. godine nove ere, kineski lekar Hua Tuo opisao je korišćenje mešavine

with a powder of various ingredients to anesthetize patients.

alkohola i praška napravljenog od raznih sastojaka za anesteziranje pacijenata.

And 13th century Arab surgeon Ibn al-Quff described patients taking anesthetics,

A u 13. veku, arapski hirurg Ibn al-Kaf je opisao kako pacijenti uzimaju anesteziju,

likely inhaling drugs like cannabis, opium, and mandrake,

uglavnom udišući narkotike kao što su kanabis, opijum i mandragora

from saturated sponges.

sa natopljenog sunđera.

By the end of the 1700s, many scientists were pondering

Već krajem 18. veka, mnogi naučnici su razmišljali

chemistry’s medical applications.

kako da primene hemiju u medicini.

This led to a profusion of anesthetic advancements involving three main players:

To je dovelo do velikog napretka na polju anestetika,

a posebno su se izdvojili azot-suboksid, etar i hloroform.

nitrous oxide, ether, and chloroform.

In 1799, English chemist Humphry Davy began experimenting with nitrous oxide,

Godine 1799, engleski hemičar Hamfri Dejvi eksperimentisao je sa azot-suboksidom,

or laughing gas— inhaling it himself and observing its effects on friends.

iliti gasom smejavcem — sam ga je udisao, a i posmatrao kako deluje na prijatelje.

Davy noted that its pain-relieving abilities might make it useful

Dejvi je primetio da njegova sposobnost ublažavanja bola može da bude korisna

for surgical operations—

za operacije —

but it would be decades before that happened.

ali proći će decenije dok se to ne dogodi.

This was, at least in part, because some surgeons and patients

Za to su delom bili zaslužni neki hirurzi i pacijenti,

were skeptical of the effectiveness and safety of anesthetic drugs.

koji su sumnjali u efikasnost i bezbednost korišćenja anestetika.

In 1804, Japanese surgeon Seishū Hanaoka successfully removed a breast tumor

Godine 1804, japanski hirurg Seišu Hanaoka uspešno je uklonio tumor dojke

from a patient anesthetized with a mix of medicinal herbs.

pacijentkinji anesteziranoj mešavinom lekovitog bilja.

But the news stayed in Japan indefinitely.

Međutim, ova vest je do daljnjeg ostala u Japanu.

Eventually, ether started garnering medical attention.

Najzad, etar je privukao pažnju u oblasti medicine.

It was first formulated centuries before then came to be used recreationally.

Formulisan je vekovima pre toga, a onda je počeo da se koristi rekreativno.

During the so-called “ether frolics” of the early 1800s,

Tokom takozvanih etarskih zabava koje su se održavale početkom 19. veka,

an American physician noted that the fall he suffered

jedan američki lekar je primetio da nije osetio bol pri padu

while using ether was painless.

dok je bio pod uticajem etra.

In 1842, he etherized a patient and successfully removed

Godine 1842, koristio je etar na pacijentu i uspešno uklonio tumor sa njegovog vrata.

a tumor from his neck.

In the meantime, dentists finally began recognizing nitrous oxide’s promise.

U međuvremenu, zubari su napokon počeli da prihvataju korisnost azot-suboksida.

But, in 1845, when an American dentist attempted a public tooth extraction

Ali, 1845. godine, kada je pred publikom jedan američki zubar pokušao da izvadi zub

on someone anesthetized with nitrous oxide,

nekome pod anestezijom izazvanom azot-suboksidom,

he apparently encountered a setback when his patient screamed.

izgleda da je naišao na prepreku kada je taj pacijent zavrištao.

It was probably just an insufficient dose—

Verovatno je bila u pitanju samo nedovoljna doza —

but it was a bad publicity moment for the drug.

ali to je bio loš publicitet za taj lek.

Meanwhile, dentists refined ether for tooth extractions.

U međuvremenu, zubari su usavršili korišćenje etra za vađenje zuba.

And, in October 1846, an American dentist administered ether to a patient,

I u oktobru 1846. godine, jedan američki zubar je pacijentu dao etar,

and a surgeon removed the man’s neck tumor.

dok je hirurg uklonio tumor sa njegovog vrata.

Two months later, Liston himself performed an upper leg amputation

Dva meseca kasnije, Liston je i sam izvršio amputaciju noge

on an etherized patient,

na pacijentu koji je bio pod uticajem etra,

who reportedly regained consciousness minutes after

i koji je navodno povratio svest nekoliko minuta nakon toga

and asked when the procedure would begin.

i pitao kada će početi sa procedurom.

Further ether-enabled successes followed from India, Russia, and beyond.

Dalji uspesi sa korišćenjem etra dolazili su iz Indije, Rusije, i drugih država.

But ether had issues, including unpleasant side effects.

Ali etar je imao i loših strana, uključujući neželjena dejstva.

Scottish obstetrician James Simpson heard about an alternative anesthetic

Škotski akušer Džejms Simpson čuo je za drugi anestetik

called chloroform.

pod nazivom hloroform.

And, in 1847, he and two colleagues decided to try some themselves

I 1847. godine, on i dvojica kolega odlučili su da ga sami probaju

and promptly passed out.

i smesta su se onesvestili.

Soon after, Simpson administered chloroform

Ubrzo nakon toga, Simpson je koristio hloroform

to one of his patients during childbirth.

na jednoj pacijentkinji tokom porođaja.

It quickly gained popularity because it was fast-acting

Postao je veoma popularan jer je brzo delovao

and thought to be side-effect-free—

i mislilo se da nema neželjenih dejstava—

though we now know it’s harmful and probably carcinogenic.

iako sada znamo da je štetan i verovatno karcinogen.

Because anesthetics weren’t yet fully understood,

Pošto anestetici nisu bili istraženi u potpunosti,

they sometimes had lethal consequences.

ponekad su imali smrtonosne posledice.

And some doctors held sexist and racist beliefs that dictated

Neki doktori su imali seksistička i rasistička uverenja prema kojima

the amount of anesthesia they’d provide, if any at all.

su određivali količinu anestezije koju će dati, ako bi je uopšte i davali.

American obstetrician Charles Meigs argued that the pain of childbirth

Američki akušer Čarls Migz tvrdio je da su porođajni bolovi

was a form of divine suffering

oblik uzvišene patnje

and was skeptical that doctors should interfere with it.

i bio je sumnjičav prema tome da doktori treba da se mešaju u to.

Throughout the 1840s, American physician James Marion Sims

Tokom 1840-ih, američki lekar Džejms Marion Sims

conducted experimental gynecological surgeries without pain relief,

izvodio je eksperimentalne ginekološke operacije bez lekova protiv bolova,

primarily upon enslaved Black women.

najviše na porobljenim crnkinjama.

By the late 19th century, those who could access anesthetics

Do kraja 19. veka, oni koji su imali pristup anesteticima

were undergoing increasingly complex operations,

bili su podvrgavani sve komplikovanijim operacijama,

including some that were previously impossible.

uključujući i neke koje su ranije bile nemoguće.

Chloroform came to be understood as a riskier, more toxic option,

Hloroform je počeo da se smatra rizičnijom i opasnijom opcijom,

and fell out of favor by the early 1900s.

te je do početka 20. veka izašao iz upotrebe.

Alongside newer drugs, ether and nitrous oxide are still used today—

Pored novijih lekova, etar i azot-suboksid se koriste i danas—

but in modified formulations that are safer and produce fewer side effects,

ali u drugačijim formulacijama koje su bezbednije i sa manje neželjenih dejstava,

while doctors closely monitor the patient’s state.

dok lekari pažljivo prate stanje pacijenta.

Thanks to these advances,

Zahvaljujući ovim naprecima,

speed is not always of the essence and, instead of acute agony,

brzina operacije nije uvek od suštinskog značaja, a umesto u stalnoj agoniji,

surgery can feel like just a dream.

operacija može da protekne i samo kao u snu.