A history of intravenous anesthesia

Abstract

Wren began intravenous (IV) anesthesia in 1656, using a goose quill and a bladder to inject wine and ale into a dog's vein. Invention of the hollow needle in 1843 and the hypodermic syringe in 1853 allowed IV administration of drugs. By the 1900s, diverse drugs, including ether, had been given IV for sedation. Redonnet made the first IV barbiturate, Somnifen, in 1920. Weese and Scharpff synthesized the short-acting hexobarbital in 1932, but the introduction of thiopental by Lundy and Tovell in 1934 provided the greater advance, dominating induction of anesthesia for the next half century. Price suggested in 1960 that thiopental redistribution from brain to muscle, rather than to fat, explained the rapid awakening from thiopental. This work underlay many subsequent pharmacokinetic and pharmacodynamic concepts. Thiopental decreased cerebral metabolism and cerebral blood flow, leading to its use in the 1970s to protect the brain from hypoxic insult. Methohexital, a shorter-acting barbiturate with central nervous system-stimulating properties, was introduced in 1956 and remains a popular anesthetic for electroconvulsive therapy (ECT).