History reflected in the evolving approaches to anesthesia for a patient undergoing cholecystectomy

Abstract

The evolving nature of modern anesthesia shows the progression of drugs used (inhaled anesthetics, induction agents, anxiolytics, opioids, neuromuscular blocking drugs), the means of their delivery (for both injected and inhaled agents), approaches to anesthetic and surgical practice (in patient vs. out patient; long stay vs. short stay), control over the anesthetic state and postoperative pain, and means to manage the airway and postoperative nausea and vomiting. They hint at the evolution of patient, surgeon, and anesthetist and the interactions among the three. But beyond surface appearances, they do not show the profound changes wrought in the quality and education of the anesthetist and surgeon, the improvement in outcomes, the amazing decreases in mortality and morbidity. They do not consider the implications of those changes to the future of the specialty.