Major anesthetic themes in the 1950s

Abstract

The effects of World War II accelerated'and retarded'the rise of modern anesthesia. It arrested development in Europe, the USSR, and Asia, but hastened development in the US. The recruitment (drafting) of physicians into the US Armed Services for a brief period of training in anesthesia, followed by a mandated practice of anesthesia, caused this acceleration. Physicians forced to learn and practice anesthesia often discovered that the calling pleased them. Succinylcholine became available in 1951. Perhaps the most important advance of the 1950s arose from Bjorn Ibsen's management of the 1952 polio epidemic in Copenhagen. His work led to the establishment of Intensive Care Medicine and Intensive Care Units, and to the development of ventilators and blood-gas analysis. The World Federation of Societies of Anaesthesiologists was founded in 1955. The advances in fluorine chemistry, needed to develop the atomic bomb paved the way for Suckling's synthesis of the inhaled anesthetic halothane. Released for clinical use in 1956, halothane soon displaced essentially all its predecessors. Important to the safe delivery of halothane, our ability to control the delivery of inhaled anesthetics increased enormously with the invention of the Copper Kettle and variable bypass vaporizers. Muscle relaxants were first used in humans in 1942. In 1954 Beecher and Todd's outcomes research indicated that muscle relaxants could be a mixed blessing if not managed properly, if their residual effects were not reversed. In the 1950s we had two new drugs in addition to halothane'succinylcholine and chloroprocaine. Beecher successfully argued for the use of placebo-controlled experimentation, for the use of informed consent, and ultimately for the establishment of Institutional Review Boards (IRBs). Finally, in 1959, Webb and Graves reported their results with the first modern outpatient anesthesia.