par De Rood, Monique
Référence Revue médicale de Bruxelles, 33, 3, page (179-187)
Publication Publié, 2012-05
Article révisé par les pairs
Résumé : Man has for a long time searched means of fighting pain, by administration of plant extracts such as poppy seed, jimson weed, henbane, mandrake and alcohol. These substances were given in the form of cataplasms, potions or clysters. Somniferous sponges, applied on the face, were known since Antiquity and have been in use in some countries up to the 13 th century.~ Surgery and pain were inseparable till mid 19 th century. Indications for surgery were few, even though some patients could benefit from these sedative drugs. The anesthetic properties of ether and nitrous oxide (laughing gas), known since the 18th century, were only recognized in the ~19 th century. William Morton, a dentist, was the first to successfully provide general anesthesia with ether in 1846 in Boston. News spread to England shortly afterwards. On the European continent, the first use of ether was due to 2 Belgian surgeons. Next came chloroform as novel anesthetic. They were administered via either a gauze or a mask by the general practitioner, a medical student or a nurse. Unlike England, the use of these drugs for obstetrical anesthesia (called anesthesia "à la reine", alluding to Queen Victoria who benefited from chloroform during childbirth) was never very popular in Belgium. Since the years 1880, the use of cocaine, then of novocaine allowed to perform local anesthesia, then local nerve blocks and spinal anesthesia, installed by the surgeon prior to operating. Since then, surgery experienced rapid progress, Belgium included. During the 1914-1918 first World War, these advances saved many human lives. When general anesthesia was necessary, it was cared for by another physician or a nurse. The interwar period did not see significant advances in anesthesia, except in intravenous anesthesia with barbiturates, appeared in the late 1930's. Intra- and postoperative complications were frequent. Apart from sulfonamides, antibiotics were non-existent. During the war 1940-45, there was no progress in anesthesia and surgery in Belgium. After the Liberation, Belgian doctors specifically trained in anesthesia by the British army, or elsewhere in non-occupied countries, will form the core of a new specialty, "anesthesiology-reanimation", ~who will fight to be recognized as a specialty in itself in Belgium. It will beneficiate from - and largely contribute to - the technical and scientific advances in the medical field. Initially based on clinical symptoms, monitoring and care of operated patients, during and after operation, will beneficiate from modern monitoring and other technical apparatus, which will allow the most audacious surgical technical performances in all domains. Postoperative and intensive care units ~will appear in the years 1960's. Nowadays, anesthesiologists work in all hospital settings, and also organize One-day clinics and Pain clinics. In Belgium, the quality of the clinical and scientific training of anesthesiologists is widely acknowledged, as well as clinical and experimental research.