Skip to main content
SpringerLink
Log in
Book cover

The Wondrous Story of Anesthesia pp 131–138Cite as

Significant Developments in the 1990s

  • Chapter

Abstract

The 1990s advanced safety, control and understanding of clinical anesthesia. Two new, poorly soluble inhaled anesthetics, sevoflurane and desflurane allowed a more precise control over the anesthetic state. Sevoflurane did so without cardiorespiratory stimulation. Both protected the heart from hypoxia. An older anesthetic, isoflurane, could reverse mental depression. We learned that all these anesthetics acted on central pattern generators in the ventral spinal cord to make patients immobile despite ongoing surgery. We also learned that the Meyer-Overton theory correlating lipophilicity and anesthetic potency didn’t always work, indirectly suggesting that inhaled anesthetics operated on proteins. Two new muscle relaxants, recuronium and cis-atracurium added to safety by acting more rapidly and for shorter times.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   189.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

Notes

  1. 1.

    Information may be accessed at update.anaesthesiologists.org/.

References

  1. Muir AW, Houston J, Green KL, Marshall RJ, Bowman WC, Marshall IG. Effects of a new neuromuscular blocking agent (Org 9426) in anaesthetized cats and pigs and in isolated nerve-muscle preparations. Br J Anaesth. 1989;63:400–10.

    Article  CAS  PubMed  Google Scholar 

  2. Wierda JM, de Wit AP, Kuizenga K, Agoston S. Clinical observations on the neuromuscular blocking action of Org 9426, a new steroidal non-depolarizing agent. Br J Anaesth. 1990;64:521–3.

    Article  CAS  PubMed  Google Scholar 

  3. Prielipp RC, Coursin DB, Scuderi PE, Bowton DL, Ford SR, Cardenas VJ Jr., Vender J, Howard D, Casale EJ, Murray MJ. Comparison of the infusion requirements and recovery profiles of vecuronium and cisatracurium 51W89 in intensive care unit patients. Anesth Analg. 1995;81:3–12.

    CAS  PubMed  Google Scholar 

  4. Fleming NW, Chung F, Glass PS, Kitts JB, Kirkegaard-Nielsen H, Gronert GA, Chan V, Gan TJ, Cicutti N, Caldwell JE. Comparison of the intubation conditions provided by rapacuronium (ORG 9487) or succinylcholine in humans during anesthesia with fentanyl and propofol. Anesthesiology. 1999;91:1311–7.

    Article  CAS  PubMed  Google Scholar 

  5. Rajchert DM, Pasquariello CA, Watcha MF, Schreiner MS. Rapacuronium and the risk of bronchospasm in pediatric patients. Anesth Analg. 2002;94:488–93.

    Article  CAS  PubMed  Google Scholar 

  6. Jones RM, Cashman JN, Mant TGK. Clinical impressions and cardiorespiratory effects of a new fluorinated inhalation anaesthetic, desflurane (I-653), in volunteers. Br J Anaesth. 1990;64:11–5.

    Article  CAS  PubMed  Google Scholar 

  7. Wallin RF, Napoli MD, Regan BM. Laboratory investigation of a new series of inhalational anesthetic agents: the halomethyl polyfluoroisopropyl ethers. In: Fink BR, editor. Cellular Biology and Toxicity of Anesthetics. Baltimore: Williams & Wilkins Co; 1972. pp. 286–95.

    Google Scholar 

  8. Wallin RF, Regan BM, Napoli MD, Stern IJ. Sevoflurane: a new inhalational anesthetic agent. Anesth Analg. 1975;54:758–65.

    Article  CAS  PubMed  Google Scholar 

  9. Holaday DA, Smith FR. Clinical characteristics and biotransformation of sevoflurane in healthy human volunteers. Anesthesiology. 1981;54:100–6.

    Article  CAS  PubMed  Google Scholar 

  10. Cook TL, Beppu WJ, Hitt BA, Kosek JC, Mazze RI. A comparison of renal effects and metabolism of sevoflurane and methoxyflurane in enzyme-induced rats. Anesth Analg. 1975;54:829–35.

    Article  CAS  PubMed  Google Scholar 

  11. Hitt BA, Mazze RI, Cook TL, Beppu WJ, Kosek JC. Thermoregulatory defect in rats during anesthesia. Anesth Analg. 1977;56:9–14.

    Article  CAS  PubMed  Google Scholar 

  12. Brown BR Jr. Sevoflurane: introduction and overview. Anesth Analg. 1995;81:S. 1–3.

    Article  Google Scholar 

  13. Yasuda N, Lockhart SH, Eger EI II, Weiskopf RB, Johnson BH, Freire BA, Fassoulaki A. Kinetics of desflurane, isoflurane, and halothane in humans. Anesthesiology. 1991;74:489–98.

    Article  CAS  PubMed  Google Scholar 

  14. Yasuda N, Lockhart SH, Eger EI II, Weiskopf RB, Liu J, Laster M, Taheri S, Peterson NA. Comparison of kinetics of sevoflurane and isoflurane in humans. Anesth Analg. 1991;72:316–24.

    Article  CAS  PubMed  Google Scholar 

  15. Weiskopf RB, Eger EI II, Ionescu P, Yasuda N, Cahalan MK, Freire B, Peterson N, Lockhart SH, Rampil IJ, Laster M. Desflurane does not produce hepatic or renal injury in human volunteers. Anesth Analg. 1992;74:570–4.

    Article  CAS  PubMed  Google Scholar 

  16. Eger EI II, Koblin DD, Bowland T, Ionescu P, Laster MJ, Fang Z, Gong D, Sonner J, Weiskopf RB. Nephrotoxicity of sevoflurane vs. desflurane anesthesia in volunteers. Anesth Analg. 1997;84:160–8.

    CAS  PubMed  Google Scholar 

  17. Higuchi H, Sumita S, Wada H, Ura T, Ikemoto T, Nakai T, Kanno M, Satoh T. Effects of sevoflurane and isoflurane on renal function and on possible markers of nephrotoxicity. Anesthesiology. 1998;89:307–22.

    Article  CAS  PubMed  Google Scholar 

  18. Gonsowski CT, Laster MJ, Eger EI II, Ferrell LD, Kerschmann RL. Toxicity of compound A in rats. Effect of a 3-hour administration. Anesthesiology. 1994;80:556–65.

    Article  CAS  PubMed  Google Scholar 

  19. Gonsowski CT, Laster MJ, Eger EI II, Ferrell LD, Kerschmann RL. Toxicity of compound A in rats. Effect of increasing duration of administration. Anesthesiology. 1994;80:566–73.

    Article  CAS  PubMed  Google Scholar 

  20. Ebert TJ, Muzi M, Lopatka CW. Neurocirculatory responses to sevoflurane in humans. A comparison to desflurane. Anesthesiology. 1995;83:88–95.

    Article  CAS  PubMed  Google Scholar 

  21. Weiskopf RB, Eger EI II, Noorani M, Daniel M. Repetitive rapid increases in desflurane concentration blunt transient cardiovascular stimulation in humans. Anesthesiology. 1994;81:843–9.

    Article  CAS  PubMed  Google Scholar 

  22. Ter Riet MF, De Souza GJA, Jacobs JS, Young D, Lewis MC, Herrington C, Gold MI. Which is most pungent: isoflurane, sevoflurane or desflurane? Br J Anaesth. 2000;85:305–7.

    Article  CAS  Google Scholar 

  23. Rampil IJ, Lockhart SH, Zwass MS, Peterson N, Yasuda N, Eger EI 2nd, Weiskopf RB, Damask MC. Clinical characteristics of desflurane in surgical patients: minimum alveolar concentration. Anesthesiology. 1991;74:429–33.

    Article  CAS  PubMed  Google Scholar 

  24. Weiskopf RB, Eger EI 2nd, Noorani M, Daniel M. Fentanyl, esmolol, and clonidine blunt the transient cardiovascular stimulation induced by desflurane in humans. Anesthesiology. 1994;81:1350–5.

    Article  CAS  PubMed  Google Scholar 

  25. Vickery RG, Sheridan BC, Segal IS, Maze M. Anesthetic and hemodynamic effects of the stereoisomers of medetomidine, an alpha 2-adrenergic agonist, in halothane-anesthetized dogs. Anesth Analg. 1988;67:611–5.

    CAS  PubMed  Google Scholar 

  26. Oliver MF, Goldman L, Julian DG, Holme I. Effect of mivazerol on perioperative cardiac complications during non-cardiac surgery in patients with coronary heart disease: the European Mivazerol Trial (EMIT). Anesthesiology. 1999;91:951–61.

    Article  CAS  PubMed  Google Scholar 

  27. Talke P, Li J, Jain U, Leung J, Drasner K, Hollenberg M, Mangano DT. Effects of perioperative dexmedetomidine infusion in patients undergoing vascular surgery. The Study of Perioperative Ischemia Research Group. Anesthesiology. 1995;82:620–33.

    Article  CAS  PubMed  Google Scholar 

  28. Rigler ML, Drasner K, Krejcie TC, Yelich SJ, Scholnick FT, DeFontes J, Bohner D. Cauda equina syndrome after continuous spinal anesthesia. Anesth Analg. 1991;72:275–81.

    Article  CAS  PubMed  Google Scholar 

  29. Schneider M, Ettlin T, Kaufmann M, Schumacher P, Urwyler A, Hampl K, von Hochstetter A. Transient neurologic toxicity after hyperbaric subarachnoid anesthesia with 5 % lidocaine. Anesth Analg. 1993;76:1154–7.

    Article  CAS  PubMed  Google Scholar 

  30. Pollock JE, Neal JM, Stephenson CA, Wiley CE. Prospective study of the incidence of transient radicular irritation in patients undergoing spinal anesthesia. Anesthesiology. 1996;84:1361–7.

    Article  CAS  PubMed  Google Scholar 

  31. Adverse Reactions with Bupivacaine. FDA Drug Bull. 1983;13:23.

    Google Scholar 

  32. Valenzuela C, Snyders DJ, Bennett PB, Tamargo J, Hondeghem LM. Stereoselective block of cardiac sodium channels by bupivacaine in guinea pig ventricular myocytes. Circulation. 1995;92:3014–24.

    Article  CAS  PubMed  Google Scholar 

  33. Weinberg GL, VadeBoncouer T, Ramaraju GA, Garcia-Amaro MF, Cwik MJ. Pretreatment or resuscitation with a lipid infusion shifts the dose-response to bupivacaine-induced asystole in rats. Anesthesiology. 1998;88:1071–5.

    Article  CAS  PubMed  Google Scholar 

  34. Kapral S, Krafft P, Eibenberger K, Fitzgerald R, Gosch M, Weinstabl C. Ultrasound-guided supraclavicular approach for regional anesthesia of the brachial plexus. Anesth Analg. 1994;78:507–13.

    Article  CAS  PubMed  Google Scholar 

  35. Slogoff S, Keats AS. Does perioperative myocardial ischemia lead to postoperative myocardial infarction? Anesthesiology. 1985;62:107–14.

    Article  CAS  PubMed  Google Scholar 

  36. Mangano DT, Layug EL, Wallace A, Tateo I. Effect of atenolol on mortality and cardiovascular morbidity after noncardiac surgery. Multicenter Study of Perioperative Ischemia Research Group. N Engl J Med. 1996;335:1713–20.

    Article  CAS  PubMed  Google Scholar 

  37. Wallace AW, Galindez D, Salahieh A, Layug EL, Lazo EA, Haratonik KA, Boisvert DM, Kardatzke D. Effect of clonidine on cardiovascular morbidity and mortality after noncardiac surgery. Anesthesiology. 2004;101:284–93.

    Article  CAS  PubMed  Google Scholar 

  38. Cason BA, Gamperl AK, Slocum RE, Hickey RF. Anesthetic-induced preconditioning: previous administration of isoflurane decreases myocardial infarct size in rabbits. Anesthesiology. 1997;87:1182–90.

    Article  CAS  PubMed  Google Scholar 

  39. Zaugg M, Lucchinetti E, Spahn DR, Pasch T, Schaub MC. Volatile anesthetics mimic cardiac preconditioning by priming the activation of mitochondrial KATP channels via multiple signaling pathway. Anesthesiology. 2002;97:4–14.

    Article  CAS  PubMed  Google Scholar 

  40. De Hert SG, Cromheecke S, ten Broecke PW, Mertens E, De Blier IG, Stockman BA, Rodrigus IE, Van der Linden PJ. Effects of propofol, desflurane, and sevoflurane on recovery of myocardial function after coronary surgery in elderly high risk patients. Anesthesiology. 2003;99:314–23.

    Article  CAS  PubMed  Google Scholar 

  41. Parke TJ, Stevens JE, Rice AS, Greenaway CL, Bray RJ, Smith PJ, Waldmann CS, Verghese C. Metabolic acidosis and fatal myocardial failure after propofol infusion in children: five case reports. BMJ. 1992;305:613–6.

    Article  CAS  PubMed  Google Scholar 

  42. Kurz A, Sessler DI, Lenhardt R. Perioperative normothermia to reduce the incidence of surgical-wound infection and shorten hospitalization. Study of Wound Infection and Temperature Group. N Engl J Med. 1996;334:1209–15.

    Article  CAS  PubMed  Google Scholar 

  43. Hopf HW, Hunt TK, West JM, Blomquist P, Goodson WH 3rd, Jensen JA, Jonsson K, Paty PB, Rabkin JM, Upton RA, von Smitten K, Whitney JD. Wound tissue oxygen tension predicts the risk of wound infection in surgical patients. Arch Surg. 1997;132:997–1004. (discussion 1005)

    Google Scholar 

  44. Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system. Washingon, DC: National Academy Press (Institute of Medicine); 2000.

    Google Scholar 

  45. Pronovost P, Jenckes M, Dorman T, Garrett E, Breslow MJ, Rosenfeld BA, Lipsett PA, Bass E. Organizational characteristics of intensive care units related to outcomes of abdominal aortic surgery. J Amer Med Assoc. 1999;281:1310–7.

    Article  CAS  Google Scholar 

  46. Lagasse RS. Anesthesia safety: model or myth? A review of the published literature and analysis of current original data. Anesthesiology. 2002;97:1609–17.

    Article  PubMed  Google Scholar 

  47. Langer G, Neumark J, Koinig G, Graf M, Schoenbeck G. Rapid psychotherapeutic effects of anesthesia with isoflurane (ED narcotherapy) in treatment-refractory depressed patients. NeuropsychoBiology. 1985;14:118–20.

    Article  CAS  PubMed  Google Scholar 

  48. Langer G, Karazman R, Neumark J, Saletu B, Schoenbeck G, Gruenberger J, Dittrich R, Petricek W, hoffmann P, Linzmayer L, Anderer P, Steinberger K. Isoflurane narcotherapy in depressive patients refractory to conventional antidepressant drug treatment. A double-blind comparison with electroconvulsive treatment. NeuropsychoBiology. 1995;31:182–94.

    Article  CAS  PubMed  Google Scholar 

  49. Engelhardt W, Carl G, Hartung E. Intra-individual open comparison of burst-suppression-isoflurane-anaesthesia versus electroconvulsive therapy in the treatment of severe depression. Eur J Anaesthesiol. 1993;10:113–8.

    CAS  PubMed  Google Scholar 

  50. Schwilden H. A general method for calculating the dosage scheme in linear pharmacokinetics. Eur J Clin Pharmacol. 1981;20:379–86.

    Article  CAS  PubMed  Google Scholar 

  51. Raemer DB, Buschman A, Varvel JR, Philip BK, Johnson MD, Stein DA, Shafer SL. The prospective use of population pharmacokinetics in a computer-driven infusion system for alfentanil. Anesthesiology. 1990;73:66–72.

    Article  CAS  PubMed  Google Scholar 

  52. Shafer SL, Varvel JR, Aziz N, Scott JC. Pharmacokinetics of fentanyl administered by computer-controlled infusion pump. Anesthesiology. 1990;73:1091–102.

    Article  CAS  PubMed  Google Scholar 

  53. Glen JB. The development of ‘Diprifusor’: a TCI system for propofol. Anaesthesia. 1998;53 Suppl 1:13–21.

    Article  CAS  PubMed  Google Scholar 

  54. Denson JS, Abrahamson S. A computer-controlled patient simulator. JAMA. 1969;208:504–8.

    Article  CAS  PubMed  Google Scholar 

  55. Gaba DM, DeAnda A. A comprehensive anesthesia simulation environment: re-creating the operating room for research and training. Anesthesiology. 1988;69:387–94.

    Article  CAS  PubMed  Google Scholar 

  56. Cooper JB, Taqueti VR. A brief history of the development of mannequin simulators for clinical education and training. Qual Saf Health Care. 2004;13 Suppl 1:i11–8.

    Article  Google Scholar 

  57. Antognini JF, Schwartz K. Exaggerated anesthetic requirements in the preferentially anesthetized brain. Anesthesiology. 1993;79:1244–9.

    Article  CAS  PubMed  Google Scholar 

  58. Rampil IJ, Mason P, Singh H. Anesthetic potency (MAC) is independent of forebrain structures in the rat. Anesthesiology. 1993;78:707–12.

    Article  CAS  PubMed  Google Scholar 

  59. Koblin DD, Chortkoff BS, Laster MJ, Eger EI II, Halsey MJ, Ionescu P. Polyhalogenated and perfluorinated compounds that disobey the Meyer-Overton hypothesis. Anesth Analg. 1994;79:1043–8.

    Article  CAS  PubMed  Google Scholar 

  60. Franks NP, Lieb WR. Molecular and cellular mechanisms of general anaesthesia. Nature. 1994;367:607–14.

    Article  CAS  PubMed  Google Scholar 

  61. Lysko GS, Robinson JL, Casto R, Ferrone RA. The stereospecific effects of isoflurane isomers in vivo. Eur J Pharmacol. 1994;263:25–9.

    Article  CAS  PubMed  Google Scholar 

  62. Franks NP, Lieb WR. Stereospecific effects of inhalational general anesthetic optical isomers on nerve ion channels. Science. 1991;254:427–30.

    Article  CAS  PubMed  Google Scholar 

  63. Saidman LJ. The 33rd Rovenstine Lecture. What I have learned from 9 years and 9,000 papers. Anesthesiology. 1995;83:191–7.

    Article  Google Scholar 

  64. Fischer SP. Development and effectiveness of an anesthesia preoperative evaluation clinic in a teaching hospital. Anesthesiology. 1996;85:196–206.

    Article  CAS  PubMed  Google Scholar 

  65. Gualtieri AC, Cosentino JP, Becker JS: The California experience with the diversion program for impaired physicians. JAMA. 1983;249:226–9.

    Article  CAS  PubMed  Google Scholar 

  66. Pelton C, Ikeda RM. The California Physicians Diversion Program’s experience with recovering anesthesiologists. J Psychoactive Drugs. 1991;23:427–31.

    Article  CAS  PubMed  Google Scholar 

  67. Paris RT, Canavan DI. Physician substance abuse impairment: anesthesiologists vs. other specialties. J Addict Dis. 1999;18:1–7.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, CA, USA

    Edmond I Eger II MD

  2. Melbourne, VIC, Australia

    Rod N. Westhorpe OAM, MB, BS, FRCA, FANZCA

  3. Departments of Anesthesia, Stanford University, Stanford, CA, USA

    Lawrence J. Saidman MD

Authors
  1. Edmond I Eger II MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rod N. Westhorpe OAM, MB, BS, FRCA, FANZCA
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Lawrence J. Saidman MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Edmond I Eger II MD .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Perioperative Care, University of California, San Francisco, San Francisco, CA, USA

    Edmond I Eger II MD Emeritus Professor

  2. Departments of Anesthesia, Stanford University, Stanford, CA, USA

    Lawrence J. Saidman MD Emeritus Professor

  3. Geoffrey Kaye Museum of Anaesthetic History, Australian and New Zealand College of Anaesthetists, Melbourne, VIC, Australia

    Rod N. Westhorpe OAM, MB, BS FRCA, FANZCA Former Honorary Curator

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Edmond I Eger, MD

About this chapter

Cite this chapter

Eger, E., Westhorpe, R., Saidman, L. (2014). Significant Developments in the 1990s. In: Eger II, E., Saidman, L., Westhorpe, R. (eds) The Wondrous Story of Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-8441-7_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-8441-7_12

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-8440-0

  • Online ISBN: 978-1-4614-8441-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation