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The History of Sedation

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Pediatric Sedation Outside of the Operating Room

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Abstract

The history of induced altered states as a means of tolerating the intolerable is as old as man and for eons has been alternately welcomed, worshipped, and vilified. As in ancient times, these three attitudes continue to often coexist, and our professional duty is to care for and educate our patients and the public and to regulate the effects of our controlled poisoning (The ancient Greek word pharmakon was used for both a remedy and a poison, a continuum with which anesthesiologists are familiar.) to enhance safety while preserving efficacy. While the modern histories of sedation and anesthesia are, and often continue to be, inseparable, particularly for children, this was far from the case for the millennia preceding the mid-nineteenth century, when medical treatments were typically viewed as too harsh, risky, and toxic for children. This chapter will focus on the various modalities and practices over time, emphasizing the differences but remaining in awe of the similarities through the ages.

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Notes

  1. 1.

    The Committee on Drugs of the American Academy of Pediatrics emphasizes that “the state and risks of deep sedation may be indistinguishable from those of general anesthesia.”2 The American Dental Association Council on Education defines general anesthesia to include deep sedation.3 The minimal distinction between deep sedation and general anesthesia has been recognized by the current author as well.4

  2. 2.

    The same name applied to the school for gladiator training.

  3. 3.

    Hibernia is the Latin name for Ireland; its people were the Hiberni.

  4. 4.

    ben (pen; 本 “root”) and cao (tsao; 草 “herb”).

  5. 5.

    The ideogram for “physician” (pronounced i) contained an arrow or a lancet in the upper half and a drug—or bleeding glass—in the lower half.

  6. 6.

    The name mafeisan combines ma (“cannabis; hemp; numbed”), fei (“boiling; bubbling”), and san (“break up; scatter; medicine in powder form”). Ma can mean “cannabis, hemp” and “numbed, tingling.” Other historians have postulated that mandrake or datura was used rather than cannabis, along with the wine. Still others have suggested hashish (bhang) or opium.

  7. 7.

    As related by Plato in Phaedo, Socrates was sentenced to die by drinking poison hemlock (Conium maculatum). Coniline, the biotransformation product post-ingestion, has a chemical structure similar to nicotine, which exerts its inhibitory actions on nicotinic acetylcholine receptors resulting in neuromuscular blockade, respiratory failure, and death.

  8. 8.

    The Greek word carotid means drowsiness, stupor, or soporific—hence the carotid artery is the artery of sleep. Galen incorporated its use as an adjective when he stated, “I abhor more than anybody carotic drugs.”

  9. 9.

    Virgil, Georgics 1. 78

  10. 10.

    As recorded in Fasti, a Roman calendar, 4:661

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Author information

Authors and Affiliations

  1. Department of Anesthesiology, Critical Care and Pain Medicine, Boston Children’s Hospital, Boston, MA, USA

    Robert S. Holzman

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  1. Robert S. Holzman
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Correspondence to Robert S. Holzman .

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Editors and Affiliations

  1. Department of Anesthesiology, Harvard Medical School, Boston, MA, USA

    Keira P. Mason, MD

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Holzman, R.S. (2021). The History of Sedation. In: Mason, MD, K.P. (eds) Pediatric Sedation Outside of the Operating Room. Springer, Cham. https://doi.org/10.1007/978-3-030-58406-1_1

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  • DOI: https://doi.org/10.1007/978-3-030-58406-1_1

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