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The History of Opioid Use in Anesthetic Delivery

  • Chapter
The Wondrous Story of Anesthesia

Abstract

“Opioids” relieved pain for 6,000 years. In 1805, Serturner isolated morphine from opium. In the last half of the nineteenth century, morphine pre-anesthetic medication shortened induction and decreased anesthetic requirement.

Several new opioids were synthesized between World Wars I and II. In 1942, the opioid antagonist nalorphine was synthesized. Using meperidine as a template, Janssen produced fentanyl in 1960, adding sufentanil and carfentanil in 1974 and alfentanil in 1976. In the late 1980s, Glaxo synthesized remifentanil. In the mid twentieth century, opioids were combined with sedatives, tranquilizers, and other drugs to produce “neuroleptanalgesia”, “neuroleptanesthesia”, and “artificial hibernation”. One form of this theme combined small doses of morphine and then fentanyl with halothane-nitrous oxide anesthesia in the 1950s and 1960s.

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Notes

  1. 1.

    In retrospect, we know that they got it backwards. Morphine penetrates more slowly than meperidine. But the rationale doesn’t matter to the end result.

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Stanley, T. (2014). The History of Opioid Use in Anesthetic Delivery. 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_48

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