anesthesia at the year 1001

ANESTHESIA AT THE YEAR 1001

ADNAN ABDALLAH ALMAZROOA

ANESTHESIA DEPARTMENT

FACULTY OF MEDICINE

KING ABDALAZIZ UNIVERSITY

Anesthesia AT 1001

1. Pain relief

2. Anesthesia

3. Resuscitation

1. Pain relief

Graeco Roman era

Islamic era

Graeco Roman era

Celsus 1st century Opium and mandrake.

Galen 2nd century consider it as a dangerous drug used only in colics and very severe pain.

Paulus 7th century didn’t use it in the trochisks acting as anodynes

Graeco Roman era The state of intillctual stagnation prevailed in

Europe in the middle ages , together with the theological doctrine that pain serves God’s purpose and must not be alleviated, it militated

against the improvement in methods of narcosis. There was no standardization of these drugs or regulation of their dosage.

Cumston, Campbell, Nuland, Bickers and Desnos

Islamic Era Ibn Sina , Al Razi, Al Bagdady and IbnElkuff

paid great importance to the Physiology of

pain and its management

– underlying cause

– analgesics

Islamic Era Anaesthetic were considered one of

analgesics.

*wide range of medical plants

*ice or ice cold water

Islamic Era Opium the most powerful Mandrake Papaveris Henbane Hyocyamus Hemlock Solanum Wild lettuce only for insomnia

Islamic Era Pharmacology of Narcotics

– Mode of action

– Potency

– Uses

– Forms

Pharmacology of Narcotics Mode of fraudes

Active ingredients

Specific action

Action on different system

Dose-toxic dose

Antidote

Islamic Era The Muslims were given the credit for

developing the science of Botany, and Ibn El Bitar’s book Al Gami Al Kabir is the most original among the Arabic Materia Medica.

Dickinson 1875, Cumston 1968 & Margotta 1968

Islamic Era“ The medicinal substances found in

Dioscorides in its scientific form is an Islamic creation”

(Cumston 1968)

II . Anaesthesia AL-Hawi fit-tibb Al-Razi

AL-Qanon fit-tibb Ibn Sina

AL-Tasrif Albucasis

AL-Mukhtarat fit-tibb AL-Bagdadi

AL-Omda Fil AL-Jiraha IbnEL-Quff

AL-Tayseer Ibn Zuhr

II . Anaesthesia

Documantation of the use of

ALMURQUID

Anesthesia techniques

Anesthesia personnel

Monitoring

Documentation of the use of ALMURQUID

WAFAITULAIAN

ALBIDAIA WALNIHAIA

DICTIONARIES

SAYED ALKHATER

Al-Murquid

Literally, Al-Murquid in Arabic means:

“drug that induces deep sleep”

BHANJ

TANWIM

Anaesthesia techniques

Al-Murquid

INGESTION

RECTAL

INHALATION

Anaesthesia techniques

Ingestion of the Infusion…

Solanum Canabis Opium Mandrake

Anaesthesia techniques

Rectally on a plug changed hourly…

Canabis Opium Mandrake

Anaesthesia techniques

Inhalation – Odourants of powder of Opium,camphor,roses seeds &mandrake

Spongia Somnifera Opium,mandrake & black poppy

Ellis 1946

Anaesthesia techniques Precisely determined

– Required dose

– Anesthesia duration

One mithkal of Mandrake 3-4 hrs

Ibn Sina

Anaesthesia personnel

–ALTABAAEI (THE PHYSICIAN)

–ALJARAAEHI (THE SURGEON)

THE ANAESTHESIOLOGIST IbnEL-Quff

MONITORING

ALTABAAEI’S finger should be on thepulse while ALJARAAEHI is performingthe surgery.

Intra-operative monitoring by palpation.

III- Resuscitation

Resuscitation team

Upper airway obstruction

Tracheotomy

Use of bellows

Nutrition

Resuscitation

Resuscitation team – ALTABAAEI (THE PHYSICIAN) – ALJARAAEHI (THE SURGEON)– Have been called to resuscitate war

trauma case

Osama Ibn AL-Munquiz

Resuscitation

Management of upper airway obstruction according to Ibn Sina :

1st clearing the secretion

2nd tube to assist breathing

3rd tracheotomy Brendt & Georig

Management of upper airway obstruction

In management of suffocation

– First

Ibn Sina tried coservative meassures including clearing of secretion using a wicker stick covered with a piece of cotton wool

Management of upper airway obstruction

In management of suffocation

- Second

Introduction of a gold or silver tube to the throat to assist breathing

- Third Tracheotomy

Tracheotomy

Aretaeus 2nd century

Aurelinus 4th century didn’t approve

Paulus 7th century only described

Al-Razi 9th century case report

Ibn Sina 10th century spoke favourably

Tracheotomy

Al-Zahrawy 11th century reported succesful management of suicidal cut wound of trachea & concluded it is not dangerous

Ibn Zuhr 12th century detail of animal experiment of performing tracheotomy on Goat that completely recovered

Ibn ElQuff &Al-Bagdadi no reservation ,considered as mode of managing upper a-w obstruction

Resuscitation

Respiratory resuscitation using bellows

Salih Ibn Bahla reported a case of a patient who was pronounced dead , but later on was successfully resuscitated by insufflating air and soap root powder in his nose.

Nutrition

Entral feeding

– Oraly via silver or tin tube gently introduced to the throat

– Rectaly using goat bladder

Ibn Zuhr

Thank you