Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1016/j.bjane.2021.02.017
Brazilian Journal of Anesthesiology
Narrative Review

Historical development of the anesthetic machine: from Morton to the integration of the mechanical ventilator

Desenvolvimento histórico do aparelho de anestesia: de Morton à integração do ventilador mecânico

Pablo Romero-Ávila, Carlos Márquez-Espinós, Juan R. Cabrera Afonso

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Abstract

The first anesthetic machines appeared following their public demonstration by Morton in 1846. These initial devices were simple inhalers based on the evaporation of the anesthetic agent. Their main problem was the loss of effectiveness with cooling. More complex inhalers were subsequently developed, in which the main difference was the possibility to provide more than one agent. Moreover, the concentration of the inhaled anesthetic was regulated for greater efficiency. At the beginning of the twentieth century, gas machines emerged, allowing the application of an anesthetic flow independent of the patient’s inspiratory effort. These machines incorporated technological advances such as flow meters, carbon dioxide absorption systems and fine adjustment vaporizers. In this period, in the field of thoracic surgery, intraoperative artificial ventilation began to be employed, which helped overcome the problem of pneumothorax associated with open pleura by applying positive pressure. From the 1930s, the gas machines were fitted with a ventilator, and by the 1950s this had become a basic component of the anesthesia system. Later still, in the 1980s, alarm and monitoring systems were incorporated, giving rise to the current generation of workstations.

Keywords

Anesthetic machine;  Mechanical ventilator;  Vaporizers;  Safety monitoring;  Modern history medicine

References

1 S.G. Venticinque, J.J. Andrews Anestesia Inhalatoria. Sistemas de Administración R.D. Miller, N.H. Cohen, L.I. Eriksson, et al. (Eds.), Miller. Anestesia (8th ed.), Elsevier, Barcelona (2016), pp. 752-820

2 M. Soro, F.J. Belda, J. Llórens, et al. Estructura de los Equipos de Anestesia F.J. Belda, J. Llórens (Eds.), Ventilación Mecánica en Anestesia y Cuidados Críticos, Arán, Madrid (2009), pp. 313-349

3 V.P. Patil, M.G. Shetmahajan, J.V. Divatia The modern integrated anaesthesia workstation Indian J Anaesth., 57 (2013), pp. 446-454

4 P.W. Thompson, D.J. Wilkinson Development of anaesthetic machines BJA., 57 (1985), pp. 640-648

5 R. Anaya-Prado, D. Schadegg-Peña Crawford Williamson Long: The True Pioneer of Surgical Anesthesia J Invest Surg., 28 (2015), pp. 181-187

6 A.C. King History and development of anaesthetic apparatus BMJ., 2 (1946), pp. 536-539

7 H.J. Bigelow Insensibility during surgical operations produced by inhalation Boston Med Surg J., 35 (1846), pp. 309-317

8 R.P. Haridas, G.S. Bause Correspondence by Charles T. Jackson containing the earliest known illustrations of a Morton ether inhaler Anesth Analg., 117 (2013), pp. 1236-1240

9 B.M. Duncum The Development of Inhalation Anaesthesia Oxford University Press, London (1947), pp. 131-134

10 J. Snow On the Inhalation of Vapors of Ether in Surgical Operations. Containing a Description of the Various Stages of Etherization and a Statement of the Results of Nearly Eighty Operations in Which Ether Has Been Employed at St. George’s and University College hospitals John Churchill, London (1847), pp. 1-15

11 J.Y. Simpson On a new anaesthetic agent, more efficient than sulphuric ether The Lancet., 50 (1847), pp. 549-550

12 A. Franco Grande, J. Álvarez Escudero, J. Cortés Laíño El Aparato de Anestesia en España. Aspectos Tecnológicos y Evolución Durante los Primeros 100 años de la Moderna Anestesia A. Franco Grande, J. Álvarez Escudero, J. Cortés Laíño (Eds.), Historia de la Anestesia en España 1847 – 1940, Arán, Madrid (2005), pp. 287-307

13 G.B. Rushman, N.J.H. Davies, R.S. Atkinson A Short History of Anaesthesia. The First 150 Years Butterworth Heinemann, Oxford (1996), p. 28

14 A.E. Sansom Chloroform: Its Action and Administration Churchill, London (1865)

15 F.E. Junker Description of a new apparatus for administering narcotic vapours Med Tim Gaz., 2 (1867), p. 590

16 J.T. Clover Chloroform accidents Br Med J., 8 (1871), p. 33

17 J. Lister Chlorofor Accidents Br Med J., 2 (1871), pp. 117-119

18 C.M. Nuñez The evolution of anesthesia machine Bull Anesth Hist., 15 (1996), pp. 12-15

19 A. Franco Grande, J. Álvarez Escudero, J. Cortés Laíño Historia de la Anestesia por el Óxido Nitroso A. Franco Grande, J. Álvarez Escudero, J. Cortés Laíño (Eds.), Historia de la Anestesia en España 1847 – 1940, Arán, Madrid (2005), pp. 275-281

20 W.D.A. Smith A history of nitrous oxide and oxygen anaesthesia. Part X: the early manufacture, storage and purity of nitrous oxide BJA., 39 (1967), pp. 351-381

21 J.A. Dorsch, S.E. Dorsch Anaesthesia Machines and Breathing Systems: An Evolutionary Success Story Eger-I.I. EI, L.J. Saidman, R.N. Westhorpe (Eds.), The Wondrous Story of Anaesthesia, Springer, New York (2014), pp. 703-714

22 J.T. Clover On an apparatus for administering nitrous oxide gas and ether, singly or combined Br Med J., 2 (1876), pp. 74-75

23 J.T. Clover Portable regulating ether inhaler Br Med J., 1 (1877), pp. 69-70

24 R.S. Atkinson, T.B. Boulton Clover’s portable regulating ether inhaler (1877). A notable one hundredth anniversary Anaesthesia., 32 (1977), pp. 1033-1036

25 F.W. Hewitt Anaesthetic and their administration Robinson, London (1893)

26 F.W. Hewitt The Administration of Nitrous Oxide and Oxygen for Dental Operations Ash & Son, London (1897)

27 F.W. Hewitt Further observations on the Use of Oxygen with Nitrous Oxide J Brit Dent Assn., 15 (1893), pp. 380-387

28 H.G. Epstein, A.R. Hunter Anaesthetic apparatus. A Pictorial Review of the Development of the Modern Anaesthetic Machine BJA., 40 (1968), pp. 636-647

29 F.X. Whalen, D.R. Bacon, H.M. Smith Inhaled anesthetics: an historical overview Best Pract Res Clin Anaesthesiol., 19 (2005), pp. 323-330

30 G. Edwards Frederic William Hewitt (1857-1916) Ann R. Coll Surg Engl., 8 (1951), pp. 233-245

31 The Roth-Drager oxygen and chloroform apparatus Br Med J., 1 (1907), pp. 1067-1068

32 M. Goerig The Development of Anaesthesiology in German-Speaking Countries Eger-I.I. EI, L.J. Saidman, R.N. Westhorpe (Eds.), The Wondrous Story of Anaesthesia, Springer, New York (2014), pp. 371-390

33 M.H. Davison, L. Essex, E.A. Pask Older methods of the vaporisation of liquid anaesthetics Anaesthesia., 18 (1963), pp. 302-310

34 K.B. Thomas The development of Anaesthetic Apparatus. A History based on the Charles King Collection of the Association of anaesthetists of Great Britain and Ireland Blackwell Scientific Publications, Oxford (1975)

35 D. Zuck The development of the anaesthetic vaporizer. The contribution of A.G. Levy Anaesthesia., 43 (1988), pp. 773-775

36 L. Ombrédanne Un Appareil pour l’anesthésie par l’éther Gaz des Hopitaux., 81 (1908), p. S1095

37 A. Thierbach Franz Kuhn, his contribution to anaesthesia and emergency medicine Resuscitation., 48 (2001), pp. 193-197

38 M. Goerig, J. Schulte am Esch History of nitrous oxide—with special reference to its early use in Germany Best Pract Res Clin Anaesthesiol., 15 (2001), pp. 313-338

39 E.I. McKesson Nitrous oxyde-oxygen Anaesthesia. With a description of a new apparatus Surg Gynecol Obstet., 13 (1911), pp. 456-462

40 F.J. Cotton, W.M. Boothby Intratracheal Insufflation Anaesthesia: Considered from its Physiological and Clinical Aspects Ann Surg., 57 (1913), pp. 43-63

41 G.S. Bause The Cotton-Boothby apparatus Anesthesiology., 111 (2009), p. 708

42 D.K. Cope James Tayloe Gwathmey: Seeds of a Developing Specialty Anesth Analg., 76 (1993), pp. 642-647

43 New inventions The Gwathmey gas oxygen apparatus The Lancet., 188 (1916), p. 607

44 C.M. Ball The Foregger Midget. A Machine that Traveled Anesthesiology., 119 (2013), pp. 1023-1030

45 D.E. Jackson A New Method for the Production of General Anesthesia and Anesthesia With a Description of the Apparatus Used Anesth Analg., 50 (1971), pp. 181-189

46 F.E. Shipway The advantages of warm anaesthetic vapours, and an apparatus for their administration The Lancet., 187 (1916), pp. 70-74

47 C. Gurudatt The basic anaesthesia machine Indian J Anaesth., 57 (2013), pp. 438-445

48 O.M. Watt The evolution of the Boyle apparatus, 1917-67 Anaesthesia, 23 (1968), pp. 103-118

49 N.H. Metcalfe Sir Geoffrey Marshall (1887–1982): respiratory physician, catalyst for anaesthesia development, doctor to both Prime Minster and King, and World War I Barge Commander J Med Biogr., 19 (2011), pp. 10-14

50 R.M. Waters, E.A. Rovenstine, A.E. Guedel Endotracheal Anesthesia and Its Historical Development Anesth Analg., 12 (1933), pp. 196-203

51 G. McLachlan Sir Ivan Magill KCVO, DSc, MB, BCh, BAO, FRCS, FFARCS (Hon), FFARCSI (Hon), DA, (1888-1986) Ulster Med J., 77 (2008), pp. 146-152

52 R.M. Waters Clinical scope and utility of carbon dioxide filtration anesthesia Anesth Analg., 3 (1924), pp. 20-22

53 B.C. Sword The Closed Circle Method of Administration of Gas Anesthesia Anesth Analg., 9 (1930), pp. 198-202

54 M.Z. Unzueta-Merino Influencia de la escuela de Oxford en el desarrollo de la Anestesiología moderna en España: La huella de Robert Macintosh PhD thesis, Universidad Autónoma de Barcelona (1999)

55 H.G. Epstein, R. Macintosh An anaesthetic inhaler with automatic thermo-compensation Anaesthesia., 11 (1956), pp. 83-88

56 L.E. Morris A new vaporizer for liquid anesthetic agents Anesthesiology., 13 (1952), pp. 587-593

57 N.R. Srinivasa Copper Kettle Revisited Anesthesiology., 104 (2006), pp. 881-884

58 D.W. Hill Halothane concentrations obtained with a Dräger “Vapor” vaporizer BJA., 35 (1963), pp. 285-289

59 D.J. Wilkinson Evolution of the Anesthesia Machine Curr Anaesth Crit Care., 2 (1991), pp. 51-56

60 W.W. Mushin, L. Rendell-Baker The principles of Thoracic Anaesthesia. Past and Present Blackwell Scientific Publications, Oxord (1953)

61 C. Chopin L´histoire de la ventilation mécanique: des machines et des hommes Réanimation., 16 (2007), pp. 4-12

62 R. Yano, J.A. Gonzalo, M. Fernández Historia de la ventilación mecánica A. González, J.A. Gonzalo, A. Del Blanco (Eds.), Manual de ventilación mecánica en medicina intensiva, anestesia y urgencias, Imprenta Gofer, Oviedo (2005), pp. 1-9

63 S.M. Cherian, R. Nicks, R.S. Lord Ernest Ferdinand Sauerbruch: Rise and fall of the piooner of thoracic surgery World J Surg., 25 (2001), pp. 1012-1020

64 T. Tuffier, L. Hallion Respiration artificielle par insufflations pulmonaire dans certaines operations intrathoraciques Gaz Hebd Med Chir., 43 (1896), p. 1131

65 T. Tuffier, L. Hallion Operations intrathoraciques avec respiration artificielle par insufflation C R Soc BioI., 48 (1896), pp. 951-954

66 T. Tuffier, L. Hallion Sur la régulation de la pression intra-broncrique et de la narcose dans la respiration artificielle par insufflation C R Soc BioI., 48 (1896), pp. 1086-1088

67 H. Milton Mediastinal Surgery Lancet., 1 (1897), pp. 872-875

68 L.R. Hutson Jr., C.A. Vachon Dr. Rudolph Matas: innovator and pioneer in anesthesiology Anesthesiology., 103 (2005), pp. 885-889

69 R. Matas Intralaryngeal insufflation JAMA. (1900), pp. 1468-1473

70 R. Matas Artificial respiration by direct intralaryngeal intubation with a modified O’Dwyer tube and a new graduated air-pump, in its applications to medical and surgical practice Am Med. (1902), pp. 1-2

71 N.W. Green, H.H. Janeway Artificial respiration and intrathoracic oesophageal surgery Ann Surg., 52 (1910), pp. 58-66

72 J.S. Somerson, M.R. Sicilia Historical perspectives on the development and use of mechanical ventilation AANA J., 60 (1992), pp. 83-94

73 E.T. Moerch Controlled Respiration by Means of Special Automatic Machines as Used in Sweden and Denmark Anaesthesia., 3 (1948), pp. 4-11

74 J.B. Brodsky, H.J. Lemmens The history of anesthesia for thoracic surgery Minerva Anestesiol., 73 (2007), pp. 513-524

75 H. Rosenberg, J.K. Axelrod Ernst Trier Mørch: Inventor, Medical Pioneer, Heroic Freedom Fighter Anesth Analg., 90 (2000), pp. 218-221

76 A.G. McKenzie The inventions of John Blease BJA., 85 (2000), pp. 928-935

77 W.W. Mushin, L. Rendell-Baker Modern Automatic Respirators BJA., 26 (1954), pp. 131-147

78 A.E. Bennet The History of the Introduction of Curare Into Medicine Anesth Analg., 47 (1968), pp. 484-492

79 A.S. Slutsky History of Mechanical Ventilation. From Vesalius to Ventilator -induced Lung injury Am J Respir Crit Care Med., 191 (2015), pp. 1106-1115

80 J. Haupt The History of Anesthesia at Dräger Lübeck: Dräger Druck, Hamburg (2014)

81 P. Scheiber Anaesthesia Equipment. Performance, Classification and Safety Springer-Verlag, Berlin (1972)
 

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