Desde el punto de vista que trataremos en este artículo, podemos considerarnos afortunados de haber nacido en estos tiempos. El uso de la anestesia, tal y como la conocemos actualmente, es relativamente reciente respecto al estudio de la medicina general. Sin embargo, disminuir la sensibilidad y menguar el dolor es algo que la humanidad lleva persiguiendo mucho más tiempo.
Aunque la elaboración de la anestesia como fármaco químico se remonta al siglo XIX, existe una larga historia que podríamos considerar antes incluso que la Grecia Antigua, de donde se deriva su nombre.
Los antecedentes de la anestesia y los paliativos que se empleaban en otras civilizaciones
El término anestesia tiene su origen en el griego, donde el prefijo an significa «sin» y la palabra aesthesis significa «sensación». En conjunto, «pérdida de la sensibilidad».
Si nos atenemos a la historia, encontraremos las primeras menciones a la anestesia en la obra Timeo de Platón. En un brevísimo recorrido por la evolución de esta rama de la medicina existen luces y sombras. Desde descubrimientos trascendentales hasta prácticas oscuras y grotescas, pasando por todo tipo de polémicas y controversias propias de las ideas disruptivas.
Desde que el hombre es hombre se enfrentó inevitablemente con la enfermedad y el dolor, así como a la búsqueda de cualquier remedio atenuante para sobrellevar el sufrimiento. Inicialmente lo que eran el miedo y desconocimiento se mitigaban con ritos y plegarias religiosas. Luego se recurrió a la herbolaria y a los químicos de la naturaleza.
Antes de existir el concepto, la anestesia se practicaba a partir del cultivo de la amapola (opio) en las primeras civilizaciones mesopotámicas 4000 años a.C. Tiempo después, se sabe que en China se empleaba la acupuntura como alivio. La Odisea de Homero menciona el uso de mandrágora, que se usó hervida más tarde en medicina y hoy se sabe que contiene altas concentraciones de atropina y escopolamina. Y en el siglo I a.C. en Grecia se empleaba una sustancia que contenía etileno como analgésico y anestésico. Los asirios y los egipcios producían inconsciencia comprimiendo las carótidas. Y más tarde se evolucionó la selección de plantas, mezclando mandrágora, amapola, cicuta y beleño. De esta amalgama hervida e inhalada se respiraba atropina, belladona, cicutoxina y opio, que generaban sedación, analgesia y cierta parálisis.
Las primeras aproximaciones al gas anestésico
Esta última práctica, llamada esponja soporífera, se describió en fórmula por primera vez en el siglo VI d.C. y más tarde fue prohibida por la Inquisición Española al considerarla magia negra y herejía. Lo que llevó a otras investigaciones.
En el siglo XIII, un médico español llamado Raymundo Lulus experimentó con etanol y ácido sulfúrico, llamándolo aceite de vitriolo dulce. En el siglo XVIII un químico alemán denominó a este compuesto «éter», lo que significa «sin peso». Y se estableció por primera vez la piedra angular de la anestesia moderna.
El nacimiento de la anestesia moderna
El primer uso de una sustancia para eliminar la sensación de dolor en la era moderna se le atribuye al dentista William Morton, el 16 de octubre de 1846. Lo hizo en una cirugía programada y delante de una audiencia en lo que se conoció como «el día del éter», fecha considerada como el nacimiento de la cirugía con anestesia.
Sin embargo, quien realizó esta práctica por primera vez fue un compañero de oficio, Horace Wells, dos años antes. Quien extrajo una muela a un paciente, durmiéndolo primero con un gas anestésico.
Por aquel entonces, se estudiaba el efecto del óxido nitroso, conocido como «gas de la risa» por los efectos que generaba al inhalarlo a cualquier paciente. Durante algunas demostraciones, Wells observó que esa sustancia mitigaba el dolor y pensó en ampliar sus aplicaciones. Una de las áreas donde más dolor se experimenta es en la odontología, especialmente en las extracciones de piezas dentales. Fue así como el 11 de diciembre de 1844 Wells aplicó el óxido nitroso por primera vez en un paciente con problemas en una muela del juicio.
Tras el éxito de esta práctica, Wells la mantuvo durante un tiempo y la transmitió a uno de sus antiguos aprendices, William Morton. Fue en ese periodo, entre diversas demostraciones fallidas, derivadas de la inestabilidad de esta solución, cuando Morton experimentó con otro gas, el éter. Morton organizó una presentación de su nueva propuesta en el mismo escenario donde Wells había fallado, el anfiteatro del Hospital General de Massachusetts, y fue un éxito. Tal día pasó a la historia como el de la invención de la anestesia y de la cirugía sin dolor, eclipsando completamente a Horace Wells.
Del éter al cloroformo y de la cima a las profundidades
Al mismo tiempo que estos descubrimientos cambiaron para siempre la medicina, no hicieron lo mismo con la vida de ambos dentistas.
Morton buscó el beneficio económico de su hallazgo tratando de patentar la fórmula de la anestesia. Hecho que evidentemente no funcionó al tratarse simplemente de un compuesto de éter. Nadie pagó por él.
Wells, por otro lado, cayó en una grave depresión al ver su trabajo en el fracaso y haber perdido todo el mérito. Llevó su carrera hacia la investigación del cloroformo, mucho más potente y del que terminó haciéndose adicto. Tras años en decadencia, resultó detenido por ciertos altercados con prostitutas y se suicidó cortándose las venas tras anestesiarse a sí mismo con esta última sustancia.
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