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Ether

It is a highly volatile liquid, produces irritating vapours which are inflammable and explosive. Ether (diethyl ether) was first prepared in 1540 by Valerius Cordus, a Prussian botanist. Cordus produced the compound, known as "sulfuric ether" at the time, by distilling sulfuric acid (oil of vitriol) with fortified wine to make an "oleum vitrioli dulce". Despite this early synthesis, ether was rarely used over the next three decades. In fact, it's only routine consumption was as a recreational drug among poor Britians who sometimes drank an ounce of ether when traditional alcohol was not available. American students adopted a variation of this practice in the "ether frolics" of the early 1800s to achieve a feeling of euphoria. Participants would hold ether soaked towels to their faces until losing consciousness.

Ether was first made use of as a general anesthetic by Dr. Crawford Williamson Long on March 30, 1842. Long was a physician and pharmacist who learned about ether while studying medicine in college. In 1842, Long removed a tumor from the neck of a patient who was under the effects of ether anesthesia. Unfortunately, the successful and unprecedented use of anesthesia during surgery was not credited to Long due to his laxity in publishing the results of the surgery until several years later.

Anesthetics used today are almost unrecognizable from anesthetics used in the late 1800s. Ether has been replaced completely by newer inhalation agents and open drop delivery systems have been exchanged for complicated vaporizers and monitoring systems. Anesthesia in the developing world, however, where lack of financial stability has halted the development of the field, still closely resembles primitive anesthetics.

Ether is a potent anaesthetic, produces good analgesia and marked muscle relaxation by reducing ACh output from motor nerve endings. The dose of competitive neuromuscular blockers should be reduced to about 1/3. It is highly soluble in blood. Induction is prolonged and unpleasant with struggling, breath-holding, salivation and marked respiratory secretions (atropine must be given as premedication to prevent the patient from drowning in his own secretions). Recovery is slow; post-anaesthetic nausea, vomiting and retching are marked. Dizziness, drowsiness, bradycardia, hypothermia, or acute excitement may also occur. Laryngospasm, loss of consciousness, and death may result. The aftereffects of emergence from ether-induced anesthesia include nausea, vomiting, and headache.

Respiration and blood pressure are generally well maintained because of reflex stimulation and high sympathetic tone. It does not sensitize the heart to Adr, and is not hepatotoxic.

Ether is not used now, except in peripheral and resource poor areas, because of its unpleasant and inflammable properties. However, it is cheap, can be given by open drop method (though congestion of eye, soreness of trachea and ether burns on face can occur) without the need for any equipment, and is relatively safe even in inexperienced hands. Ether was safe, easy to use, and remained the standard general anesthetic until the 1960s when the fluorinated hydrocarbons (halothane, enflurane, isofluorane and sevoflurane) came into common use. 

Published : Oct 20 2023