Throughout history, medical professionals all over the
world have been looking for ways to aid those in pain whether it be during
surgery or in everyday life. One way
that doctors use to reduce pain specifically in surgery is through
anesthetics. Anesthetics are substances
(usually pharmaceutical drugs) that people are administered to help lower their
sensitivity to pain. Although these
substances are widely used, they effect each person differently. Although it is unknown how exactly most anesthetics
work, researchers are aiming to discover their mechanisms in the search for
many answers to the mysterious brain.
Anesthetics were first developed in the early 1950s as the
search for a safer drugs to use during surgery.
In the past, history has shown that different cultures began using
similar types of methods to attempt to reduce pain in patients. The ancient Chinese used different forms of acupuncture
and ancient Greeks used mixtures with popular ingredients of opium or
alcohol. In the late 1700s, chemists
discovered nitrous oxide or laughing gas which became a popular party drug
rather than medical pain reducer. After
1840, nitrous oxide was introduced into the medical field as well as
chloroform. All of these drugs were
helpful and effective for some time, but if not administered properly, the more
intense drugs were found to be extremely lethal. After many accidental incidents that turned
lethal, scientists were in search of a more stable and less dangerous anesthetic
like halothane which was introduced in 1955.
Although this drug seems to be a much better fit, there is still a lot
of work to be done understanding the ways in which pain is reduced.
In or class, a researcher Gerald Gerhart shared some work
that he was a part of on visceral pain. Visceral
tissues are organs and internal parts of the body that contain neurons, but
often do not convey pain in a direct way, but instead refer a lot of their
sensations to other tissues. For
example, when someone has a heart attack, it is not the area of the heart or
chest that feels the most pain, but instead most pain is felt on the left
shoulder or down the left arm. These
tissues within the visceral area have low localization of pain, and high referral
to other areas of the body. This means
that very little pain is felt at the sight of the problem, but a lot of pain is
instead spread to other areas of the body.
This can be a simple fix if doctors know where the original sensations
are coming from and can fix the source, but in some situations, it can be
difficult to identify where the pain is stemming from when it is not localized
well. This becomes an issue with cross-organ
sensitization, when different neurons that convey this information from
multiple organs start to interfere with one another. It can become very difficult to locate the
location of the problem, and identify what the problem is as well. Most visceral pain is induced by stretching
or inflammation, rather than cutting or burning whereas pain from the skin is
most likely to be the opposite. This can
most likely be explained by both their makeup of tissue and their purpose. Skin is made to be flexible and protective
and internal organs are to carry out bodily processes. In these processes, pain is used to tell us
that there is a problem somewhere along the line, but finding this problem is not
always clean cut.
Within science, there is a lot of work yet to be done on
how to address chronic pain that may come from visceral tissues and treat
it. In order to fully take it on,
researchers have to fully understand the mechanisms of pain and how it effects
individuals. Pain has multiple
components, both a physical one and a cognitive one. In different tissues it also can be
interpreted in different ways. With work
from Dr. Gerhart we can see that there is much work being done to identify how
neurons receive and refer pain in visceral tissues. With knowledge that has been acquired it is
hopeful that in the near future there may be a way to address diseases that cause
pain and suffering to all who have encountered them. Until then, research on anesthetics may be
helpful to solving this mysterious problem.
Some have proposed that mild anesthetics may be the answer to some chronic
pain illnesses. This proposal sounds
promising, but how are people supposed to accept this hope when doctors now are
relatively unsure how anesthetics really block out the pain one should
feel? Is it because they have taken the
cognitive portion of pain out when a person is unconscious? Is there more to pain and its process than we
know? There are few ethical ways to test
for pain, but with trials of new techniques, there may be a way to set those
with chronic pain free. Through the
history of anesthetics we can see that there have been attempts to free pain in
the past, and there will be in the future until we can fully understand the mechanisms
that pain uses. Until then, there needs
to be more research in the processes that we have identified that do work to
block out pain. Can we adapt these anesthetics
to help those with long-term pain? One
can only hope that this answer comes soon.
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