Perspectives of Rural Surgeons - Anaesthesia in Rural Practice: How I Do It?

The word 'Anaesthesia' comes from the Greek word 'Anaistheto,' meaning insensibility. 150 years ago, William Morton, a surgeon, successfully demonstrated the use of diethyl ether to induce general anaesthesia. Thus started the era of 'insensible' surgery and surgeons themselves were anaesthesiologists. Anaesthesia induced and maintained on ether remained a gold standard for almost 100 years. Today administering anaesthesia has become a speciality in itself and a branch of medicine. In the last decade, this branch has made enormous progress by the addition of new drugs, machines and some very modern gadgets making surgery that much easier, safer and of course painless. India is a huge country, divided into two main classes. The urban population comprising 25 to 30 per cent of India's population has access to most of the modern developments in medicine. However more than 70% of this country's population lives in the villages, with poor communications, inferior facilities and a dearth of specialists. As a result maternal and perinatal mortality is high. Common conditions like hernia, hydrocele, septic wounds, emergencies like obstructed labour, acute appendicitis, duodenal ulcer perforations, blunt trauma to the abdomen or the thorax, minor and simple fractures have to be treated by a general surgeon who lives in the vicinity. Such a general surgeon is a "Jack and Master of all", including the technique of administering anaesthetic agents as well as inducing regional analgesia. There is no denying that thousands of surgical procedures have been performed in this manner and as a result an equal number of lives have been saved. The author wishes to share his experiences of having performed more than 15, 000 operations (anaesthesia included) at a place called Lonand, which is not even a taluka headquarter. The experience extends over a period of 13 years.