Advances in anaesthesia. Some recent developments in techniques for short stay surgery

Anaesthesia is now a world away from the single agent techniques of the 19th and early 20th centuries. There is an ever increasing requirement to obtain quicker throughput and minimal post-operative morbidity in every surgical specialty. Patients and managers expect a shorter and shorter hospital stay after surgery which would have required two or three times as long in hospital as little as ten years ago. Many, or perhaps most, of the advances in surgery since anaesthesia began in the 1840s have depended on advances in anaesthesia. The current trend to short stay surgery is no exception. I will give an historical perspective of the development of anaesthetic techniques which have permitted this development. I will describe some of the practical and theoretical considerations behind the techniques and a forecast of some of the techniques which are in development or might be anticipated in the future.