Anaesthesiology in Odessa: the history of development and today’s methods

 Anaesthesiology in Odessa: the history of development and today’s methods

  • Issue 78

Tarabrin , A.Vladyka, O. Suslov , H. Balytska, R. Sukhonos , I. Basenko , D. Volodychev , P. Tarabrin
tarabrinoleg@gmail.com

Through all its history, Odessa, Ukraine, was among the first cities responding to the World’s innovations in science and technology. The same was with true with anaesthesia: the first mention of its use in Odessa is around 1848, when M.I. Pirogov, during his trip to Odessa at the First City Hospital, personally demonstrated ethereal anesthesia [1,2]. In the years 1856-1858 M.I. Pirogov was the Head of the Odessa Educational District [3, 4].

In 1902, Second City Hospital was opened in Slobodka; that hospital used general anaesthesia by inhalation of vapour and injection of solutions of narcotic drugs, local anaesthesia by cocaine application, infiltration, conduction and regional novocain injections [5, 6]. Odessa surgeons Y.V. Zilberberg, P.O. Nalivkin, N.A. Kukoverov were pioneers of local and conductive anaesthesia use [7, 8, 9]. For inhalative anaesthesia, mostly chloroform through masks of Esmarch, Shimmelbush, Jyllard, and apparatus of Ombredana-Sadovenko were used. For non-inhalation anaesthesia scopolamine-morphine was widely used.

In the 1920s-1930sthere was debate among surgeons about how to further develop anaesthesia in the USSR. During the second (1924) and third (1928) All-Ukrainian congresses of surgeons [10], the predominant role of local anaesthesia in surgical practice was settled.

After World War II, Odessa began to use gas-liquid inhalation anaesthesia devices by Mc Kesson, supplied by the USA on the Lend-Lease, but the predominant method of anaesthesia remained local anesthesia.

In the late 1940s and early 1950s in the Second City Hospital, which since 1932 was called the Regional Hospital, in the surgical clinic of Professor Y.M. Voloshin, appendectomy and herniotomy in some patients was selectively made under hypnosis “without a drop of novocaine”.

In the first half of the 1950s so called intubative anaesthesia attempts were made, in particular, by the staff of the Department of General Surgery O.P. Docenko and V.V. Larin. At the end of the 1950s this type of anaesthesia began to be used in the 411th District Hospital by L. N. Aryayev, and at the Marine Hospital by Y.N. Kryvchikov.

The situation began to change in 1957 in the New City Hospital, two new surgical departments became the clinical base of the Department of General Surgery of Professor I.Y. Deineka. With his initiative in 1958, the department had an associate professor’s course in anaesthesiology. In 1962, following an assessment by the Ministry of Health of the USSR, and by order of the WHO № 270 of May 15, 1962 [13], the organisation of two resuscitation centers were suggested: at the Regional Clinical Hospital and at Emergency Care Hospital, as well as resuscitation centers at all surgical departments of city and district hospitals, maternity homes and dispensaries.

In that same year, one of the first models of a serial native apparatus “artificial kidney” appeared in the Regional Clinical Hospital. The Heads of the Department of haemodialysis, founded in January 1964, were A.S. Vladyka. They built up 20 years of experience and began a program of dialysis treatment of chronic renal failure and subsequently proceeded with kidney transplantation [14]. In 1970,  the first in Odessa Unit of Reanimation and Intensive care was created.

Then, anaesthesiology and resuscitation services started to develop in other medical institutions of the city and in the districts of the region. By the year 2000 in Odessa, as well as in all 26 administrative districts of the region an anaesthesia service was formed. In 2019 the service was represented by 8 intensive care units, 21 anaesthesia departments with intensive care beds and 18 anaesthetic departments without beds for intensive care.

In 1967 L.M. Aryaev was invited to the position of Associate Professor in the course of anaesthesiology. He organised and (until 1976) headed the Department of Anaesthesiology and Reanimatology. He was the Chief Anaesthesiologist of the Odessa Regional Health Department, the Head of the Anaesthetic section of the Regional Scientific Society of Surgeons.

1976. Stacyunas was invited to be Chair of the Department in 1976. Professor V.P. Stacyunas is one of the first anaesthesiologist in the USSR and a veteran of the WWII. In Odessa, he organised courses for primary specialisation of anaesthesiologist, intensive care physicians; organised and headed the Odessa Scientific Society of Anesthesiologists-Reanimatologists; he was co-author of the textbooks “Reanimatology” (1976) and “Anesthesiology and Reanimatology” (1979); and a member of the Board of the All-Union and Ukrainian Scientific Societies of Anaesthesiologists and Reanimatologists.

In 1981, the temporary Head of the Department was associate professor A.Y. Bahar. The improvement of the anaesthetic and resuscitation service of the Odessa Clinical Hospital, which began at the hospital on Slobidka, continued on the site of the Odessa Clinical Hospital.

From 1982 to 1995 Professor A.S. Vladyka was the Head of the Department. Under his guidance many of investigations were performed: methods of paediatric anaesthetic support (assistant professor O. V. Borozenko); protein exchange in critical states evaluation; new methods of shock diagnostics and evaluation of the efficacy of its treatment (associate professor M.P. Yuzvak); and problems of intensive therapy of cranial trauma (associate professor O. Petelkaki).

In 1988, postgraduate qualification courses were reorganised into an independent Department of Anaesthesiology and Resuscitation of the Faculty of Therapy, headed by Professor P. M. Chuyev. Since 1992, pre-certification courses and internship training in specialties “Anaesthesiology”, “Children’s Anaesthesiology”, “Medicine of Emergency Conditions” have been organised [15]. In 1995, both departments were reorganised into Department of Anaesthesiology and Intensive Care with postgraduate training. Professor P. M. Chuyev became the Chairman of the new department; however, in 2008 a severe illness cut short both his brilliant career, and ultimately, his life.

Since 2008 Professor Oleg Tarabrin has become the Head of the Department [15]. Thanks to his efforts a Scientific School of Haemostasis was created in Odessa [16]. Under his leadership of international congresses, “Black Sea Pearl” and “Autumn meetings” in Odessa became annual events. During his ten-year tenure, it is worth noting his membership in the committee of the European Society of Anaesthesiology (ESA); this allowed Odessa to conduct twice-yearly courses since 2013as part of the Committee for European Education in Anaesthesiology (CEEA), as well as to open 4 new CEEA centers – in Odessa, Kiev, Ternopil, andDnipro.

After the appointment of Tarabrin as consultant on simulation education in ONMedU, 9 simulation centers, which were established in 10 years, received a new round of development; as co-author with academician V.M. Zaporozhan, the book “Simulation medicine. Experience. Gaining. Perspectives.” was written [17]. In 2015, the department team had translated the sections of the Russian-language edition of “Miller’s Anaesthesia” about haemostasis [18]. Traditionally, a significant part of the work of the Department is the education of future specialists and student scientific associations. It should be noted that over the past 40 years, students from more than 20 countries have received high-quality education on the basis of the Department of Anaesthesiology and Intensive Care with the postgraduate training in ONMedU.

 

References

  1. Novorossiysk calendar for 1869. Odessa; typogr. L.Nitche, 1868. – 185 p.
  2. Odessa 1794-1894 / ed. City Public Administration to the centenary of the city. – Odessa: A.Shults printing house, 1893 –С.656-658.
  3. Sobchuk, G.S., Golden Autumn, N.I.Pirogov / G.S.Sobchuk, P.A.Klantsa, OP.Klantsa. – Vinnitsa, 2005. – 154 p.
  4. Pirogov Nikolai Ivanovich // Anesthesiology in persons / A.S. Vladyka, V.V. Suslov, O.A. Tarabrin / Under the editorship of professor V.V.Suslov. 3rd ed .- Sumy: University Book, 2016. – 46-49.
  5. Shaak V.A. Local, regional and spinal anesthesia // Ibid. -C.101-159.
  6. Nalivkin Pavel Alekseevich / Professor of Odessa National Medical University (1900-2015). Bibliographic dictionary / comp. V.I. Zaporozhan, V.I.Kresyun, G.I.Handoikova. – Odessa: ONMEDU. – P.188-189.
  7. Kukoverov N.A. / Ibid., S. 148-149.
  8. V.I. Zaporozhan, P.N. Chuev, I.I.Ratovsky, Yu.L.Kurako, R.F. Makulkin, A.I. Danilenko. Essays on the history of public health in Odessa to its 200th anniversary / Pld ed. VI Zaporizhan. – Odessa, 1994. – 192 p.
  9. Belenky M.S. Olesk district hospital, its past and present / Anniversary collection of the Odessa District Hospital. – Odessa, 1927.- P.5-56.
  10. Geshelin S.A. Spinal cord and epidural anesthesia // Guide to anesthesiology / Ed. TM Darbinyan. – M .: Medicine. – Pp. 188-204.
  11. The second congress of surgeons of the Odessa province, September 12, 1924, Odessa. – Yekaterinoslav: 1925. – 206 p.
  12. The order of the Odessa GPA number 374 of July 4, 1959 // ibid. – Right 201, Arkush 243.
  13. Order of the Odessa GPA number 270 dated May 15, 1962 // ibid. – Right 262, Arkush 124-125a.
  14. Zaporozhan V. Krok to pіznannya, Step to cognition: Peredmova chief editor, Edition-in-Chief-Foreword // Klіnіchna anaesthesiologia and intensive therapy, №1, 2013. – P.5-6.
  15. Anesthesiology in persons(Anesteziologiya v litsakh)/ A. S. Vladyka, V. V. Suslov, O. A. Tarabrin; by ed. V. Suslov, 3rdedition, 2016. – 302 p.
  16. Anesteziolohiya, intensyvna terapiya ta nevidkladni stany: Navchalʹnyy posibnyk / Basenko I.L., Budnyuk O.O., Vladyka A.S.; by ed. O. A. Tarabrin, 2017. – 584 p.
  17. Simulation medicine. Experience. Gaining Perspectives (Symulyatsiyna medytsyna. Dosvid. Zdobuttya. Perspektyvy) / V.M. Zaporozhan, O. A. Tarabrin, 2018. – 240 p.
  18. Miller’s Anesthesia (Anesteziya Ronal’da Millera) / Ronald D. Miller, 4thedition, Russian-language version, 2015. – 3460 p.