The Theory of Anesthesia, Analgesia, and Allostasis

Today few patients appreciate the danger they invite when they undergo surgery. Surgeons avoided surgery before the discovery of anesthesia because it was invariably followed by a “surgical stress syndrome” that manifested as inexorably increasing fever, delirium and agonizing pain that reached peak severity in about 48 hours and often culminated in death regardless of the success of the surgery itself. General anesthesia revolutionized surgery because it enabled most patients to survive, but the struggle to conquer the surgical stress syndrome continues to this day. It manifests as fever, fatigue, nausea, vomiting, organ dysfunction, dementia, heart attacks, strokes, and reduced life span due to cancer, heart disease, and chronic illness in the distant aftermath of successful surgery. The stress mechanism confers a fresh theory of anesthesia, analgesia and allostasis that enables anesthetists to alter anesthetic technique to optimize surgical outcome, and it paves the path to completely abolish the surgical stress syndrome, re-revolutionize surgery, improve accident survival, control the combat stress syndrome, and enable extensive surgical repairs that are presently impossible.