The notion of decreasing pain in surgery stretches back thousands of years with alcohol noted as one of the first anesthetics. Natural elements including coca and opium have been used by various civilizations in an attempt to mute the searing pain of surgery. By the 16th century, physicians around the world began to experiment with nitrous oxide and ether, providing the groundwork for the future of modern anesthesia. The successful application of general anesthesia in surgery was first documented in 1804 by Dr. Seishu Hanaoka (Fig. 1) in Wakayama, Japan, during a breast lumpectomy. During the case, Dr. Hanaoka served as the surgeon, anesthesiologist, and pharmacist. Although most of his worldwide contemporaries were unaware of his successes...