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Throughout recorded history, attempts at producing a state of general anesthesia can be traced back to the writings of ancient Sumerians, Babylonians, Assyrians, Egyptians, Indians, and Chinese. Despite significant advances in anatomy and surgical technique during the Renaissance, surgery remained a last-resort treatment largely due to the pain associated with it. However, scientific discoveries in the late 18th and early 19th centuries paved the way for the development of modern anesthetic techniques.[citation needed]
In the late 19th century, two major advances enabled the transition to modern surgery: the development and application of antiseptic techniques as a result of the germ theory of disease, which reduced morbidity and mortality rates, and the advances in pharmacology and physiology that led to the development of general anesthesia and pain control. In the 20th century, general anesthesia's safety and efficacy were further improved with the routine use of tracheal intubation and advanced airway management techniques, monitoring, and new anesthetic agents with improved characteristics. Standardized training programs for anesthesiologists and nurse anesthetists emerged during this period.
Moreover, the application of economic and business administration principles to healthcare in the late 20th and early 21st centuries led to the introduction of management practices, such as transfer pricing, to improve the efficiency of anesthetists.[1]