Sun Dajin (1929-2024), Professor of Anesthesiology, former Director of the Department of Anesthesiology at Renji Hospital, one of China’s renowned anesthesiologists

Introduction:

A pioneering medical scientist revolutionized anesthesiology in China by introducing world-class theories and monitoring equipment, while also integrating valuable traditional Chinese methods. His philosophy of “bringing in and going out” fostered a dynamic exchange between Chinese practices and global advancements, enriching both. Under his leadership, China’s discipline of anesthesiology was revitalized.

The progress of modern medicine from traditional to contemporary practices is built upon advances in chemistry, physics, and the life sciences. However, its evolution from brutal to humane procedures is owed to the development of anesthesiology.

In 2017, The Lancet published a study ranking healthcare quality and access in 195 countries and regions. It revealed that between 1990 and 2015, China achieved one of the most significant improvements globally, rising from 110th to 60th place—the third-greatest leap worldwide. This progress has undoubtedly continued in the years since, with anesthesiology playing a critical role in this success.

We must remember the pioneers who laid the foundation. In an era of medical and resource scarcity, an earlier generation of anesthesiologists, including the eminent Dr. Sun Dajin, overcame immense challenges to take the first crucial steps for the discipline. The advent of anesthesia eliminated the fear and pain of surgery, marking a monumental leap forward in medical history.

A Life of Unwavering Dedication

Sun Dajin was born in Shanghai on December 1, 1929, a time of national turmoil. His childhood and youth were shaped by the upheaval of war.

Following the outbreak of the Anti-Japanese War in 1937, a group of educators established a school within the unoccupied foreign concessions of Shanghai. In 1938, they founded its predecessor, “Jueyuan” (Garden of Awakening), a name symbolizing the nation’s conscious revival. In 1939, this institution officially became Yuying Middle School.

Admitting only Shanghai’s top students, Yuying was Sun Dajin’s alma mater. In its environment of dedicated teaching and eager learning, he built a strong academic foundation.

In 1948, after graduating high school with honors, Sun Dajin was admitted to Tongji University in Shanghai, driven by a passion for fundamental sciences. Beyond his studies, he engaged in student clubs and formed friendships with like-minded peers.

A year later, in 1949, Sun transferred to the Shanghai Tongde Medical College to begin his medical journey. He immersed himself in his studies, mastering clinical skills and professional knowledge. This blend of rigorous theory and hands-on patient care cultivated not only his exceptional medical expertise but also a profound sense of medical humanism.

Sun Dajin’s talent soon became evident. In 1954, with great enthusiasm for his medical career, he joined the Department of Anesthesiology at Renji Hospital, affiliated with the Shanghai Second Medical College. It was a new world and a platform for his ambitions.

There, he was mentored by Professor Li Xingfang, a leading figure in Chinese anesthesiology renowned for her vast knowledge and skill. Under her guidance, Sun Dajin embarked on his path of discovery in the field.

This was a path of pioneering. In the discipline’s early days, conditions were extremely difficult. The workload was heavy, staff was scarce, and anesthesia was often performed by surgeons or nurses. The entire hospital was equipped with only one or two basic anesthesia machines, a simple breathing bag, and a few intubation kits. Textbooks were scarce, anesthetic drugs were limited, and new techniques like epidural anesthesia were still in their infancy and prone to accidents. Undeterred, Sun Dajin worked to expand the department’s services and introduce new techniques.

In March 1954, Renji Hospital successfully performed China’s first closed mitral commissurotomy. Sun Dajin’s anesthetic management was indispensable to the surgery’s success.

Subsequently, Sun Dajin participated in many groundbreaking cardiac surgeries. In 1956, his department participated in China’s first resection of an abdominal aortic aneurysm under hypothermic anesthesia, achieving a new milestone in anesthesia.

In 1957, he again made history by administering anesthesia for China’s first direct-vision pulmonary valvotomy under hypothermia, publishing several key papers on cardiac anesthesia that same year.

In the early 1960s, Sun Dajin assumed full leadership of the Renji Hospital’s Department of Anesthesiology. Under his direction, the department’s clinical, teaching, and research missions fully developed, and it began conducting independent experimental research.

In 1963, he authored the department’s formal “Work Regulations.” In 1964, he presented four papers at the first National Anesthesia Academic Conference, including a major study on 400 mitral commissurotomy cases, earning widespread acclaim.

After years of dedicated work, and building on the foundation laid by his mentor, Sun Dajin came into his own as a leader. Beginning in the 1970s, he phased out outdated drugs like ether and introduced advanced techniques such as enflurane and isoflurane inhalation, total intravenous anesthesia, and new agents like midazolam. The acquisition of imported anesthesia machines, ventilators, and monitors dramatically improved the working environment and significantly enhanced patient safety.

“To safeguard the baseline of life and elevate its upper limit is our unshirkable responsibility.” This statement from Sun Dajin captures the essence of anesthesiology and reflects his profound devotion to medicine.

For Sun Dajin, a mission was a lifelong pursuit. He dedicated all his energy to clinical work and research, approaching every challenge with the utmost caution and meticulousness.

His life was intertwined with the discipline of anesthesiology. Every case was an opportunity to explore and innovate. His professionalism and dedication earned the respect of his peers and inspired countless successors. He was both a guardian of patient safety and an explorer of new frontiers, embodying the true spirit of medical healing.

Acupuncture Anesthesia: A Bridge Between Tradition and Innovation

Traditional Chinese Medicine (TCM) is a time-honored practice, valued for its deep cultural roots and unique medical wisdom.

In 1972, Dr. Sun Dajin collaborated with cardiothoracic surgeons on a groundbreaking achievement: performing modern cardiopulmonary bypass heart surgery using traditional acupuncture anesthesia. This innovation drew significant attention, both within China and from the international medical community.

Acupuncture anesthesia, an ancient TCM technique, reduces pain by stimulating specific acupoints. Compared with conventional anesthesia, it offers fewer side effects and can shorten postoperative recovery, making it an increasingly valued option in surgery. Successful acupuncture anesthesia requires doctors to precisely select acupoints and techniques tailored to each surgery, making their skill and meticulous care critical to the outcome.

Following this initial success, Sun Dajin formed a special group with experts from other fields to conduct standardized research on acupuncture and combined acupuncture-drug anesthesia, deeply integrating the wisdom of TCM with Western medical technology.

In 1979, Sun Dajin presented his work at China’s first National Acupuncture Conference. After the conference, Chairman Hua Guofeng met with the delegates and commended Sun Dajin for his contributions to the research and application of acupuncture anesthesia.

Through his work, Sun Dajin demonstrated the profound value of integrating traditional Chinese practices with modern medicine.

Leading Trends and Going Global

Sun Dajin championed the connection between discipline development and international exchange. He believed that continuous learning was essential for progress, pioneering a “bringing in and going out” philosophy. This approach focused on introducing advanced global anesthetic theories and monitoring equipment to elevate the standard of care at Renji Hospital.

Following China’s period of reform and opening-up, Sun Dajin actively promoted international collaboration, improving his own skills by learning from overseas experts and bringing cutting-edge knowledge back to China. He also invited top international anesthesiologists to Renji Hospital for academic exchange, fostering the global development of the field.

In August 1981, Sun Dajin participated in the Fifth International Conference on Electrical Bio-Impedance in Tokyo, where he was elected as a council member, marking his arrival on the international stage. He established “anesthesia and circulation” and “cardiovascular surgery anesthesia” as key research directions for his department in China.

During this time, Sun Dajin introduced a series of new technologies to China, including hemodynamic monitoring techniques like central venous and pulmonary artery catheterization, and the use of Swan-Ganz catheters to measure cardiac output. He was also an early adopter of modern monitoring methods like pulse oximetry and end-tidal carbon dioxide monitoring, making vital contributions to the development of clinical monitoring in China.

Furthermore, he conducted pioneering research on anesthetic drugs, studying inhalational and intravenous anesthetics and muscle relaxants to improve the effectiveness and safety of anesthesia.

In 1982, a collaboration with American expert Dr. Tompkins BM enabled a technological breakthrough for Sun Dajin’s department. Their joint efforts pioneered advanced hemodynamic monitoring in China, transforming the management of critical anesthesia and giving new momentum to the country’s cardiovascular medicine.

This collaborative spirit continued in 1983, when Sun Dajin co-led a multidisciplinary team of Chinese medical professionals to the United States for a scholarly exchange on advanced techniques for coronary artery bypass grafting. This professional dialogue fostered a sharing of knowledge that was instrumental in advancing the cardiovascular surgery field in both nations.

These early interactions laid the groundwork for long-term partnerships between Renji Hospital and renowned heart centers in the U.S. and Germany. Under Sun Dajin’s leadership, his department remained at the forefront of the discipline, driving progress through sustained international cooperation.

By 1987, Sun Dajin’s team had introduced pulse oximetry monitoring, allowing doctors to clearly observe a patient’s oxygenation status and detect subtle changes in organ function, effectively reducing postoperative risks.

By 1989, the team introduced end-tidal carbon dioxide monitoring, which accurately assessed airway patency and respiratory recovery. This technology became crucial for procedures like cardiopulmonary resuscitation and a highlight of medical progress.

From 1995 to 2003, the Department of Anesthesiology at Renji Hospital was designated a key discipline in Shanghai. As a leader across several major hospitals, Sun Dajin guided his teams to complete numerous research projects, securing significant funding, publishing over ten high-level papers, and cultivating new talent. He also helped secure national-level research grants, guiding the future of anesthesiology through dedicated research.

A Devoted Educator, Carrying Forward a Medical Mission

Sun Dajin was also a passionate educator whose half-century teaching career earned him deep respect from his students. He was known for his rigorous academic standards and profound dedication to anesthesiology, making him an outstanding mentor.

His educational contributions advanced not only the training of anesthesiologists but also the overall safety and comfort of medical care, which is critical in the treatment of critically ill patients.

Sun Dajin compiled English-language undergraduate textbooks for anesthesiology and was dedicated to both undergraduate and specialized teaching. He established the “Critical Care Medicine” program at Renji Hospital, which was rated as an excellent course in 2004. He personally mentored numerous master’s and doctoral students, many of whom became leaders in their fields. Since 1951, Renji Hospital has trained over five hundred anesthesiologists from across China.

He was also a prolific author, editing and contributing to numerous anesthesiology monographs, including “Theory and Application of Anesthesia Machines and Ventilators” (1987), “Critical Care Monitoring and Treatment” (1998), and “Practical Clinical Anesthesiology” (2001). He published over two hundred papers in fields such as anesthesiology, critical care, and cardiovascular surgery.

Even in his later years, Sun Dajin’s passion for anesthesiology never waned. He continued to follow the latest advancements and encouraged the next generation, telling them, “The scepter of science has been passed to your hands; you must exert its maximum energy.”

Sun Dajin passed away in April 2024. The Department of Anesthesiology at Renji Hospital, the institution he dedicated his life to, will continue to uphold his philosophy of excellence and innovation. Future anesthesiologists will stand more confidently at the forefront of medicine, providing patients with safer, more effective, and more humane care.

His name, and the discipline he loved, are forever etched in the history of Renji Hospital.

Editor: Chen Qing @ ShanghaiDoctor.cn

Note: Chinese Sources from “The Path of Benevolent Medicine” which was published in 2024. It records 90 important medical figures in the history of Renji Hospital. Yewen Renyi (ShanghaiDoctor.cn) team was one of the major writers of the book and is authorized by Renji hospital to create English version on the website of ShanghaiDoctor.cn