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History of Regional Anaesthesia

The use of regional anaesthesia was first reported by Paré (France) in 1564. He obtained local anaesthesia by nerve compression. The term spinal anaesthesia was first introduced by Corning in his famous second paper in 1885, although it was the result of a brilliant yet erroneous idea because he had in mind to deliver cocaine in the interspinal blood vessels. Regional anaesthesia on an Enea's soldierIn 1891 Heinrich Quincke introduced and popularized the subarachnoid lumbar puncture, and in 1899 the German surgeon August Bier published his celebrated paper on spinal anaesthesia. The same year Tait and Caglieri of San Francisco performed the first spinal anaesthesia in the United States in a patient undergoing an osteotomy of the tibia. The Seattle physician John Bonica led the effort to grow pain medicine care in the US. Bonica’s interest was to better understand matching regional anaesthesia to patients experiencing chronic pain, and his interest eventually led to the establishment of the International Association for the Study of Pain (IASP) in 1974, and the Journal of Pain in 1975. In Italy Achille Mario Dogliotti (1897–1966), founder member and first president of S.I.A. (Italian Anaesthesia Society), led clinical research in regional anaesthesia. To Dogliotti belongs the credit of describing and introducing in clinical practice what he termed ‘segmental peridural spinal anaesthesia’. He emphasized that an amount of anaesthetic solution to bathe a sufficient length of the spinal nerves is required, and stressed the sudden loss of resistance when the point of the epidural needle enters the epidural space after having pierced the ligamentum flavum. In 2000 Rodgers and colleagues reported a 30% decrease in mortality if regional anaesthesia is used compared to general anaesthesia.

The use of regional techniques in small animals clinical anaesthesia has been introduced few decades ago, and it is not common practice yet. In practice the most popular techniques are: caudal epidural anaesthesia, unintended spinal anaesthesia and field block. Data on morbidity and mortality reduction by regional anaesthesia in small animals are not available to date.



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