The History of Local and Regional Anesthesia

  • Brendan T. Finucane

Key Points

  • The discovery of the local anesthetic properties of cocaine by Koller in 1884 was one of the most important discoveries in the history of Medicine and revolutionized the practice of Ophthalmology, Dentistry, Anesthesia, and Surgery.

  • Chemists studied the pharmacological properties of cocaine and developed a series of synthetic local anesthetic compounds which were less toxic than cocaine and more predictable and efficacious.

  • Systemic toxicity to local anesthetics continues to be an issue, but we have seen a significant reduction in the incidence of this problem and great advances in prevention and management.

  • Spinal anesthesia was first introduced by Bier in 1884 and today remains one of the most reliable and safe techniques used in regional anesthesia more than 120 years after it was first introduced.

  • Bier also introduced Intravenous Regional Anesthesia in 1908 (Bier Block) and this technique has also withstood the test of time and remains one of the most reliable techniques for short surgical procedures involving the upper extremity.

  • A succession of leading figures in regional anesthesia have introduced and developed a number of safe and effective local and regional techniques, including epidural anesthesia and numerous peripheral nerve blocks. The lives of these great contributors to local and regional anesthesia are highlighted in this chapter, all of whom also wrote classic textbooks on the subject of regional anesthesia.

  • The introduction of nerve stimulation more than 40 years ago represented a significant advance in the practice of regional anesthesia and the importance of this advance is emphasized in this chapter.

  • The recent introduction of ultrasonography has transformed regional anesthesia practice, increasing safety and precision of nerve blocks.


History Local anesthetics Regional anesthesia Topical anesthesia Spinal anesthesia Peripheral nerve block Epidural anesthesia Nerve stimulation Ultrasound 


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain MedicineUniversity of AlbertaEdmontonCanada

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