Cousins and Bridenbaugh’s Neural Blockade in Clinical by Michael J. Cousins AM MB BS MD (SYD) FAN, Phillip O.

By Michael J. Cousins AM MB BS MD (SYD) FAN, Phillip O. Bridenbaugh MD, Daniel B. Carr MD DABPM FFPMANZCA(Hon), Terese T. Horlocker MD

This complete, authoritative textual content offers the medical foundations and scientific perform of neural blockade in either neighborhood anesthesia and the administration of ache. The descriptions and illustrations of ache mechanisms are thought of vintage examples. The Fourth version has been sophisticated for readability and flows logically from ideas and pharmacology, to ideas for every anatomic area, to purposes. This variation has new co-editors and a number of other new chapters on subject matters together with neurologic problems, neural blockade for surgical procedure, therapy of soreness in older humans, and problems in ache medication.

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Additional info for Cousins and Bridenbaugh’s Neural Blockade in Clinical Anesthesia and Pain Medicine

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Two years later, Kappis described his poste¨ rior approach to the splanchnic plexus (92). In 1922, Lawen Chapter 1: The History of Regional Anesthesia 19 FIGURE 1-19. Fidel Pag´es (1886–1923). found unilateral paravertebral block of selected spinal nerves useful in the differential diagnosis of intra-abdominal disease (93). For example, he observed that a 10-mL injection of 2% procaine at T10 could completely relieve the pain of a severe biliary colic for 3 hours. The use of segmental paravertebral block for the differential diagnosis of painful conditions was ¨ an original idea of Lawen’s.

Koster’s work followed an earlier work by Jonnesco, who was an early proponent of the wide use of spinal anesthesia for surgical procedures. TA B L E 1 - 6 LISTING OF SURGICAL PROCEDURES PROMOTED BY KOSTER AS SUITABLE FOR SPINAL ANESTHESIA, CIRCA 1928 Amputation of lower extremity up to hip Embolectomy of external iliac artery Herniotomy Reduction of fractures and dislocations Operation for osteomyelitis, lower and upper extremity Appendectomy Excision of rectum for carcinoma Colectomy Enterectomy Hemorrhoidectomy Anterior and posterior colporrhaphy Tracheoplasty Interposition operation Repair of vesicovaginal and rectovaginal fistutae Salpingo-oophorectomy Hysterectomy Hysteropexy Nephropexy Nephrectomy Nephrolithotomy and pyelotomy Uretotomy Prostatectomy Cholecystectomy, choledochotomy, and cholecystenterostomy Splenectomy Gastrectomy, pylorectomy, pyloroplasty, and gastroenterostomy Costectomy and thoracotomy Radical mastectomy Embolectomy of the axillary artery Thyroidectomy Resection of cervical glands Excision of tumors of the tongue, face, and scalp Craniectomy Mastoidectomy Nasal plastic Cesarean section As with many new ideas, proponents are often characterized as zealots, and such is the case with Thomas Jonnesco of Bucharest (80): At a meeting of the German Society of Surgery in Berlin in April, 1909, Professor Beir of Berlin is reported to have said that the method of general spinal analgesia described by me at the Congress of the International Society of Surgery in Brussels, in September, 1908, must be rejected, and Professor Rehn of Frankfurt is reported to have said that experiments on animals showed that considerable danger attended such injections if made higher than the lumbar region as recommended by me.

Halsted had introduced the use of rubber gloves at operations in the winter of 1889 to 1890, as noted earlier in this chapter, but not with the intention of avoiding wound infection. That consequence was actually serendipitous. His motive was to spare the hands of his operating room nurse (whom he later married), who had developed a dermatitis from exposure to mercurous chloride. Soon the operators took to wearing them as well, but only out of convenience. It was not until 1894 that the wearing of gloves was recommended as part of aseptic technique (32).

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