European Journal of Anaesthesiology



Review

A history of neuraxial administration of local analgesics and opioids


S. Brill a1c1, G. M. Gurman a1 and A. Fisher a1
a1 Soroka University Medical Center, Faculty of Health Sciences, Division of Anesthesiology, Ben Gurion University of the Negev, Beer Sheva, Israel

Article author query
brill s   [PubMed][Google Scholar] 
gurman gm   [PubMed][Google Scholar] 
fisher a   [PubMed][Google Scholar] 

Summary

The history of intrathecal and epidural anaesthesia is in parallel with the development of general anaesthesia. As ether anaesthesia (1846) is considered the first modern anaesthetic since its use by Morton 157 yr ago, so Bier made history by using cocaine for intrathecal anaesthesia in 1898. The first published report on opioids for intrathecal anaesthesia belongs to a Romanian surgeon, Racoviceanu-Pitesti, who presented his experience at Paris in 1901. It was almost a century before the opioids were used for epidural analgesia. Behar and his colleagues published the first report on the epidural use of morphine for the treatment of pain in The Lancet in 1979. Epidural and intrathecal opioids are today part of a routine regimen for intra- and postoperative analgesia. Over the last 30 yr, the use of epidural opioids has became a standard for analgesia in labour and delivery, and for the management of chronic pain. Finally, epidural opioids have been shown to have a pre-emptive effect, when used before major surgery. We present the evolution of neuraxial anaesthesia and the history of intrathecal and epidural administration of opioids.

(Accepted January 2003)


Key Words: ANAESTHESIA, CONDUCTION, anaesthesia spinal; ANALGESIA, epidural; HISTORY OF MEDICINE; NARCOTICS, opioids.

Correspondence:
c1 Correspondence to: Silviu Brill, Division of Anesthesiology, Soroka University Medical Center, Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheva 84101, Israel. E-mail: s_bril@yahoo.com; Tel: +972 8 6400262; Fax: +972 8 6423765