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The first planned spinal anaesthesia for surgery on a human was administered by August Bier (1861–1949) on 16 August 1898, in Kiel, when he injected 3 ml of 0.5% cocaine solution into a 34-year-old labourer. [14] After using it on six patients, he and his assistant each injected cocaine into the other's spine. They recommended it for ...
In labouring women, the onset of analgesia is more rapid with combined spinal and epidural anaesthesia compared with epidural analgesia. [2] Combined spinal and epidural anaesthesia in labour was formerly thought to enable women to mobilise for longer compared with epidural analgesia, but this is not supported by a recent Cochrane review. [2]
Spinal and epidural are the most commonly used forms of central neuraxial blockade. Spinal anesthesia is a "one-shot" injection that provides rapid onset and profound sensory anesthesia with lower doses of anesthetic, and is usually associated with neuromuscular blockade (loss of muscle control).
It was modified and revived in the 1990s, primarily by chiropractors, and also by osteopathic physicians; this was likely due to safer anesthesia used for conscious sedation, along with increased interest in spinal manipulation (SM). [26] In the MUA literature, spinal manipulation under anesthesia has been described as a controversial procedure.
Epidural anaesthesia causes a loss of sensation, including pain, by blocking the transmission of signals through nerve fibres in or near the spinal cord. For this reason, epidurals are commonly used for pain control during childbirth and surgery , for which the technique is considered safe and effective, and is considered more effective and ...
Neuraxial blockade is local anaesthesia placed around the nerves of the central nervous system, such as spinal anaesthesia, caudal anaesthesia, epidural anaesthesia, and combined spinal and epidural anaesthesia. [1] [2] The technique is used in surgery, obstetrics, and for postoperative and chronic pain relief. [3]
On 16 August 1898, Bier performed the first operation under spinal anesthesia at the Royal Surgical Hospital of the University of Kiel. The patient was scheduled to undergo segmental resection of his left ankle, which was severely infected with tuberculosis , but he dreaded the prospect of general anesthesia because he had suffered severe ...
Intraoperative neurophysiological monitoring (IONM) or intraoperative neuromonitoring is the use of electrophysiological methods such as electroencephalography (EEG), electromyography (EMG), and evoked potentials to monitor the functional integrity of certain neural structures (e.g., nerves, spinal cord and parts of the brain) during surgery.