Hadzic's Regional Anesthesia > Part I. History > Chapter 1. The History of Local Anesthesia Bonnie Deschner, MD, Christopher Robards, MD, Lakshmanasamy Somasundaram, MD, William Harrop-Griffiths, MD

Twentieth-Century Regional Anesthesia

"Orthopedic surgery has always lent itself to regional anesthesia techniques because of the ability to isolate anesthesia to the extremity being operated on. Initially, general anesthesia and nerve blocks were combined (still a somewhat common practice today). Harvey Cushing is credited with coining the name regional anesthesia for his method of blocking a nerve plexus under direct vision during general anesthesia. His goal was to decrease the anesthetic requirements and to provide postoperative pain relief. It's amazing to consider that he developed this technique in 1902, more than 100 years ago. A similar approach had been proposed by George Crile, 15 years earlier, to decrease the stress of surgery. Upper extremity anesthesia by blocking the brachial plexus percutaneously was achieved by many of our early colleagues. G. Hirschel is credited with developing the "blind" axillary brachial plexus block and D. Kulenkampff the supraclavicular technique, both in 1911. Because the risk of pneumothorax was high with the technique described by Kulenkampff, it was subsequently modified by A. Mulley using a lateral paravertebral approach. Mulley's approach is most likely the precursor of what is now commonly referred to as the "Winnie block" for the brachial plexus...."