Hadzic's Regional Anesthesia > Part III. Clinical Practice of Regional Anesthesia > Section Two. Neuraxial Anesthesia > Chapter 14. Epidural Blockade Bonnie Deschner, MD, Marina Allen, MD, Oscar de Leon, MD

Epidural Blockade: Introduction

"Epidural blockade is one of the most useful and versatile procedures in modern anesthesiology. It is unique in that it can be placed at virtually any level of the spinal spine, allowing more flexibility in its application to clinical practice. It is more versatile than spinal anesthesia, giving the clinician the opportunity to provide anesthesia and analgesia, as well as enabling diagnosis and treatment of chronic disease syndromes. It can be used to supplement general anesthesia, decreasing the need for deep levels of general anesthesia, therefore providing a more hemodynamically stable operative course and faster emergence from general anesthesia. It provides better postoperative pain control and more rapid recovery from surgery. When combined with spinal anesthesia in a technique called a CSE (combined spinal-epidural), benefits of both techniques can be combined and shortcomings of each avoided.Two French physicians, Jean-Anthanase Sicard, a radiologist, and Ferdinand Cathelin have been credited with the intentional administration of caudal epidural anesthesia over a century ago in 1901. They found that injecting a dilute solution of cocaine through the sacral hiatus can provide an effective treatment for severe sciatic pain and suggested the technique for surgical procedures.¹⁰ Nineteen years later, a Spanish military surgeon by the name of Fidel Pages Mirave, is credited with describing the lumbar approach to "peridural" anesthesia. Unfortunately he was killed in an accident at the early age of 37, and his work..."