Updated Review of Intrathecal Analgesia

Abstract

Analgesica can be considered as the f:pirit of the Anesthesiology Science and is one of the essenti8.l concerns of anesthestists all over m<my centuries.

Injecting a substance intrathecally to relieve pain is one of the most interesting modes of analgesia firstly described by Alexander Wood in 1853. The clinical demonstration of the local analgesic properties of-cocaine by Koller in 1884 were direct steps leading to spinal analgesia. In 1885, corning, a neurologist, injected cocaine into the subarachnoid space, but he did so unintentionaly and without recognising what he had done. In 1891, Essex Wynter and Quincke described the technique of lumbar puncture, essentially the same as that practised today. The first two publications on spinal analgesia for surgical operation were made in 1899 by Bier and Tuffier. in 1909, Barker, Professor of Surgery at London's University college hospital, had written three articles including 300 carefully studied cases, in them he advocated general principles of spinal analgesia that are in current use till now. During many years, spinal analgesia had gone through alternating periods of enthusiastic acceptance and relative unpopularity. The use of spinal analgesia was greatly encouraged by the introduction of the use of ephedrine to combat hypotension in 1927• by Ockerblad and Dillon of the + University of Kansas School of Medicine, and by Rudolf and Graham. With the use of bupivacaine for intradural block, attention has been increased to the spinal anaesthesia. It has been used both in its isobaric state and made hyperbaric by the addition of glucose.