ABSTRACT
The introduction of regional anesthetic techniques into mainstream medical practice in the late 19th and early 20th centuries brought with it the promise of a new era in which surgery could be performed in a safer and more comfortable fashion. While regional techniques were almost universally adopted in the field of ophthalmology at an early stage, it was not until World War I that, building on Koller’s work, techniques were developed that allowed major abdominal surgery to proceed. Gaston Labat was recruited to bring these techniques to the Mayo Clinic, Rochester, Minnesota in 1921. Until then, deep ether anesthesia was required to provide adequate muscle relaxation, and, in turn, was associated with a high incidence of complications, especially atelectasis and pulmonary infection, in all but the most skilled of hands. Labat’s preferred anesthetic technique for abdominal surgery was multiple, bilateral paravertebral nerve blockade. The short duration of spinal and epidural anesthesia was a limiting factor until the introduction of epidural catheters in the 1940s. The further developments in and improved safety of general anesthesia through the 20th century served to obscure the early promise of regional anesthesia for much of that time. More latterly, however, a number of randomized control studies and meta-analyses have reawakened interest in these techniques, and it could now be said that regional anesthesia is undergoing a renaissance and earning its place at the forefront of perioperative care.
