The History and Development of Intravenous Regional Anaesthesia

Intra‐Osseous Regional Anesthesia for the Limbs of Buffalo‐Calves

“…Intramedullary administration of a bulk of local anesthetic solution, however, posed a problem. In humans this method of producing regional anesthesia of the limbs has been described (1,3,4,6, and 7), and has been reported useful where a peripheral vein is not available for injection (6,7). Although intramedullary infusion of solutions has been reported to be as easy and convenient as the intravenous route in human patients (3,7), in this study, it did not hold true.…”

“…The introduction of intravenous regional anesthesia (2, 5) marked a new era of regional anesthesia which enjoys wide popularity in human medicine (6,7) and has been adopted recently in veterinary medicine (8,9). The technic of intra-osseous regional anesthesia in human limbs was reported in 1943 (3) and more recently, in 1965 and 1969 (4,7).…”

Anestesia regional intravenosa primeiro centenário (1908-2008): Início, desenvolvimento e estado atual

“…De qualquer forma, essa última proposta, que passou a permitir a difusão da solução anestésica por todo o sistema venoso da região isquêmica, simplificou o método original, aumentou sua eficiência e foi parcialmente responsável pelo posterior desenvolvimento da ARI. A origem dessa modificação técnica foi, três décadas depois, várias vezes atribuída a Holmes [26][27][28] , equívoco que ele reconheceu em publicação sobre a história e o desenvolvimento da ARI 29 ; realmente, pesquisa histórica posterior 30 mostrou que Bier 18 , seguido de Lenormant 31 , já havia utilizado um só torniquete em alguns casos, como exposto em artigo datado de 1910: "Nós também experimentamos eliminar o torniquete periférico e injetar a solução em toda a região isquêmica do membro, mas isso só é aconselhável nos casos em que há possibilidade de puncionar uma veia um pouco acima da articulação de pé ou punho." Em 1946, outra modificação do método original de Bier [17][18][19] foi sugerida pelo mexicano Herreros 32 , que propôs o emprego de torniquete pneumático com pressão inferior à sistólica, mas superior à distólica, permitindo a circulação arterial na extremidade; conduta semelhante já havia sido empregada por Morrison 24 , dentro de determinadas indicações.…”

“…Anyway, the last proposal, which allowed the diffusion of the anesthetic solution throughout the venous system of the ischemic area simplified the original method, increased its efficacy, and was partly responsible for the future development of IVRB. Three decades later the origin of this technical modification was attributed to Holmes [26][27][28] , an equivoque recognized by him in a report on the history and development of IVRB 29 ; in fact, a historical investigation conducted 30 demonstrated that Bier 18 , followed by Lenormant 31 , had already used a single tourniquet in some cases as exposed in a report of 1910: "We also tried to eliminate the peripheral tourniquet and injected the solution in the entire ischemic area of the limb, but this is advisable only when a vein just above the foot or wrist joint can be catheterized." In 1946, another modification of Bier's original method was suggested by Herreros 32 who proposed the use of a pneumatic tourniquet with a pressure below the systolic pressure but above the diastolic pressure, maintaining the arterial circulation in the extremity; Morrison 24 had used a similar technique for specific indications.…”