SubSpecialties  |   March 2020
Obstetric Anesthesia: Origins and Current Practice
Author Affiliations
  • Lisa R. Leffert, M.D.
    President, Society for Obstetric Anesthesia & Perinatology (SOAP)
Article Information
Obstetric Anesthesia / SubSpecialties
SubSpecialties   |   March 2020
Obstetric Anesthesia: Origins and Current Practice
ASA Monitor 3 2020, Vol.84, 50-52.
ASA Monitor 3 2020, Vol.84, 50-52.
It wasn’t so long ago that physicians in training, obstetricians and surgeons served as ad hoc obstetric anesthesiologists, administering labor analgesia and cesarean delivery anesthesia. In 1845, the surgeon Crawford Long first administered inhalational ether to his own wife for childbirth. The use of chloroform and nitrous oxide for labor analgesia followed, most often administered by trainees under the supervision of surgeons with little to no understanding of aspiration risks.
Many of the pioneers of neuraxial techniques were also surgeons: August Bier introduced spinal anesthesia in 1898; Walter Stoeckel and Arthur Läwen applied the then novel single-shot caudal technique to obstetric deliveries in 1901. The Spanish military surgeon Fidel Pagés Miravé introduced the thoracolumbar approach to single-shot epidural anesthesia in 1921; and the Italian surgeon Achille Dogliotti popularized the single-shot epidural technique. It was Manuel Martinez Curbelo, an anesthesiologist, who revolutionized the field in 1947 by introducing the first continuous lumbar epidural technique using a modified silk ureteral catheter to deliver an infusion of local anesthetic for surgical anesthesia.1  In 1953, Virginia Apgar revolutionized the practices of obstetrics, anesthesiology and perinatology by introducing a simple quantitative measure of newborn health, subsequently known as the Apgar score.2 
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