Regional Anesthesia. The term “spinal anesthesia” was coined in 1885 by a neurologist, Leonard Corning, although it is likely that he actually performed an epidural injection. In 1944, Edward Tuohy of the Mayo Clinic introduced the Tuohy needle to facilitate the use of continuous spinal techniques. In 1949, Martinez Curbelo of Havana, Cuba, used Tuohy's needle and a ureteral catheter to perform the first continuous epidural anesthetic.John J. Bonica's many contributions to anesthesiology during his periods of military, civilian, and academic service at the University of Washington included development of a multidisciplinary pain clinic and publication of the text The Management of Pain.
Cardiovascular Anesthesia. Many believe that the successful ligation of a 7-year-old girl's patent ductus arteriosus by Robert Gross in 1938 served as the landmark case for modern cardiac surgery. The first successful use of Gibbon's cardiopulmonary bypass machine in humans in May 1953 was a monumental advance in the surgical treatment of complex cardiac pathology. In 1967, J. Earl Waynards published one of the first articles on anesthetic management of patients undergoing surgery for coronary artery disease. Postoperative mechanical ventilation and surgical intensive care units appeared by the late 1960s. Transesophageal echocardiography helped to further define the subspecialty of cardiac anesthesia.
Neuroanesthesia. Although the introduction of agents such as thiopental, curare, and halothane advanced the practice of anesthesiology in general, the development of methods to measure brain electrical activity, cerebral blood flow, and metabolic rate put neuroanesthesia practice on a scientific foundation.
Obstetric Anesthesia. Social attitudes about pain associated with childbirth began to change in the 1860s, and women started demanding anesthesia for childbirth. Virginia Apgar's system for evaluating newborns, developed in 1953, demonstrated that there was a difference in the neonates of mothers who had been anesthetized. In the past decade, anesthesia-related deaths during cesarean sections under general anesthesia have become more likely than neuraxial anesthesia-related deaths, making regional anesthesia the method of choice. With the availability of safe and effective options for pain relief during labor and delivery, today's focus is improving the quality of the birth experience for expectant parents.