2024-09-23 06:39:33
Epidural anesthesia was born more than 100 years ago, in times of war. Its creator was a Spanish military doctor, Fidel Pagés (1886-1923), who developed this method to reduce the pain of soldiers during operations.
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When epidural anesthesia was not yet available, in July Year 1909 The Spanish army suffered an ambush by Rife tribes in an area called Barranco del Lobo, close to the city Melillain North Africa. The attack left 153 dead and 528 injured.
All this hurt They join those who have already succeeded from the previous weeks, so in Melilla there is a true emergency situation.
The city’s hospitals could no longer cope and other places had to be set up to treat the wounded, such as schools, theaters, military casinos and even private homes.
In particular these days he arrived in Melilla Fidel PagesA young medical officer in the Spanish Army. In addition to providing its services during the Rif War, Pagés work in different hospitals to different Spanish cities during these years and He worked as a surgeon at the Vista Alegre bullring. from Madrid.
Inside The year 1917in the middle of World War I, he was assigned to Vienna with the task of inspecting the prison camps of the Austro-Hungarian Empire. There, in addition to doing this work, care for patients and perform surgeries.
A new anesthetic technique
All this hard experience led him to design and implement a new anesthetic technique. In 1921 he published an article in the Spanish Journal of Surgery in which he described his procedure, which he called metameric anesthesia.
“In the month of November last year, when I was doing spinal anesthesia, I had the idea of stopping the cannula in the spinal canal, before it passed through the dura mater, and I proposed to block the roots outside the meningeal space , and before passing through the holes of the connection, since the tips of the needles have crossed the corresponding yellow ligament.
[…] Analyzing sensitivity, we are able to assure ourselves that after five minutes a hypoesthesia begins in the infraumbilical part of the stomach, […] The hypoesthesia becomes progressively more pronounced, and twenty minutes after the injections, we think it is reasonable to start working. […] without any discomfort for the patient,” explained Dr. Pagés.
The result of this effort encouraged us to continue studying this method, which is clinically called metameric anesthesia, because of the possibility it offers us. deprive a part of the organs of sensationThis is as described Doctor Pages his novel process in said article.
Spinal anesthesia
Them anesthesia or rhachianesthesia It depends on the administration of the anesthetic intradural spaceinside the spine, passing through the dura mater, which is the skin that covers the spine. Anesthetic injected into the cerebrospinal fluid and needle away.
On the other hand, “in epidural anesthesia, the administration of the anesthetic is done in the epidural space, which corresponds to the space between the dura mater and the bone of our spine,” explains military doctor Francisco de Asís Gallardo Chamizo, Army captain.
To treat epidural anesthesia, “First, it is necessary to perform asepsis in the area where the injection was made with a special solution and make it a local anesthetic. Anesthetic is then injected through a carefully inserted catheter into the epidermal space, usually often. In this way, we can treat anesthesia before, during surgery and even after surgery,” Dr. Gallardo pointed out.
The first epidural
Inside The year 1947 Cuban anesthesia Manuel Martínez Curbelo use a lumbar epidural catheter for the first time.
Currently, when epidural anesthesia is administered, a needle is used to insert a catheter into the epidural space. The needle is removed and the catheter is stuck in and attached to the legl with tape so it doesn’t move.
As Dr. Gallardo explains, the amount of anesthesia required is progressively increased through this catheter as long as necessary.
“Overdose anesthesia has the advantage over general anesthesia that it requires less amount of anesthetic and produces fewer side effects. abdomen (inguinal hernias, bladder, etc.), muscles, legs or feet, since epidural treatment is usually performed at the level of the vertebrae where the organs from the abdomen and lower extremities arrive,” he explain.
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