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Neuroa nesthesia and Regional Techniques
1932 - 1938
During the 1932–1938 period, neuraxial and regional anesthesia emerged as the central research axis, detailing segmental peridural spinal anesthesia, experimental spinal techniques, and epidural approaches while examining hemodynamic effects and local anesthetic pharmacology across thoracic and regional surgery. The neuroendocrine dimension of analgesia linked adrenal function, anesthetic hyperglycemia, sympathetic nervous system surgery, and denervation strategies for dysphagia and migraine, signaling an integrated neurophysiological framework for perioperative analgesia. Perioperative risk management emphasized dehydration, postoperative respiratory complications, and ether-related anaphylaxis, underscoring safety monitoring and mitigation across diverse surgical contexts. Historical Significance: Cross-period influences culminated in landmark techniques that shaped decades of practice, notably segmental peridural spinal anesthesia and endotracheal anesthesia. The 1937 publications Inhalation anaesthesia: A Fundamental Guide and Anæsthesia for Intracranial Operation codified safety standards, training, and neuroanesthesia protocols, while neurophysiological work on the effects of anaesthetics on action potentials in the cerebral cortex of the cat expanded understanding of cerebral management and anesthetic choice. Together these cross-period innovations laid the groundwork for modern regional techniques, airway management, inhalation protocols, and neuroanesthesia strategies.
• Neuraxial and regional anesthesia emerged as a central research axis, detailing segmental peridural spinal anesthesia, experimental spinal techniques, and epidural approaches, while examining hemodynamic effects and local anesthetic pharmacology across thoracic and regional surgery [2], [3], [7], [13], [14], [17].
• Autonomic nervous system and endocrine modulation are tied to anesthesia and analgesia, with studies on adrenal function, anesthetic hyperglycemia, sympathetic nervous system surgery, and denervation strategies for dysphagia and migraine, illustrating a neuroendocrine framework for analgesia [4], [6], [9], [10], [15].
• Perioperative risk management highlights dehydration risks, postoperative respiratory complications, and anaphylactic events during ether anesthesia, underscoring safety protocols, monitoring needs, and complication mitigation across surgical contexts [16], [19], [20].
• Systemic pharmacology and anesthesia modalities cover intravenous pentothal anesthesia, cyclopropane gas anesthesia with respiratory/ECG monitoring, and local anesthetics, illustrating pharmacodynamics, monitoring, and safety in diverse anesthetic practice [1], [11], [14].
• Pain management in neurological and surgical contexts appears as migraine relief, syringomyelia surgical intervention, and sympathectomy outcomes, reflecting neural-targeted strategies to reduce pain and functional impairment [5], [8], [10].
Mid-Century Molecular Neurophysiology
1939 - 1968
Multimodal Preemptive Analgesia
1969 - 1996
Risk-Stratified Multimodal Perioperative Care
1997 - 2003
Multimodal Perioperative Optimization
2004 - 2010
Multimodal Perioperative Optimization
2011 - 2023