Recognizing the Chinese Pioneer of Neuraxial Labor Analgesia: Dr Guang-Bo Zhang and Her Unpublished Manuscript From More Than a Half-Century Ago.

Dr Guang-Bo Zhang was the first anesthesiologist to administer and study the effects of labor epidural analgesia in China. Between September 1963 and March 1964, she conducted an observational study evaluating the effects of neuraxial analgesia for laboring women. She presented her research and prepared an article; however, due to the Great Proletarian Cultural Revolution (Cultural Revolution), which began in 1966, her work went unpublished. She successfully preserved her unpublished article, notes, and slides throughout the Cultural Revolution by hiding them in a countryside location near Beijing. These 54-year-old, previously unpublished documents represent the first known clinical trial of neuraxial labor analgesia conducted in China.

[Akiko Yosano, the famous Japanese poet and writer, is the first lady who experienced labor analgesia in Japan?].

There have been some records of labor analgesia with intravenous or rectal anesthetics since 1925. It is widely believed that labor epidural analgesia in Japan started to become popular after the World War II (1939-1945). However, the author found that Akiko Yosano, a well-known Japanese female poet and writer, had labor analgesia for her 5th son as early as 1916. She was given a mixture of an opioid alkaloid and scopolamine and had painless labor and delivery. She took this experience as a pleasant surprise and described "Never once, had I screamed or feel sweaty during my labor". She loved this comfortable and easy labor so much that she had it again for her 6th son in 1917. Her obstetrician was Dr. Yuzo Ohmi, who had studied in Munich University from 1910 to 1913. He brought this miracle painkiller from Germany to Japan and gave it to her for the first time in Japan. Akiko's husband, Tekkan Yosano, met Dr. Ohmi on a ship to Marseilles in 1911. Then, they and Akiko promoted friendship in Munich and Japan. Her labor experience and friendship with Dr. Ohmi are described in her collected essays "Warera-naniwo-motomuruka? (What do we long for?)" and "Ai-Risei-oyobi-yuhki (Love, Reason, and Bravery)". Dr. Ohmi's wife became a pupil of Akiko.

[Epidural analgesia for vaginal delivery].

Epidural anaesthesia is the most efficient method of pain reduction. The effect of pain over physiological mother's and fetuse's process; indications, contraindications and conditions for epidural analgesia for vaginal delivery, as like as side effects and complications of epidural analgesia are established in this review.

Tattoo and epidural analgesia: Rise and fall of a myth.

Since 2002, it has been unclear whether epidural analgesia (EA) could safe through a lower back tattoo. Theoretical risks of pigment tissue coring have led to precautionary measures and misconception that EA should be excluded. We reviewed chronologically the 18 years of medical literature summarizing the so-called risks of EA through lower back tattoo in parturient women. To date, no convincing complication has been ever reported after an EA through a tattoo. We hope this review will bring a closure to a 18-year-old "non-issue" that has poisoned and stressed unnecessarily a generation of parturient.

[Continuous spinal analgesia. A review]. / Kontinuerlig spinal analgesi. En oversigt.

Continuous spinal analgesia is a recognized method of analgesia for surgical interventions which was originally described in 1907. A brief historical review is presented with a description of the current technique. Emphasis is laid on comparison with other regional techniques, particularly single-shot analgesia and epidural analgesia. A review is presented of the current knowledge about technique, particularly the equipment, analgesic agents, advantages and disadvantages and indications and contraindications. it is concluded that continuous spinal analgesia probably offers certain advantages, particularly cardiovascular stability. However, the lack of randomized comparisons of the various techniques make further clinically controlled investigations necessary to illustrate this.

The historical narrative: tales of professionalism?

The historical narrative is a story told to illustrate a point, however subconsciously. The "giants" of obstetric anesthesia -- Simpson, Snow, Apgar -- and countless other less well-known physicians all contributed to the history of obstetric anesthesia. We remember them by retelling this history to illustrate elements of professionalism and how we as a profession wish to act. The Physician Charter is an excellent first approximation of a workable definition of this quality, which can and does change over time. By using the three principles and 10 professional responsibilities as a template, the past comes alive as a teaching method to each and every obstetric anesthesiologist.

A history of neuraxial administration of local analgesics and opioids.

The history of intrathecal and epidural anaesthesia is in parallel with the development of general anaesthesia. As ether anaesthesia (1846) is considered the first modern anaesthetic since its use by Morton 157 yr ago, so Bier made history by using cocaine for intrathecal anaesthesia in 1898. The first published report on opioids for intrathecal anaesthesia belongs to a Romanian surgeon, Racoviceanu-Pitesti, who presented his experience at Paris in 1901. It was almost a century before the opioids were used for epidural analgesia. Behar and his colleagues published the first report on the epidural use of morphine for the treatment of pain in The Lancet in 1979. Epidural and intrathecal opioids are today part of a routine regimen for intra- and postoperative analgesia. Over the last 30 yr, the use of epidural opioids has became a standard for analgesia in labour and delivery, and for the management of chronic pain. Finally, epidural opioids have been shown to have a pre-emptive effect, when used before major surgery. We present the evolution of neuraxial anaesthesia and the history of intrathecal and epidural administration of opioids.

Analgesia and anaesthesia in childbirth: obscurantism and obfuscation.

The terms 'analgesia' and 'anaesthesia' have been defined by emphasizing differing aspects of their effects. The distinction between these interventions has not been clarified by their definitions. The historical remedies for pain were similarly unclear. This lack of clarity is apparent in the introduction of chloroform in childbirth, which has much in common with the introduction and effects of epidural analgesia. The reasons for and benefits of this lack of clarity are examined.