Preface

Abstract

In 1884 the American neurologist J. L. Corning, by blocking the neural conduction to the hind extremities of a dog by injecting cocaine-solution into the lumbar vertebral interspace, was the first to perform spinal (or epidural?) anaesthesia [1]. At that time, he was unaware of the local anaesthetic properties of cocaine (discovered in the same year by C. Koller, who applied cocaine to the eye of one of his patients [3]) and did not intend to introduce an anaesthetic procedure. Coming’s primary aim was the application of drugs in proximity of the central nervous system, i.e. spinal cord, in order to treat or even heal different, especially painful, nervous diseases. His discovery, however, marks the onset of the era of regional anaesthesia. It took almost one hundred years until his original idea of “local medication of the cord” was again reconsidered due to two reasons:

• 1. The discovery of different drug receptors in the spinal cord made it possible, by intrathecal injection (or epidural application, if the drug penetrates the dura), to alter nociceptive or motor transmission within the spinal cord.

• 2. Implantable devices for long-term application of drugs to specific sites of the body, including the spinal spaces, were developed during the 1970’s.