Regional anaesthesia was first performed in 1884 by Karl Koller, an Austrian ophthalmologist in Vienna, using cocaine for eye surgery. This was followed in 1898 by August Bier, a German surgeon, using cocaine for spinal anaesthesia. The advantages ofregional anaesthesia have been debated ad infinitum: reduced cardiorespiratory complications, less thromboembolic events, modification of the stress response, improved patient satisfaction to name but a few. However, the overwhelming benefit is one of superior perioperative analgesia. This applies to both central and peripheral nerve blockade.
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