Paradigm shift.

In 1900, Oskar Kreis (1872-1958), a gynecologist and obstetrician who received his training at the Basle University Women's Hospital, pioneered the use of spinal anaesthesia in six parturients for labour pain relief. Cocaine was used as a local anaesthetic, which had previously been shown to be effective for spinal anaesthesia by August Bier in 1898. This important advance in anaesthetic care was not widely acknowledged for a long period of time and it has only been during the past few decades that spinal anaesthesia was rediscovered as an important technique available for obstetric anaesthesia.

Analgesia, Obstetrical↗

PubMed2001

Anesthesiologists' interest in neonatal resuscitation certification.

STUDY OBJECTIVE: To survey graduates from our residency program to determine their involvement and their interest in becoming certified in neonatal resuscitation. DESIGN: Survey questionnaire. SETTING: Graduates from the University of Pennsylvania Anesthesia Program between 1989 and 1999. SUBJECTS: 212 individuals completed the residency; addresses were available for 189 and the response rate for these individuals was 156. RESULTS: Of the respondents with obstetric anesthesia responsibilities, 65% have been involved in resuscitation of the newborn. Sixteen percent were certified, but 81% were interested in certification. If the hospital had less than 1000 deliveries per year, the probability of the anesthesiologist having to perform neonatal resuscitation was 11.0 times greater than if the hospital had more than 1000 deliveries per year (confidence interval, 1.4--86). CONCLUSIONS: Despite guidelines recommending the contrary, anesthesiologists are involved in the resuscitation of the newborn. The majority of these individuals are not certified but are interested in becoming certified. The ASA should establish programs to offer the opportunity to learn and to reinforce these skills.

Analgesia, Obstetrical↗