![]() After injection of spinal cocaine into Hildebrandt, Bier conducted experiments on the lower half of Hildebrandt’s body. ![]() Otto Hildebrandt, volunteered to have the procedure performed after Bier was unable to continue due to the PDPH. Dural puncture was described in 1891 by Essex Wynter followed shortly by Heinrich Quincke 6 months later.Īugustus Karl Gustav Bier, a German surgeon, used cocaine intrathecally in 1898 on six patients for lower extremity surgery. In true scientific fashion, Bier decided to experiment on himself and developed a postdural puncture headache (PDPH) for his efforts. The presence of a neuraxial fluid was first noted by Galen in AD 200, and CSF was later studied in the 1500s by Antonio Valsalva. Because Corning made no mention of cerebrospinal fluid (CSF) efflux, most likely he inadvertently gave an epidural rather than a spinal injection to the patient. Ten minutes after the second injection, the patient complained of sleepiness in his legs but was able to stand and walk. ![]() Because Corning did not notice any effect after 8 minutes, he repeated the injection. Next, Corning injected cocaine into a man at the T11–T12 interspace into what he thought was the subarachnoid space. Corning first injected cocaine intrathecally into a dog and within a few minutes the dog had marked weakness in the hindquarters. Because Corning was a frequent observer at Roosevelt Hospital, the idea of using cocaine in the subarachnoid space may have come from observing Halsted and Hall performing cocaine injections. James Leonard Corning, a neurologist in New York City, in 1885 described the use of cocaine for spinal anesthesia. William Halsted and Richard Hall, surgeons at Roosevelt Hospital in New York City, took the idea of local anesthesia a step further by injecting cocaine into human tissues and nerves to produce anesthesia for surgery. Adrian Chin and André van Zundert THE HISTORY OF SPINAL ANESTHESIAĬarl Koller, an ophthalmologist from Vienna, in 1884 first described the use of topical cocaine for analgesia of the eye.
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