Der Anaesthesist
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Biography Historical Article
[100 years ago: Oskar Kreis, a pioneer in spinal obstetric analgesia at the University Women's Clinic of Basel].
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.
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In the present study 48 sagittal and transversal magnetic resonance images of volunteers were examined for biometric data concerning risk of pneumothorax at the vertical infraclavicular blockade (VIP) of the brachial plexus. With a correct puncture the plexus can be reached after 3 cm. The shortest way to the lung is 5.3 cm (3.1-8.7 cm) at a incorrect medial angle of puncture of 46.3 degrees (35-58 degrees). ⋯ In one case, the risk for pneumothorax could be measured even with the correct puncture technique. Overall, the VIP is a very safe method for brachial plexus anaesthesia with regard to the risk of pneumothorax. In asthenic women, the risk seems to be higher but can be minimised by reducing the maximum puncture depth.