Regional anesthesia and chronic pain management in the 1920s and 1930s. The influence of the American Society of Regional Anesthesia.

BACKGROUND AND OBJECTIVES: Physicians in the 1920s and 1930s began to treat patients with chronic pain syndromes using regional anesthetic techniques for both temporary and permanent block of pain pathways. The founding of the American Society of Regional Anesthesia (ASRA) in 1923 provided a unique venue for the dissemination of information concerning regional anesthesia for both surgery and chronic pain management.

METHODS: The growth of chronic pain management on a national basis was assessed by using the Quarterly Cumulative Index to the Medical Literature to trace the distribution of information on regional anesthesia. From the Minutes of Meeting of the American Society of Regional Anesthesia, presented papers and the discussion that followed were analyzed.

RESULTS: Inquiries into regional anesthesia during the 1920s and 1930s predominantly dealt with technique. For the first time pain papers were listed under the regional anesthesia heading in the Index. The papers presented at ASRA meetings during the period helped develop the use of regional anesthesia for both chronic pain management and surgical anesthesia.

CONCLUSIONS: The ASRA was instrumental in bringing together physicians interested in regional anesthesia and pain management. During the 1930s physician anesthetists came to predominate as the organization's officers and members and helped translate the work of the ASRA into a part of the knowledge required to be a specialist physician in anesthesia.