This historical issue of the NEWSLETTER recognizes the 150th anniversary of the introduction of modern obstetrical anesthesia. It is sheer coincidence that my first clinical experiences in anesthesia occurred in obstetrical clerkships as a medical student and long before I would consider a career in anesthesiology.

My first obstetrical clerkship, as a third-year medical student, was at a municipal institution. My first obstetrical anesthetic was a spinal for cesarean section; this was administered by me and supervised by a senior ob/gyn resident. Apparently all went well, as I have no negative recollections of the event.

Between my third and fourth years of medical school, a summer externship at a small community hospital led to my next encounter with obstetrical anesthesia. I was rudely awakened by a House Officer and told to report to the obstetrical suite where I was promptly handed a Schimmelbusch mask and a can of ether; my instructions were to drop ether on the mask until the patient was asleep for an episiotomy repair. Oblivious to laryngospasm, aspiration and the second stage of ether anesthesia, I poured. The patient, eager to be asleep, inhaled the vapor and, in surprisingly short order, was soundly asleep.

During my internship year (PGY-1 in today's terminology), a six-week rotation in obstetrics again tested my anesthesia skills. First came a low forceps delivery for which I administered open-drop chloroform on instruction from an obstetrical nurse. Then, once again, I was called to do a regional for an elective section. Since this medical school hospital had no anesthesiologist on staff, all sections were begun under field block. Once the infant was delivered, a nurse anesthetist administered general anesthesia.

The above experiences notwithstanding, the major portion of my PGY-1 year was spent in the Department of Medicine as I anticipated a medical residency.

Erwin Lear, M.D.
Editor

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FEATURES

Celebrating 150 Years of Modern OB Anesthesia

• Management of Childbirth Pain Before Anesthesia
  
  
• Fanny Longfellow and Nathan Keep
  
  
• Analgesia in Labor Becomes Respectable: The Role of John Snow
  
  
• 'To Give Birth Without Pain!' The First Cases of Mesmeric Pain Relief for Obstetrics
  
  
• 150 Years of Obstetric Anesthesia: A Pictorial Overview
  
  
• And What About the Baby? Virginia Apgar and the Apgar Score
  
  
• Obstetric Anesthesia: The Last Five Decades
  
  
• John J. Bonica Makes Obstetric Anesthesia an Academic Concern
  
  

ARTICLES

• Breaking Down the Barriers to Pain Management
  
  
• Practice Options: Considerations in Setting Up an Office-Based Anesthesia Practice

DEPARTMENTS

• To the Membership
  
• Washington Report
  
• Practice Management
  
• Residents' Review
  
• ASA News
  
• Letters to the Editor
  
• FAER Report
  

The views expressed herein are those of the authors and do not necessarily represent or reflect the views, policies or actions of the American Society of Anesthesiologists.

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