Obstetric anesthesia - then and now

In 1947 John Bonica as new Chief of Anesthesiology at Tacoma General Hospital organized one of the first around-the-clock labor anesthesia services and when became the first chairman of the new Department of Anesthesiology at the University of Washington (1960), caudal anesthesia was the primary technique used for providing labor analgesia. In 1967 the first volume of Bonica's classic textbook ''Principles and practice of obstetric analgesia and anesthesia'' was published. The text was a comprehensive treatise that pulled together virtually everything that was known in that field. Perhaps the most significant development in obstetric anesthesia in the past 20 years has been the introduction of spinal opioid analgesia.. Bonica predicted the probable success of these techniques in the last edition of his ''Obstetric analgesia and anesthesia'' handbook published in 1980. Current obstetric anesthetic practice, though quite different from what it was 30 or 40 years ago, has its roots in the priorities, techniques and teachings of Dr. John J. Bonica.