Marhofer P, Kapral S
Anesthesiology. 2025; DOI: 10.1097/ALN.0000000000005548
This retrospective article revisits the landmark 1994 study by Kapral et al., which first described an ultrasound-guided supraclavicular approach to the brachial plexus. That “Classic Paper” marked a turning point in the field of regional anesthesia by introducing direct nerve visualization using two-dimensional ultrasound—an innovation met with early skepticism but ultimately embraced worldwide. Marhofer and Kapral recount their pioneering efforts in Vienna, Austria, detailing how ultrasound guidance gradually replaced nerve stimulation techniques, improved safety, and reduced local anesthetic volumes. The article also traces the evolution of technology and education in the field, culminating in global collaborations and modern enhancements like in-plane needle guidance, pediatric applications, and augmented reality-assisted procedures. Their work laid the foundation for ultrasound-guided regional anesthesia to become a new standard of care.
References
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Kapral S, et al. Anesth Analg. 1994;78:507–13.
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Koller C. Lancet. 1884;124:990–2.
3–42. [Refer to full article for complete reference list.]
We thank the journal Anesthesiology for revisiting this pivotal contribution to regional anesthesia. Their dedication to highlighting historical milestones reinforces the value of innovation and collaboration in anesthesiology’s continued progress.