In 1908, the German physician August
Bier (1861–1949) discovered the novel
concept of intravenous anesthesia,
which he referred to as “vein anesthesia.”
However, he was not trying to capitalize
on the systemic effects of injected drugs;
his intent was just to numb a region of
the body, so he first used pressure to
push most of the blood from a limb and
then applied a tourniquet to prevent it
from flowing back into the limb. Then he
injected procaine into a vein in the limb,
which numbed the entire region. This
method of regional anesthesia, now
called a “Bier block,” is still used today for short operations on the arms or legs, although it was
not frequently used until 50 years after Bier’s discovery. After World War I, intravenous injection
caught on with morphine addicts, who were able to appreciate the stronger systemic effects of
“vein anesthesia.” Although barbiturates were discovered in the early 1900s, the use of intravenous
general anesthesia was not firmly established until the development of improved substances such as
sodium thiopental (also called by its trade name Pentothal) in the 1930s. Sodium thiopental induces
sleep very quickly, within 30 to 45 seconds, but does not relieve pain and must therefore be used in
combination with an analgesic.