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Recalling the First Battlefield Use of Regional Anesthesia in Iraq

Doctors at Walter Reed have been using regional anesthesia for years, but Oct. 7, 2003, was the first time they used it on the battlefield.

Regional anesthesia involves placement of a catheter through which local anesthetic can be administered to a specific area where the patient is experiencing pain.

"Army Spc. Brian Wilhelm was the first individual that ever had a continuous peripheral nerve block on the battlefield that was used during evacuation," said Buckenmaier. "We kept him pain-free from Iraq to Landstuhl and from Germany back to Walter Reed by redosing him through those same catheters we inserted in Balad, Iraq. We also used the same catheters during five operations."

Wilhelm was suffering from a rocket-propelled grenade wound to the back of his leg that blew off the hamstrings.

"Specialist Wilhelm was awake during the operation, just slightly sedated," the pioneering anesthesiologist said. "He was wide awake at the end of the case, interacting with his buddies. It was a happy time, rather than a sorrowful time like it usually is after a general anesthetic, where patients are groggy and feel so bad about what's happened to them, and you can't really talk to them."

"With this anesthetic, they're alert, they're awake, and they're talking to you like I'm talking to you right now," Buckenmaier said. "The first time we used regional anesthesia on the battlefield was a very powerful moment. Brian went through a horrible experience. And, yes, it was a horrible wound. Brian went on to lose his leg, but he's pain-free."

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