Disclaimer

Buckenmaier was on a forward surgical team with the 31st Combat Support Hospital in Balad. He said the first definitive surgery wounded soldiers get is at a combat support hospital, and that's where anesthesiologists work and where regional anesthesia techniques are used.

"I'm unaware of it being used in Afghanistan, but I do know that it's being used at the 31st Support Hospital in Baghdad and in Balad," he noted. Chiles is in Baghdad, he added, and Maj. (Dr.) Todd Williams is in Balad.

Buckenmaier said the Army surgeon general was concerned about wounded soldiers being flown from the battlefield in excruciating pain. The surgeon general sent an e-mail to Chiles, who was Buckenmaier's boss at the time, asking if anything could be done to mitigate pain in wounded soldiers being medically evacuated from Iraq.

"Well, here at Walter Reed, we'd been working with regional anesthesia for a long time," Buckenmaier pointed out. "We'd been preaching that we could do this for years. So finally, the surgeon general said 'put your money where your mouth is. Why don't you go and prove it?'"

Buckenmaier went to Iraq hoping to get a case or two, but it turned out to be much more than he expected. "I wanted that index case, which Brian Wilhelm was, to prove that we could do this," Buckenmaier said. "But it exploded. It's such a good idea that the surgeons ceased allowing us to just put it in Americans. They immediately (realized) 'I don't have to take this Iraqi prisoner back to the operating room to do a dressing change every time. I can have this doctor put this block in, and he can dose the catheter and do the dressing change right at the bedside.'

"That's where this is really impacting in Iraq," he continued. "Most of the American soldiers get injured and they're out of the country within 48 hours. Some of them are moving so fast that we don't have time to get a block in them. But when the Iraqis get injured, they don't go anywhere. So these catheters are being used every day in Iraqis."

Reprinted with permission by Rudi Williams, American Forces Press Service.

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