Even before pain management's recognition as a stand-alone specialty (1993), it has always been within the skill set of the anesthesiologist. I recount one experience from 1985:

"Bill" was in the terminal phase of widely-metastatic prostate carcinoma. He had excruciating and continuous pain affecting one leg and hip; his condition was too advanced to tolerate surgery. His adult daughter approached me stating that he was in continuous agony. Narcotic pain relievers were not working. Was there something I could do? He wanted no residual fogginess so that he could communicate with family.

A brief interview and neurologic exam revealed his pain to be affecting one major nerve root going to the leg. I was aware that even before the 1940s, practitioners had used super-concentrated alcohol to p

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