Achille Mario Dogliotti

Achille Mario Dogliòtti (1897-1966) portrait 2

Achille Mario Dogliotti (1897-1966) was an Italian surgeon

Dogliotti was a highly versatile surgeon-scientist whose work spanned anaesthesia, pain therapy, general and cardiac surgery. Trained as a surgeon, he approached anaesthesia and analgesia as integral components of operative care rather than separate disciplines.

Dogliotti made foundational contributions to neuraxial blockade, particularly through his development of segmental epidural (peridural) anaesthesia in the early 1930s. He demonstrated that controlled, regional blockade could be achieved by injecting local anaesthetic into the epidural space at lumbar or thoracic levels, avoiding many of the haemodynamic and meningeal complications of spinal anaesthesia. His description of the loss-of-resistance technique for identifying the epidural space (“Dogliotti’s principle”) transformed epidural anaesthesia into a reproducible and widely adoptable procedure.

Dogliotti was a pioneer of pain therapy, employing chemical neurolysis and alcoholisation of posterior nerve roots and cranial ganglia for refractory neuralgia. From the late 1940s he also emerged as a leader in cardiac surgery, founding a dedicated centre in Turin and, on August 7, 1951, reporting one of the earliest successful human operations using total extracorporeal blood circulation.

Biographical Timeline
  • Born September 25, 1897, Turin, Italy. Son of Luigi Dogliotti, physician and mayor of Alba, and Clotilde Ferrara Bardile
  • 1914 – Entered the Faculty of Medicine, University of Turin
  • 1915–1918 – Volunteered for military service during World War I. Served initially as medical orderly, then medical officer. Awarded two War Crosses for bravery
  • 1920 – Graduated in Medicine, University of Turin. Doctoral thesis: Splenectomy in haemolytic jaundice. Appointed intern at the Institute of Surgical Pathology, Turin, under Ottorino Uffreduzzi (1881–1943)
  • 1923 – Appointed Assistant in Surgical Pathology, University of Turin
  • 1925–1929 – Advanced surgical training abroad. Study visits to France (Lyon, Paris) and the United States (major surgical centres). Early experimental work on shock, blood transfusion, renal vascularisation, and pain
  • 1926 – Achieved libera docenza (habilitation) in Surgical Pathology
  • 1933 – Described the peridural segmental anaesthesia technique. Formulated Dogliotti’s principle (loss of resistance for epidural space identification)
  • 1935 – Appointed Professor of Surgical Pathology, University of Modena. Research in anaesthesia, pain therapy, and neurosurgery
  • 1937 – Appointed Professor of Clinical Surgery, University of Catania. Built and directed a major surgical centre
  • 1942 – Volunteered for Second World War service. Served as consultant army surgeon on the Eastern Front. Founded and organised a large Italian military hospital at Voroshilovgrad (Luhansk)
  • 1943 – Appointed Professor and Director of Clinical Surgery, University of Turin
  • 1946 – Visit to the United States and met with Alfred Blalock (1899–1964)
  • 1951 – Founded the Blalock Cardiac Surgery Centre, Turin
  • August 1951: Performed the first successful human operation using total extracorporeal circulation
  • 1952 – Performed mitral commissurotomy and further pioneering cardiac procedures
  • 1956 – Led the Italian medical relief mission into Soviet-invaded Hungary
  • 1961 – Presided over medical events linked to the Centenary of Italian Unification (Turin)
  • 1964 – Awarded Honorary Citizenship of Alba
  • 1965 – Underwent neurosurgery in Zurich for a frontal lobe tumour
  • Died June 2, 1966 (age 68 years), in Turin, Italy
Key Medical Contributions
Key contributions to neuraxial blockade and Dogliotti’s principle

Dogliotti was central to the modernisation and international adoption of epidural anaesthesia, transforming it from a variably effective procedure into a reproducible, anatomically grounded technique. His work in the early 1930s consolidated epidural blockade as a distinct neuraxial modality, capable of producing controlled, segmental anaesthesia without entering the subarachnoid space.

Segmental epidural spread 1933
1. Injected local anaesthetic surrounds the dura mater and tracks into the intervertebral foramen to bathe the spinal nerve and spinal ganglion [S.G.].
2. Sagittal section of the spinal column showing cranio-caudal diffusion of local anaesthetic within the epidural space, producing controlled segmental blockade without intrathecal injection. [A-A1 = diffusion of anaesthestic; N = needle in epidural space] Dogliotti 1933

Dogliotti described segmental peridural anaesthesia with the injection of local anaesthetic into the epidural space so that it could act on spinal nerves along their course “between the dura mater and the intervertebral canals”. He determined this method would be “an intermediate position between the Corning–Bier method of spinal anesthesia and paravertebral anesthesia”, allowing safe and targeted blockade of selected spinal segments.

With this method one can anesthetize a series of spinal nerves… without danger of diffusion of the anesthetic toward the bulb, of serious fall of blood pressure and without the occurrence of meningeal irritation.

Dogliotti 1933
Dogliotti’s principle

Dogliotti described his method of identifying the epidural space by the loss of resistance encountered as the needle passes through the ligamentum flavum into the epidural space. By applying constant pressure to the syringe plunger during needle advancement, the sudden decrease in resistance provided a reliable physiological sign of correct needle placement. This simple but powerful concept dramatically improved the safety, accuracy, and reproducibility of epidural anaesthesia.

Quando la punta dell’ago supera i legamenti gialli l’iniezione non incontra più alcuna resistenza e dà l’impressione di versarsi nel vuoto.

Dogliotti 1931

In his 1933 English-language synthesis, he reiterated the use of the simple tactile sign

As soon as the needle pierces the ligaments and arrives in the peridural space, all resistance is at once removed and the liquid enters with every facility

Dogliotti 1933
Dogliotti’s principle (loss of resistance technique)
Dogliotti’s principle. Continuous pressure is applied to the syringe plunger as the needle advances; sudden loss of resistance signals entry into the epidural space after traversing the ligamentum flavum. Dogliotti 1933

Through anatomical dissection, cadaveric injection studies, radiological imaging, and clinical observation, Dogliotti demonstrated that epidural anaesthesia acts primarily on the spinal nerves and ganglia extradurally, with “only a very small quantity” of anaesthetic passing into the cerebrospinal fluid. His contributions assisted in the transition of epidural anaesthesia from experimental innovation to standard clinical practice.

Cardiac surgery in Italy

From the late 1940s Dogliotti emerged as a pioneer of cardiac surgery in Italy. After a post-war visit to the United States where he met Alfred Blalock (1899–1964), he established a dedicated cardiac surgery program in Turin, culminating in the foundation of the Blalock Centre in 1951.

On August 7, 1951, working with A. Costantini, Dogliotti performed a landmark operation employing total extracorporeal blood circulation. During an operation to remove a large mediastinal tumour from a 49-year-old man, intraoperative bradycardia necessitated connection to a heart–lung machine. The patient tolerated 20 minutes of extracorporeal circulation, and survived the operation, representing one of the earliest successful clinical applications of an apparatus for extracorporeal blood circulation.

Pain therapy and Chemical Neurolysis

Dogliotti helped formalise pain therapy as a surgical and neuro-anatomical discipline. He pioneered and critically evaluated techniques of chemical neurolysis, including alcoholisation of posterior spinal roots, cranial ganglia, and peripheral nerves in patients with refractory neuralgia.

Through anatomical localisation, staged clinical series, and long-term follow-up, Dogliotti demonstrated that targeted interruption of pain pathways could provide lomg-lasting relief in conditions such as trigeminal neuralgia and essential facial spasm.

Major Publications
References

Biography

Eponymous terms

Eponym

the person behind the name

more eponyms…

BA MA (Oxon) MBChB (Edin) FACEM FFSEM. Emergency physician, Sir Charles Gairdner Hospital. Passion for rugby; medical history; medical education; and asynchronous learning #FOAMed evangelist. Co-founder and CTO of Life in the Fast lane | On Call: Principles and Protocol 4e| Eponyms | Books |

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