Stories from over 50 years of exceptional experiences as an anesthesiologist are not often shared widely. This year, however, André P. Boezaart, M.D., Ph.D., FASRA, emeritus professor with the University of Florida (UF) Department of Anesthesiology, received the 2026 Gaston Labat Award from the American Society of Regional Anesthesia and Pain Medicine in April. At the acceptance ceremony, he delivered an autobiographical lecture, “My Half-Century Love Affair with Regional Anesthesia: Hard Lessons from War to Microanatomy to Acute Pain Medicine and Beyond,” which was recently published by Regional Anesthesia & Pain Medicine.
Boezaart’s narrative began in 1975, when as a young anesthesiologist conscripted into the South African Defense Force, he served in a forward surgical unit during “the Secret War” of Operation Savannah in Angola. Over the course of treating soldiers’ injuries, he and his colleagues improvised a procedure that, according to Boezaart, “may have been the first continuous peripheral nerve blocks.” By inserting a central venous catheter adjacent to the axillary artery and securing it, they could deliver local anesthetic repeatedly for daily treatment and interfacility transport. This technique made repeated blocks possible for the wounded soldiers, and it was only after the wartime records were declassified in 2006 that the origins of the ingenious technique could be shared.
The practitioner’s work extended beyond war wounds. During the 1980s, he and his colleagues implemented continuous epidural labor analgesia, establishing the “walking epidural” concept that has become common practice worldwide. Later, in a triumph of innovation over challenge, a 20% failure rate for thoracic epidural blocks ultimately led to the adoption of electrically stimulated catheters, which reduced failures to near zero.
As part of his lecture, Boezaart reflected on his vantage point during the evolution of regional anesthesia. While the field grew to include continuous epidurals, nerve stimulation, and ultrasound guidance, his experiences underscored the necessity of humility, as lessons learned from difficult experiences led to breakthroughs. “Most of the important lessons about regional anesthesia and acute pain medicine I learned by improvising and getting things wrong,” wrote Boezaart. “If there is a single lesson from these fifty years, it is that progress never comes from defending what we think we know but rather from the discomfort of realizing we were wrong and the discipline to adopt, adapt, and improve.”
The narrative of his personal history with acute pain medicine also revealed how microanatomy shapes outcomes. His discovery of a book by Miguel A. Reina, M.D., Ph.D., a courtesy faculty member with the Department of Anesthesiology, dramatically enhanced his understanding of regional anesthesia. This led to a close friendship, scientific collaboration, and numerous shared publications. Boezaart’s lecture details how microanatomical understanding guide current treatment and informs future advances.
The lecture concluded on a philosophical note: progress in pain care depends on learning from uncomfortable errors. “Being wrong and making mistakes is uncomfortable, but it’s also the best form of ongoing education,” said Boezaart. “If we’re never wrong, we’re not asking hard enough questions. . . We have much to learn, so learn we must, not only for ourselves but also for those who depend on us and are forced by circumstance to endure pain.” From a wartime field hospital to the hallways UF Health, the message remains clear: humility, curiosity, and a willingness to adapt are the hallmarks of clinical advancement.
Congratulations to Dr. Boezaart!