. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. one-half hour beforehand, and allow them to wait for the solutionto diffuse and become fixed in the tissues. This practice, wliile ad-visable elsewhere, we do not find necessary here, and proceed at oncewith the operation. Also some prefer to use a i per cent, novocainsolution to infiltrate the nerves as they are encountereil, l)ut, as all HERNIA 365 the nerve
. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. one-half hour beforehand, and allow them to wait for the solutionto diffuse and become fixed in the tissues. This practice, wliile ad-visable elsewhere, we do not find necessary here, and proceed at oncewith the operation. Also some prefer to use a i per cent, novocainsolution to infiltrate the nerves as they are encountereil, l)ut, as all HERNIA 365 the nerves concerned are very small, it is unnecessary to use any butthe ordinary infiltration solution (Xo. i). Begin the injection with the small hypodermic syringe at thehighest point of the proposed incision, at the upper and outer part ofthe field, about i>^ inches internal and slightly below the anteriorspine of ihum. ;Make the injection intradermally. With the largesyringe and long needle enter through this wheal directing the needledownward, injecting as it is advanced and distribute about 2 dramsof solution in the subcutaneous tissues at this point (Fig. 83). Byadvancing the needle sHghtly further through the subcutaneous tis-. Fig. 84.—Xeedle is partially withdrawn from position shown in Fig. 8j and directedsubcutaneously toward pubes. sues the aponeurosis of the external oblique is reached; this is recog-nized as the first plane of resistance which the needle encountersafter the skin is passed and varies in depth according to the stoutnessof the indivadual. The aponeurosis is gently pierced at this pointand about 2 drams of solution deposited beneath it. This is the firstpoint at which the iHoh}^ogastric nerve is encountered and in itsnormal position will not be found to be }i inch from the needle needle is now slightly withdrawn into the subcutaneous tissuesand its point directed toward the spine of the pubis injecting as theneedle is advanced the entire dista
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