. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. nt remain perfectly quiet afteroperation, as he is able to do following the use of local remarks apply equally to all herniae. One difficulty encountered in postoperative herniae is the largeamount of fibrous tissue encountered, which mats all the structurestogether, but if a zone of anesthesia is created just outside of thearea no special
. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. nt remain perfectly quiet afteroperation, as he is able to do following the use of local remarks apply equally to all herniae. One difficulty encountered in postoperative herniae is the largeamount of fibrous tissue encountered, which mats all the structurestogether, but if a zone of anesthesia is created just outside of thearea no special difficulties are encountered. Herniae in the midline should be dealt with the same as umbili- HERNIA 3(>3 cal herniae, by a complete circumferential injection around the gap,thus sequestering all nerve-endings within the area. Herniae just to either side of the midline will also require a circum-ferential injection, as the nerve-fibers from the other side lap over themidline some little distance; but where the hernia is some distanceremoved, as is the case of those resulting from appendicular opera-tions, a circumferential injection is not necessary. As all the nervesin the anterior abdominal wall proceed downward and forward be-. Fig. 91.—Method of making crescentic line of anesthesia around postappendicular injections made through heavy dots. tween the muscle planes, it is only necessary to make the injection insuch a way as to block these. Consequently, a crescentic-like areaof anesthesia on the outer side of the hernia will prove sufficient,having the horns of the crescent to embrace the upper and lower ex-tremities of the gap and carried as a wall of anesthesia from the skinto the peritoneum. (See Figs. So and 91.) I have often closed largepostappendicular herniae in this way, and have found it very satis-factory. CHAPTER XIX GENITO-URINARY, ANORECTAL, AND GYNECOLOGIC OPERATIONS GENITO-URINARY ORGANS While the pudic nerve is the principal source of innerv
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
