. 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. iculty,passing the needle under them. After thirty minutes the area, as indicated in Fig. 38,I, also almost the entire flexor surface of the forearm and a part of the extensor surfacehad become anesthetic. The injection was made at 12 oclock, and about 4 oclock inthe afternoon sensation returned. Anesthesia of a part of a finger can be obtained by direct l
. 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. iculty,passing the needle under them. After thirty minutes the area, as indicated in Fig. 38,I, also almost the entire flexor surface of the forearm and a part of the extensor surfacehad become anesthetic. The injection was made at 12 oclock, and about 4 oclock inthe afternoon sensation returned. Anesthesia of a part of a finger can be obtained by direct localinfiltration; more often the anesthesia of an entire finger is necessary,especially in inflammatory affections (bone felons, panaritium, teno-synovitis, traumatism, foreign bodies, etc.). In all such cases the para-neural infiltration method applied at the root of the fingers will yieldperfect results. This is the method which we have continuouslyfollowed in our practice. If, for example, it is a bone felon that we wishto open, the skin of the root of the finger, a little above the level of thepalmar web, is infiltrated on the dorsal side (Fig. 39); a fine hypo-dermic needle is used for infiltration, and a wheal of intracuticular. Fig. 39.—Cross-section of finger: a, Flexor tendon; b, bone; c, extensor tendon; 1 and2, points of entrance of needle to reach dorsal and palmar nerves. (From Braun.) edema serves as the starting-point from which a circle of anesthesiais carried around the base of the digit. After this has been done, theneedle is driven in painlessly through the infiltrated skin into thelateral aspect of the ringer in search of the digital nerves, which lies oneach side of the phalanx in close proximity to the blood-vessels; a fewdrops (5 to 10) of strong solution of novocain ( per cent.) are in-jected into the paraneural regions so as to create an anesthetic at-mosphere around the nerves. The arm is now raised and the finger is exsanguinated by gravity,after
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
