. Regional anesthesia : its technic and clinical application . njection of the operative field with per cent, solution. If the field-block is resorted to for the resectionof small portions of two adjacent ribs, either on the lateral or on theanterior aspect of the thorax, wheals are raised at the extremities of theoperative field, in the three adjacent intercostal spaces in the middle of OPERATIONS ON THE THORAX 335 which lie the two ribs, and each intercostal nerve injected as describedfor the resection of a single rib. For more than two ribs it is better toinduce the paravertebral blo
. Regional anesthesia : its technic and clinical application . njection of the operative field with per cent, solution. If the field-block is resorted to for the resectionof small portions of two adjacent ribs, either on the lateral or on theanterior aspect of the thorax, wheals are raised at the extremities of theoperative field, in the three adjacent intercostal spaces in the middle of OPERATIONS ON THE THORAX 335 which lie the two ribs, and each intercostal nerve injected as describedfor the resection of a single rib. For more than two ribs it is better toinduce the paravertebral block (page 214), injecting one or two nervesabove and one or two nerves below the field involved in the operation,unless the operative area lies on the anterior wall of the thorax (), in which case the field block finds its practical usefulness. For the resection of costal cartilages it is much better to use the field-block procedure than to inject the thoracic nerves at their emergencefrom the spine. The costal cartilages are far from the spine and are. Fig. 256.—Field-block for resection of costal cartilages. The intercostal nervesand spaces are injected through 1 to 5, and the field circuminjected along the dottedlines 1-2-3-4-5-6-7-1. more easily anesthetized by blocking the intercostal nerves in theneighborhood of the operative field, as is done for rib resections, andmaking subcutaneous injections along the midline of the sternum, incase of unilateral operation. For bilateral resection the intercostalnerves are blocked on both sides a little beyond the operative area andthe midline infiltration is dispensed with. For operations on the sternum it is easier to block the region thanto induce a paravertebral block of seven thoracic nerves, which meansfourteen injections. Wheals are raised on both sides of the sternum, as il-lustrated in Fig. 257. Through each of these wheals needle No. 2 (5 cm.) 336 REGIONAL ANESTHESIA is inserted perpendicular to the surface of the sk
Size: 1742px × 1434px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookidregionalanes, bookyear1922
