. Regional anesthesia : its technic and clinical application . f from 10 to 15 of the 2 per cent, solution. Thesyringe is almost completely discharged in the depth, and the rest ofthe solution distributed while the needle is withdrawn. The axillaryartery is then retracted upward (toward the pectoralis major) by theindex-finger, and the needle inserted through another wheal raised alittle below the first site of puncture (Fig. 152). The needle is advanceddeeply behind the artery, in a direction parallel with the axis of the BLOCKING OF SPINAL NERVES 187 arm, along the outer wall of the axi
. Regional anesthesia : its technic and clinical application . f from 10 to 15 of the 2 per cent, solution. Thesyringe is almost completely discharged in the depth, and the rest ofthe solution distributed while the needle is withdrawn. The axillaryartery is then retracted upward (toward the pectoralis major) by theindex-finger, and the needle inserted through another wheal raised alittle below the first site of puncture (Fig. 152). The needle is advanceddeeply behind the artery, in a direction parallel with the axis of the BLOCKING OF SPINAL NERVES 187 arm, along the outer wall of the axilla, thus aiming at its apex, so as toreach the radial (musculospiral) nerve in front of the head of the latissi-mus dorsi muscle. If no paresthesias are obtained, part of the solutionis injected in the depth, and the rest while the needle is withdrawn, asfor the first injection, using from 10 to 15 of the 2 per cent,solution. But if the needle happens to hit one of the main branchesof the plexus during its progression in the axillary space it should be. Fig. 152.—Brachial plexus block by the axillary route. The axillary artery is re-tracted upward and the needle, inserted through a wheal raised a little below the firstsite of puncture, is advanced behind the artery. stopped and the injection made without moving. The axilla is thenlightly massaged for a while to hasten the diffusion of the anestheticfluid. As a rule the needle is never attached to the syringe when it isintroduced in the vicinity of large blood-vessels. Time is allowed beforeconnecting the syringe, and the aspiration test made and renewed, soas to make sure that the point of the needle does not lie in the lumen ofa blood-vessel. I»» REGIONAL ANESTHESIA It has been advised to start the injection as soon as the needle hasreached a depth of from 2 to 3 cm., distributing the solution while theneedle is advanced, with a view to clearing the way in front of its point,thus avoiding the puncture of a blood-vess
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Keywords: ., bookcentury1900, bookdecade1920, bookidregionalanes, bookyear1922
