. Regional anesthesia : its technic and clinical application . Fig. 27.—Costo-iliac block. The shaded area represents the anesthesia resultingfrom the infiltration of a wall extended from the tip of the eleventh rib to the anteriorsuperior iliac spine (*). The dots represent the wheals. greater importance than the simple injection of the nerve from the anesthesia produced by intraneural injections is instan-taneous in most cases, this procedure is occasionally followed by post-operative neuralgia. Extraneural injections are not painful, while GENERAL PRINCIPLES OF TECHNIC 55 i
. Regional anesthesia : its technic and clinical application . Fig. 27.—Costo-iliac block. The shaded area represents the anesthesia resultingfrom the infiltration of a wall extended from the tip of the eleventh rib to the anteriorsuperior iliac spine (*). The dots represent the wheals. greater importance than the simple injection of the nerve from the anesthesia produced by intraneural injections is instan-taneous in most cases, this procedure is occasionally followed by post-operative neuralgia. Extraneural injections are not painful, while GENERAL PRINCIPLES OF TECHNIC 55 intraneural injections produce shock, especially when they are repeatedon several large trunks. They give as good anesthetic results, providedthe solution is not injected too far from the nerve and the correctstrength of solution used. It is hardly necessary to wait more than. Fig. 28.—Field-block of one-half or entire abdominal wall. Costal margin block andcosto-iliac block combined (see Figs. 26 and 27). five minutes if the injected fluid has been deposited in the immediatevicinity of the nerve. Nerve-block does not, as a rule, give a dry field. Contrary to whatis expected, there is more bleeding, due to the action of the anestheticfluid on the sympathetic chain accompanying the blood-vessels; but, 56 REGIONAL ANESTHESIA as already stated, the hemorrhage is only transient and does notinterfere with the operation. Sensibility is abolished; in very rare instances motility is instance, after a brachial plexus block almost all patients areable to move their forearm, wrist, and fingers during the operation,although the normal function of the limb is greatly altered. Thereis always a loss of tonicity of all the muscles, realizing a state ofparesis rather than paralysis. Nerve-block produces such a com-plete physiologic section of the nerve at the sit
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