. 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. lfreelv the femoral vessels; rather free infiltration between and around THE UPPER AND LOWER EXTREMITIES 253 the vessels and on their inner side should reach all branches of the nerveand leave the parts below completely anesthetic. Such a thoroughprocedure as the above will, however, only be necessary in extensiveresections of the joint, many lesser proced
. 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. lfreelv the femoral vessels; rather free infiltration between and around THE UPPER AND LOWER EXTREMITIES 253 the vessels and on their inner side should reach all branches of the nerveand leave the parts below completely anesthetic. Such a thoroughprocedure as the above will, however, only be necessary in extensiveresections of the joint, many lesser procedures involving only theanterior parts of the joint (the parts most frequently the site of surgicalintervention) can be easily performed through infiltration, or by block-ing the anterior crural and external cutaneous nerves at Poupartsligament. The latter procedure will suffice for the operative treat-ment of fracture of the patella, drainage in infected arthritis, theremoval of foreign bodies, lipomatosis, and other similar conditions. In operating upon fracture of the patella by infiltration, the jointcavity should be filled with i or 2 ounces of solution No. 2, with5 drops of adrenalin (i:iooo), and allowed to remain for from five. Fig. 51.—Peri-arlicular infiltration for operation in patella region. (Braun.) to ten minutes before the joint is opened; this will anesthetize thesynovial surfaces and permit the painless removal of clots or a thor-ough washing out of the joint. Even strong solutions, up to 2 per cent,novocain, could be used if necessary, as most of it escapes after thejoint is opened. It is, of course, advisable to use a constrictor abovethe knee in extensive operations here under infiltration and aftermaking a strong intra-articular injection. The method of infiltratingaround the patella region is seen in Fig. 51. These intra-articular injections may be made use of in breakingup adhesions within the joint when not too firm; it should be with-drawn after five
Size: 1865px × 1340px
Photo credit: © The Reading Room / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
