. 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. ent agents. Beta-eucain is affected to a less extent than cocain and the samewith stovain, while with tropococain it has little or no effect. Novo-cain is decidedly affected, its action being greatly intensified and pro-longed by its addition. Other effects noticed by these combinations are that when usedwith cocain, which has a slight vasoconstrictor effe
. 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. ent agents. Beta-eucain is affected to a less extent than cocain and the samewith stovain, while with tropococain it has little or no effect. Novo-cain is decidedly affected, its action being greatly intensified and pro-longed by its addition. Other effects noticed by these combinations are that when usedwith cocain, which has a slight vasoconstrictor effect, that the result-ing anemia is slightly more marked than with such agents as novocain(Fig. 3). ADRENALIN 143 Large operative fields can be rendered completely bloodless byits use; here it is not necessary to thoroughly saturate the entire fieldwith the solution, but to make the injections in a peripheral or cir-cumferential manner around the field, as with the Hackenbruch planfor local anesthesia, or only in the directions from which the circula-tion enters, thus constricting all vessels which enters the operativearea; this use of the agent may often be of value when operatingupon very vascular areas even under general /JO /90 Fig. 3.—Illustrating diagrammatically the action of adrenalin in combination withdifferent anesthetics (after Lawen): A, Adrenalin; B, adrenalin with cocain; C, adrenalinwith eucain; D, adrenalin with tropococain (Braun). To obtain this perfect anemia in operating upon the extremities,unless at the extreme distal parts, it will be necessary to make theinjections on the distal as well as the proximal side of the field, toinfluence, on the one hand, the veins; on the other, the arteries asthey enter the field. The synthetic preparations, such as arterenin, homorenon, andsuprarenin synthetic, are found to be identically the same in formulaand action as adrenalin. Braun found that homorenon was aboutfifty times less toxic and fifty times les
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