. Regional anesthesia : its technic and clinical application . the following manner: After performing thesacral block (page 285) by injecting 20 of the 1 per cent, solutionin the sacral canal, and about 30 of the same solution in the pos-terior sacral foramina from S^ to S^, the patient is placed in the dorso-sacral position and two wheals are raised, one on each side, over thepubic spines. Through these wheals a needle of convenient length,attached to the syrmge filled with the per cent, solution, is passedfirst in a direction perpendicular to the surface of the skin, then more
. Regional anesthesia : its technic and clinical application . the following manner: After performing thesacral block (page 285) by injecting 20 of the 1 per cent, solutionin the sacral canal, and about 30 of the same solution in the pos-terior sacral foramina from S^ to S^, the patient is placed in the dorso-sacral position and two wheals are raised, one on each side, over thepubic spines. Through these wheals a needle of convenient length,attached to the syrmge filled with the per cent, solution, is passedfirst in a direction perpendicular to the surface of the skin, then more GENITO-TXRINARY AiW RECTAL OPERATIONS 42] and more obliquely, distributing the solution in the subcutaneous tissueof the pubic eminence and genitofemoral fold lateral to the labia another point of entrance placed between the anus and vulvarorifice, subcutaneous injections are made in the direction of the pubic injections are meant for blocking the nerves approaching thelabia majora from the inguinal region; those from the preanal wheal. Fig. 301.—Field-block for operations on the vulva. The two upper dots are whealsraised at the level of the pubic spine; the lower, between the anus and the vulva. Thearrows show the direction of the subcutaneous infiltration. complete the anesthesia in case the pudendal branch of the small sciatichas been missed by the sacral injections. CESAREAN SECTIONCesarean section is most easily performed by means of local orregional anesthesia, especially when the pregnancy has reached its fullterm. The injection of the per cent, solution along the line of in-cision is all that is necessary in the majority of cases. The idea ofavoiding alteration in the vitaHty of the tissues to be approximatedsometimes suggests the injection of two walls of anesthesia, one oneach side of the linea alba, and parallel with it. The advantages of the 422 REGIONAL ANESTHESIA field-block procedure, by which the injections are made within therectus
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