. Regional anesthesia : its technic and clinical application . he maxillary block (page 72) and the medialorbital block (page 70) on both sides, so as to secure a wide anestheticarea which will be available in case of need. The resection of the septum does not always necessitate the use 136 REGIONAL ANESTHESIA of nerve-blocking. An intranasal block is realized by means of appli-cators moistened with 10 per cent, novocain-adrenalin, or cocain, solu-tion introduced in the manner shown in Fig. 109 and held in position fortwo or three minutes. A comparison of Figs. 110 and 111 shows clearlyhow the
. Regional anesthesia : its technic and clinical application . he maxillary block (page 72) and the medialorbital block (page 70) on both sides, so as to secure a wide anestheticarea which will be available in case of need. The resection of the septum does not always necessitate the use 136 REGIONAL ANESTHESIA of nerve-blocking. An intranasal block is realized by means of appli-cators moistened with 10 per cent, novocain-adrenalin, or cocain, solu-tion introduced in the manner shown in Fig. 109 and held in position fortwo or three minutes. A comparison of Figs. 110 and 111 shows clearlyhow the nerve supply of both walls is reached by the same applicator,and since the nerves he immediately beneath the mucous membrane,the anesthesia is realized in a relatively short time; but this procedureis rendered difficult by the presence of spurs and deviations of theseptum or other irregularities of the nasal cavity. Curved applicators Max llarySphenopalatine gang Vid arNasopalatine NInf. post nasal NMid palatine N Antpalat ne N. Fig. 110.—Areas of nerve distribution on the lateral wall of the nasal cavity. are very useful in those cases. Applications are renewed if solution gives more rapid anesthesia, but it must be usedcautiously. The patient, as advised by Bresgens (Braun), is asked tobend his head sharply forward so that the anesthetic does not runinto the throat, he is also at the same time directed to blow the side ofthe nose which has been anesthetized, the opposite half of the nose beingclosed. Cocain has also the advantage of enlarging the nasal cavitiesby contracting its blood-vessels and, consequently, its mucous lining;but the addition of adrenalin to novocain solutions is satisfactory if OPERATIONS ON THE HEAD 137 time is allowed. Submucous injections on both sides of the septum arefrequently necessary to produce absolute anesthesia of its bony andcartilaginous structures. The Killian method of regional anesthesia o
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