. Regional anesthesia : its technic and clinical application . Fig. 273.—Costo-iliac block for appendectomy (McBurney-Weirs incision). Thetwo dots mark the points of entrance of the needle, and the interrupted line the direc-tion of the anesthetic wall created across the nerve supply of the region. 3. Field-block C (Battle-Jalaguier-Kammerer Incision).—^With thepatient lying in the same position as before, i. e., on his back, whealsare raised along the right costal margin, from the xiphisternum to aboutthe level of the tip of the eleventh rib, and from that point downward 38o REGIONAL ANESTHES
. Regional anesthesia : its technic and clinical application . Fig. 273.—Costo-iliac block for appendectomy (McBurney-Weirs incision). Thetwo dots mark the points of entrance of the needle, and the interrupted line the direc-tion of the anesthetic wall created across the nerve supply of the region. 3. Field-block C (Battle-Jalaguier-Kammerer Incision).—^With thepatient lying in the same position as before, i. e., on his back, whealsare raised along the right costal margin, from the xiphisternum to aboutthe level of the tip of the eleventh rib, and from that point downward 38o REGIONAL ANESTHESIA to the iliac crest (Fig. 274). The needle, connected with the syringefilled with the per cent, solution, as before, is introduced through eachof these wheals in succession and advanced in the deeper structures, wherefanwise injections are made within the muscle layer. Subcutaneous. Fig. 274.—Field-block of the right half of the abdominal wall affording oppor-tunities for cholecystectomy as well as for appendectomy. Right rectus incisions canbe made at any level. injections are then made which join all the wheals together except thefirst to the last. From 100 to 150 of the solution are thus injectedin planes parallel to the surface of the skin, cutting off the innervationof half of the abdominal wall, thus affording a very wide zone of anes-thesia which establishes most favorable conditions for exploring the OPERATIONS ON THE ABDOMEN 381 abdominal organs, the gall-bladder especially. If splanchnic analgesia(page 358) is associated with this field-block procedure, it is possibleto complete the operation without the use of a general anesthetic, pro-^^ded gentleness is used in handling the abdominal organs, since theparietal anesthesia covers only the right half of the abdominal wall. The injections along the costal margin may be started from a pointmidway be
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