. 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. ty to thirty minutes before the time foroperation, instilling a few drops every five minutes, allowing it ample THE ORGANS OF SPECIAL SENSE WITH DENTAL ANESTHESIA 581 time to be absorbed and affect the deeper parts. During this time itis necessary to keep the eye closed to prevent evaporation and dryingof the cornea. The difficulty of rendering the iris ab
. 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. ty to thirty minutes before the time foroperation, instilling a few drops every five minutes, allowing it ample THE ORGANS OF SPECIAL SENSE WITH DENTAL ANESTHESIA 581 time to be absorbed and affect the deeper parts. During this time itis necessary to keep the eye closed to prevent evaporation and dryingof the cornea. The difficulty of rendering the iris absolutely anestheticby this method led surgeons in the earlier use of cocain to inject someof the solutions into the anterior chamber after the corneal section,a method which has now been almost entirely superseded by the sub-conjunctival injection. This method was practiced by Roller as farback as 1885, and is carried out as follows: After several instillationsinto the conjunctival sac to render this and the cornea anesthetic, aspeculum is inserted, and the conjunctiva seized by means of a mouse-tooth forceps; three points of injunction are usually selected, one justbelow the cornea and one on each side just below the middle line; it. Fig. 236.—Method of anesthesia of upper eyelid. (Braun.) is necessary that these sites be so chosen that the resulting edema willnot interfere with the operation. At each point 2 drops of a 5 per cent,solution are injected, care being taken that the needle does not pene-trate into the subconjunctival layers, which would result in toomuch edema. After these injections the eye is closed for five minutes,by which time some of the edema subsides and the solution has beengiven time to act and the iris is thoroughly anesthetic, when the opera-tion may be undertaken. For the removal of cataract several instillations at intervalsof a few minutes of a 5 per cent, solution, keeping the eye closed duringthe interval, will usually suffice; but when it is ne
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