. 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. tion for hour-glass contraction, when unaccompanied bysurrounding complicating conditions. Gastro-enterostomy and gastric resections are now no longernovelties under local anesthesia. The early and extensive workdone by Mikulicz, and later by Braun, Lawen, Bakes, and a host ofothers, especially Finsterer with his classic contributions upon thissubject, hav
. 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. tion for hour-glass contraction, when unaccompanied bysurrounding complicating conditions. Gastro-enterostomy and gastric resections are now no longernovelties under local anesthesia. The early and extensive workdone by Mikulicz, and later by Braun, Lawen, Bakes, and a host ofothers, especially Finsterer with his classic contributions upon thissubject, have placed this method of operating upon a firmly estab- 340 LOCAL ANESTHESIA lished foundation, and secures for it a recognition among other ac-cepted procedures. In posterior gastroenterostomy by the no-loop method, theoperation now generally performed, the posterior stomach wall is astolerant of operative intervention without discomfort as is the anterior;to secure access to it the mesocolon, in the usually selected non-vascu-lar area, is first freely infiltrated between its layers before it is dividedand the stomach seized: In drawing the omentum and transversecolon out of the field and displacing it above, as is usually done, they. Fig. 77.—1, Line of anesthesia for exposing stomach. Upper oblique line is foradditional incision for Ssabanajew-Frank gastrostomy; 2, for exposure of gall-bladder; 3,appendectomy through straight rectus incision. should be carefully covered with wet towels (saline solution), as theirprolonged contact with the air may excite some complaint. Afterinfiltration of the mesocolon no further infiltration is necessary, andthe various steps of the operation are carried out the same as under ageneral anesthetic. For gastric resections the gastrocolic and lesser omentums mustbe freely infiltrated between their folds for an area some little distancebeyond the proposed field of resection; this should not be undertakenby local anesthesia alone, except under
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