. 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. 90). Neither is there any danger of puncturing the artery, which pos-sesses thick walls, is protected by the lingula, and has enough space toevade into the loose surrounding tissues or into the depth of the in-ferior dental canal (Fig. 188). The corresponding vein is arrangedaround the artery in form of an intricate plexus and is equally wellprotected. The
. 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. 90). Neither is there any danger of puncturing the artery, which pos-sesses thick walls, is protected by the lingula, and has enough space toevade into the loose surrounding tissues or into the depth of the in-ferior dental canal (Fig. 188). The corresponding vein is arrangedaround the artery in form of an intricate plexus and is equally wellprotected. The injection in the left ramus offers somewhat greater THE HEAD, SCALP, CRANIUM, BRAIN, AND FACE 525 difficulties. While in the right oblique foramen the retromalar tri-angle is palpated with the left hand and the injection is made with theright, it is advisable to use the left hand for injection on the left side,according to Peuckarts suggestion, palpating and fixing the retro-malar triangle with the right. Effect of Injection—About three minutes after the injection thepatient perceives a slight tingling in the lip and tongue on the in- Occipitofrontal m. A poneitrosisTemporal jascia Temporal m. Zygomatic arch Parotid gland Masscler. Fig. 191.—Frontal section of temporal region. The solid black line indicates theaponeurosis, the dotted line the periosteum and temporal fascia. At the mandibularforamen a mass of adipose tissue is observed which offers no resistance to the advanceof the needle. (After Merkel.) jected side. The tingling is the best indication as to the correct execu-tion of the injection. The sensation gradually increases, and a certain numbness ofthe entire half of the jaw ensues. The lip on the anesthetized sidedepends slightly, exhibiting symptoms of partial paralysis, and thepatient usually feels as if it were greatly swollen. Difficult deglutition 526 LOCAL ANESTHESIA is absent if the technic has been executed correctly. Its presence indi-cates that the inj
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