Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice . ted, as the indica-tions require, with a freedom of manipulation so necessary forthorough work that is rarely possible except in anesthetizedtissues. Fig. 21 shows a contused and lacerated wound with underminededges; it is to be treated the same as Fig. 20; the radiating lines from PRINCIPLES OF TECHNIC 189 the area of laceration will require slitting up to per
Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice . ted, as the indica-tions require, with a freedom of manipulation so necessary forthorough work that is rarely possible except in anesthetizedtissues. Fig. 21 shows a contused and lacerated wound with underminededges; it is to be treated the same as Fig. 20; the radiating lines from PRINCIPLES OF TECHNIC 189 the area of laceration will require slitting up to permit access to anddrainage from the deeper parts. Poisoned wounds from snake-bites, rabid animals, or otherdangerous sources will require handling as expeditiously as possible;this may not permit of the use of local anesthesia, although in thehands of those skilled in its use but a very few minutes are requiredfor the infiltration, which of course should always be carried out bythe above-mentioned Hackenbruch plan, keeping well away fromthe possible area of infection, and never by making the injectionsdirectly into the wounds. ]\Iany such wounds occur in surround-ings where the necessary facilities and instruments are not at hand. Figs. 20 and 21.—Method of surrounding scalp or other cutaneous wounds with zone of anesthesia (Braun). for the practice of local anesthesia, or any other form, and the indi-cations may be sufficiently urgent to demand a heroic procedure toremove or lessen the influence of the poison without any , many cases will present themselves where the indicationsare not so urgent; here the application of a constrictor will preventany further absorption, and the few minutes delay necessary for theanesthesia will be more than repaid by the greater facihty and thor-oughness with which incisions or cauterizations can be carried out,and the great satisfaction on the part of the medical attendant thathe is not inflicting pain on a screaming and wri
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