. Regional anesthesia : its technic and clinical application . e wrist bracelet (page 316), passing through the sites of punc-ture of the said nerves, unless pathologic conditions contraindicate in-jections at that level, in which case they are made at the elbow, or thebrachial plexus is block induced. In case of infection of the diffusephlegmonous type the anesthetic procedures must always be accom-phshed at the greatest possible distance from the infected region. Thebrachial plexus block by the supraclavicular route (page 189) is to beresorted to in preference to any of the other procedures.
. Regional anesthesia : its technic and clinical application . e wrist bracelet (page 316), passing through the sites of punc-ture of the said nerves, unless pathologic conditions contraindicate in-jections at that level, in which case they are made at the elbow, or thebrachial plexus is block induced. In case of infection of the diffusephlegmonous type the anesthetic procedures must always be accom-phshed at the greatest possible distance from the infected region. Thebrachial plexus block by the supraclavicular route (page 189) is to beresorted to in preference to any of the other procedures. For operations on the skin of the dorsum of the hand it is sufiicientto circuminject the operative field with the per cent, solution injectedsubcutaneously; but for those in the palmar region it is absolutely nec-essary to block the median and ulnar nerves (pages 206 and 212) andinfiltrate the wrist bracelet, unless the operation involves only theulnar margin of the hand, in which case the ulnar block at the elbow OPERATIONS ON THE UPPER EXTREMITIES 325. Fig. 244.—Zone of anesthesia resulting from the median and the ulnar block associatedwith the wrist bracelet. (page 212) is the method of choice. It is not customary to anesthetizethe hand by puncturing the skin of its palmar aspect. The injections 326 REGIONAL ANESTHESIA are made from the dorsum of the hand, which lends itself better to thepassage of the needle than the skin of the palm. The fingers are anesthetized either separately or with their meta-carpals, according to the needs of the operation, by local infiltrationand field-block. The amputation of the little finger, however, is bestperformed by the ulnar block at the wrist, or at the elbow (page 212).
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