. 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. the abscess with an exploring needle, andthe needle left in position while the infiltration is being carried is done the same as for thoracotomy, either by blocking thenerves or by massive infiltration. The rib next below the exploringneedle is exposed and resected for about 2 or 3 inches. If it is foundnow that the diaphragmatic pleura is adherent to
. 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. the abscess with an exploring needle, andthe needle left in position while the infiltration is being carried is done the same as for thoracotomy, either by blocking thenerves or by massive infiltration. The rib next below the exploringneedle is exposed and resected for about 2 or 3 inches. If it is foundnow that the diaphragmatic pleura is adherent to the parietal, theincision can be made at once down to the abscess, along the course ofthe exploring needle which has been left in position. The diaphragmis not usually sensitive, but, if it is found so, a few small syringes ofsolution, distributed along the course of the proposed incision, willsuflice to control it. The liver itself is never sensitive. If it isfound that the pleural space is still open at this point, the diaphragmmust be sutured to the chest wall before the abscess is incised. Indoing this, if pain is occasioned, the diaphragm is easily reachedwith a long needle and infiltrated. To illustrate the extensive pro-. Fig. 71.—Schematic representation of method of anesthetizing rib for resection in thor- actomy. (From Braun.) cedures, which are possible under local anesthesia in this region, wequote the following from a paper by the author, which appeared inthe Transactions of the Orleans Parish Medical Society for 1909:The next case is rather unusual, and one of the most interestingupon which I have ever operated, and, owing to the rare combinationof conditions found, I would like to put it upon record at this time: H., admitted to Ward 9, had been suiTering from dysentery for several weeks,having frequent bloody stools, in which amebae had been found. Medical treatmentchecked, but did not stop, the bloody evacuations. He shortly developed pain andswelling over t
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