. Regional anesthesia : its technic and clinical application . ?Stvjloid processExt. pterL(goid plate Fig. 68.—Mandibular block by the extra-oral route (2). The needle (in dottedlines) impinges on the pterygoid process, is withdrawn a little, swung in the directionof the arrow, and reintroduced toward the foramen ovale. BLOCKING OF CRANIAL NERVES 97 witli the skin surface as soon as the bone is felt. The needle is thendrawn back a little and reintroduced, aiming at about 1 cm. behindthe point at which it first impinged on the pterygoid process, until the. Fig. 69.—Con of Offerhaus. Determinati
. Regional anesthesia : its technic and clinical application . ?Stvjloid processExt. pterL(goid plate Fig. 68.—Mandibular block by the extra-oral route (2). The needle (in dottedlines) impinges on the pterygoid process, is withdrawn a little, swung in the directionof the arrow, and reintroduced toward the foramen ovale. BLOCKING OF CRANIAL NERVES 97 witli the skin surface as soon as the bone is felt. The needle is thendrawn back a little and reintroduced, aiming at about 1 cm. behindthe point at which it first impinged on the pterygoid process, until the. Fig. 69.—Con of Offerhaus. Determination of the intertubercularFig. 70. (After Braun.) recorder reaches the surface of the skin (Fig. 68). If no paresthesiasare obtained at that point, the needle is advanced cm. deeper beforeinjecting. The use of a depth recorder in the shape of a small piece of rubber,7 98 REGIONAL ANESTHESIA or cork, threaded on the needle, as first proposed by Braun, is a simple,easy, and rapid procedure, almost as accurate as the Offerhaus calipermethod (Figs. 69 and 70). When making intraneural injections of the mandibular nerve, eitherby the oral or extra-oral route, it frequently happens that the solutiondiffuses up to the gasserian ganglion, thus anesthetizing the whole areasupplied by the trigeminus. Anesthesia of the cornea in such cases
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