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 . l anesthesia, and should be done with asmall syringe and fine needle. In highly sensitive individuals thepoint of entrance of the needle may first be anesthetized with ethylchlorid, but this is ordinarily unnecessary; if the skin at the selectedpoint is first pinched up between the thumb and finger and hcklfirmly it lessens its sensibility; with a quick but lig
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 . l anesthesia, and should be done with asmall syringe and fine needle. In highly sensitive individuals thepoint of entrance of the needle may first be anesthetized with ethylchlorid, but this is ordinarily unnecessary; if the skin at the selectedpoint is first pinched up between the thumb and finger and hcklfirmly it lessens its sensibility; with a quick but light thrust theneedle is advanced beneath the epidermis. Wliile making this ini-tial stick the thumb should be on the plunger, so that at the momentthat the needle enters the skin the solution can be injected; in thisway this initial stick is often made without the patients knowledge. PRINCIPLES OF TECHNIC 177 This injection must be intradermal and not subcutaneous; itshould develop a distinct wheal, which stands up from the surround-ing surface like an urticarial wheal (Fig. 6). This anesthetic pointshould be regarded as a station from which the anesthesia is dis-tributed in the desired direction, either continuously in an intra-.
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