. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. the inguinal region. (After Cushing.) Preparation for the Operation.—Preliminary hypodermic or mor-phin, \ gr., with scopolamin, yxj gr., one hour beforehand. Four ounces of solution No. i (novocain, per cent.; sodiumchlorid, per cent.), to which add 15 drops of adrenalin solution(1 : rooo). If the hernia is very large, it is well to have on hand
. Local and regional anesthesia : with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and on other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. the inguinal region. (After Cushing.) Preparation for the Operation.—Preliminary hypodermic or mor-phin, \ gr., with scopolamin, yxj gr., one hour beforehand. Four ounces of solution No. i (novocain, per cent.; sodiumchlorid, per cent.), to which add 15 drops of adrenalin solution(1 : rooo). If the hernia is very large, it is well to have on hand more HERNIA 35i than the 4 ounces. Small hernias may not require this much, but it iswell to have an ample supply. Two small hypodermic syringes and one large 10 syringe,with long fine needles, or a Matas infiltration apparatus—all welltested beforehand to be sure they are in good working order. Some operators prefer to inject the cases about fifteen minutes toone-half hour beforehand, and allow them to wait for the solutionto diffuse and become fixed in the tissues. This practice, while ad-visable elsewhere, we do not find necessary here, and proceed at oncewith the operation. Also some prefer to use a 1 per cent, novocain. Fig. 82.—Long needle passed through intradermal station to reach position of iliohypo-gastric nerve beneath tendon of external oblique. solution to infiltrate the nerves as they are encountered, but, as allthe nerves concerned are very small, it is unnecessary to use any butthe ordinary infiltration solution (No. 1). Begin the injection with the small hypodermic syringe at the high-est point of the proposed incision, at the upper and outer part of thefield, about ii inches internal and slightly below the anterior spine ofilium. Make the injection intradermally. With the large syringe andlong needle enter at this point, directing the needle downward to thesubcutaneous tissues (Fig. 82), and inject about % ounce in this posi-tion; another \ ounce
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
