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 . Fig. 17.—Apparatus for rapid massive infiltration anesthesia. Charging the cylinder with air-pump (Matas). Matas; as it is discussed in detail in the surgery of the extremitiesit will not be repeated here. This method is also utilized in the courseof any operation whenever nerves are encountered, as in herniotomies^thoracotomies, Fig. 18.—Cylinder charged
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 . Fig. 17.—Apparatus for rapid massive infiltration anesthesia. Charging the cylinder with air-pump (Matas). Matas; as it is discussed in detail in the surgery of the extremitiesit will not be repeated here. This method is also utilized in the courseof any operation whenever nerves are encountered, as in herniotomies^thoracotomies, Fig. 18.—Cylinder charged and inverted. The pumping outfit is detached when theapparatus is in operation (Matas). The method of making the intraneural injection is of importance;the nerve should not be pinched up by forceps or other instruments,as any such manipulations cause pain referred to its peripheral dis-tribution, and may be sufliciently severe to make the patient cry outor lose confidence in the promise of a i)ainlcss operation; the injec- PRINCIPLES OF TECHNIC 185 tion should be made with the nerve lying in its bed, by inserting afine needle in the long axis of the nerve, first within its sheath, whichis edematized; the needle is then gently advanced between the dif-ferent nerve-bundles and the infiltration continued until the nervepresents a fusiform swelHng at this point, this may require from5 to 15 minims of solution. Complete anesthesia of its entire distribution usually results infrom five to ten minutes, but may exceptionally be delayed to twentyminutes or longer. A
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