. 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. ethra was easily followed and several stricturesdivided under infiltration. The case made an uneventful recovery. The urinary fistula onthe side of the scrotum closed without any special treatment. Subse-quent examination of the urine showed albumin and granular casts. This case would certainly have been a dangerous risk with generalanesthesia. Spinal anal
. 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. ethra was easily followed and several stricturesdivided under infiltration. The case made an uneventful recovery. The urinary fistula onthe side of the scrotum closed without any special treatment. Subse-quent examination of the urine showed albumin and granular casts. This case would certainly have been a dangerous risk with generalanesthesia. Spinal analgesia could, however, have been employed, 374 LOCAL ANESTHESIA but we resort to the latter only when local and regional methods areimpracticable. Epispadias and hypospadias, or other plastic operations, are usu-ally quite easily performed under local anesthesia, but should not bedone under infiltration. Instead, the regional method of blocking thenerves of the root of the organ as already mentioned should be em-ployed; when extensive, always combining the operation with an ex-ternal urethrotomy. SCROTUM All operations upon the scrotum can be performed under infiltra-tion. Where resections are to be done, as in the case of superficial. Fig. 99.—Method of surrounding penis and scrotum with zone of anesthesia for opera-tions upon scrotum. (From Braun.) growths or for elephantiasis, a zone of anesthesia should be createdaround the part to be excised. If it involves the entire organ, infiltra-tion should be done around the base (Figs. 99 and 100). If the opera-tion involves the contents of the scrotum, the cord should be exposedjust below the spine of the pubis on one or both sides, as the case mayrequire, and blocked there. The genitocrural nerve lies at the back ofthe cord, near the vas (Figs. 93 and 101). By infiltrating the cordfreely in this position the nerve is reached; it is not necessary to directly GENITO-URINARY, ANORECTAL, AND GYNECOLOGIC OPERATIONS 375 expose it. In m
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
