. Regional anesthesia : its technic and clinical application . viz.,the field-block and the paravertebral block. Field-block is the pro- ?cedure usually employed, no matter what the size and consistency ofthe hernia, whether it be reducible or irreducible, strangulated or not. 1. Field-Uock.—Four wheals are raised as shown in Fig. 1 is the para-iliac wheal of the procedure used for inguinal herni-otomy. It lies cm. medial to and above the anterior superior spineof the iliimi. Wheal 2 is the pubic wheal raised over the pubic 3 occupies the lateral margin of the hernial
. Regional anesthesia : its technic and clinical application . viz.,the field-block and the paravertebral block. Field-block is the pro- ?cedure usually employed, no matter what the size and consistency ofthe hernia, whether it be reducible or irreducible, strangulated or not. 1. Field-Uock.—Four wheals are raised as shown in Fig. 1 is the para-iliac wheal of the procedure used for inguinal herni-otomy. It lies cm. medial to and above the anterior superior spineof the iliimi. Wheal 2 is the pubic wheal raised over the pubic 3 occupies the lateral margin of the hernial mass and lies belowPouparts ligament. Wheal 4 is placed at its lower margin. Through 398 REGIONAL ANESTHESL^ the para-iliac wheal 1 fanwise injections are made in the manner de-scribed for inguinal herniotomy (page 387), involving the entire thick-ness of the abdominal wall and extending from the iliac crest toward theumbilicus, to a point about midway between the umbilicus and thelateral margin of the rectus muscle. About 50 of a mixture of equal. Fig. 286.—Field-block for femoral herniotomy. Through 1 injections are madeacross the abdominal wall along the dotted line, and at the internal inguinal ring in thedirection of the arrows. The pubes and obturator nerve are injected from 2; Poupartsligament, from 3. From 4 the needle is passed beneath the hernial mass toward the neckof the sac. parts of the and 1 per cent, solutions are used for these the same wheal a longer needle is passed and advanced sub-cutaneousjy in the direction of the internal inguinal ring; and, afterpiercing the aponeurosis of the external oblique muscle, 10 of thesolution are distributed at the margins of the ring. If the swellingoverlaps or distorts this region, subfascial injections are made on each OPERATIONS ON THE ABDOMEN 399 side of the hernial mass as far down as possible. Through the pubicwheal 2, 10 of the solution are distributed along the horizontalramu
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