. 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. efer to establish a wall ofanesthesia along the proposed line of incision from the skin to theperitoneum, and have not found that muscular contractions interfereif anesthesia has been perfect, and no pain excited either in theincision or operation on the deeper parts, the muscles usually beingquite relaxed. The method of procedure is usually as follows: An
. 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. efer to establish a wall ofanesthesia along the proposed line of incision from the skin to theperitoneum, and have not found that muscular contractions interfereif anesthesia has been perfect, and no pain excited either in theincision or operation on the deeper parts, the muscles usually beingquite relaxed. The method of procedure is usually as follows: An THE ABDOMEN 337 intradermal wheal is established midway along the line of the proposedincision; the long needle with 10 syringe is entered at this pointand directed up and then down, without withdrawing the needle, alongthe proposed line of incision in the subcutaneous tissues, injectingfreely as the needle is advanced, detaching and refilling the syringe asoccasion requires; without withdrawing the needle from the skinits direction is now changed, and it is passed inward toward the rectalsheath; this is the first plane of decided resistance which the needleencounters; this is gently pierced, injecting as the needle is advanced. Fig. 76.—i, Brauns method of anesthetizing abdominal wall around area of incision; 2,authors method: infiltration of line of incision from one midpoint. to about i cm. within the sheath; the needle is then partially with-drawn and redirected within the sheath at several points aboveand below in a similar manner (Fig. 76). Returning now to theskin, the intradermal infiltration is completed along the proposed lineof incision. The deeper injections thus made first have ample time todiffuse. Having completed the skin infiltration, the incision is madedown to the rectus sheath without need of further delay; with therectal sheath now within plain view, further injections can be made 338 LOCAL ANESTHESIA within it if necessary. At this point the superf
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
