. 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. c preparations have been proved topossess greater keeping qualities, and, especially with suprareninsynthetic, capable of a moderate amount of sterilization (boiling forfrom three to five minutes). j68 LOCAL ANESTHESIA The sterilization of these tablets can be depended upon whenobtained from reliable manufacturers, but it is impossible to keepthem sterile
. 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. c preparations have been proved topossess greater keeping qualities, and, especially with suprareninsynthetic, capable of a moderate amount of sterilization (boiling forfrom three to five minutes). j68 LOCAL ANESTHESIA The sterilization of these tablets can be depended upon whenobtained from reliable manufacturers, but it is impossible to keepthem sterile when the container is constantly being opened for theremoval of tablets. We consequently prefer for institution or hospi-tal work to prepare our own solutions freshly sterilized, to which weadd just before use the desired quantity of adrenalin or suprareninsynthetic as preferred. This method has been found more satis-factory in major operations, where it is imperative to have an abso-lutely sterile and dependable solution. CLINICAL APPLICATION In starting to anesthetize any area the first step should be theproduction of intradermal anesthesia, and should be done with asmall syringe and fine needle. In highly sensitive individuals the. Fig. 6.—Formation of an intradermal wheal (Braun). I point of entrance of the needle may first be anesthetized with ethylchlorid, but this is ordinarily unnecessary; if the skin at the selectedpoint is first pinched up between the thumb and finger and heldfirmly it lessens its sensibility; with a quick but light thrust theneedle is advanced beneath the epidermis. While making this ini-tial stick the thumb should be on the plunger, so that at the momentthat the needle enters the skin the solution can be injected; in thisway this initial stick is often made without the patients injection must be intradermal and not subcutaneous; itshould develop a distinct wheal, which stands up from the surround-ing surface like an urticarial wheal
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
