. Regional anesthesia : its technic and clinical application . emergency cases the sole object is to savethe patients life. Anesthesia is of no use, since sensibility is alreadygreatly diminished by the state of shock in which the patient is. Butit is perfectly clear that inhalation narcosis, especially ether, is absolutelycontraindicated in all cases of stenosis of the air-passages, whateverbe its cause. Thyrotomy.—With the patient lying in the same position as for 3o6 REGIONAL ANESTHESIA tracheotomy, head a little more in extension, a rhombus is infiltratedfrom two points of entrance one on
. Regional anesthesia : its technic and clinical application . emergency cases the sole object is to savethe patients life. Anesthesia is of no use, since sensibility is alreadygreatly diminished by the state of shock in which the patient is. Butit is perfectly clear that inhalation narcosis, especially ether, is absolutelycontraindicated in all cases of stenosis of the air-passages, whateverbe its cause. Thyrotomy.—With the patient lying in the same position as for 3o6 REGIONAL ANESTHESIA tracheotomy, head a little more in extension, a rhombus is infiltratedfrom two points of entrance one on each side of the larynx, as illustratedin Fig. 227. The deep structures are first infiltrated and then the sub-cutaneous tissue along the sides of the rhombus. A wide anestheticarea is thus produced from the lower border of the hyoid bone to thefirst tracheal ring, without any distortion of the anatomic features alongthe line of incision. Intratracheal instillations are then made accordingto Canuyts technic described on page 304, distributing the solution. Fig. 227.—Field-block for thyrotomy: 1 and 1 are the points of entrance of theneedle for the injection of the soft structures in the direction of the arrows; a, the siteof puncture for instillation into the laryngeal cavity. upward and downward on the mucosa. The circumferential infiltrationor field-block takes about 30 of the per cent, novocain-adrenalinsolution, while the intratracheal instillations require only 2 of a10 per cent, cocain solution. Ten minutes are allowed for the anesthesiato set in. Total Laryngectomy.—As a rule, a preliminary tracheotomy hasbeen performed a fortnight before. The second-stage operation isperformed under regional anesthesia induced in the following manner: OPERATIONS ON THE NECK 307 (a) The cendcal plexus block (page 174) is performed on both sides. {b) With the patient lying on his back and a cushion slipped underthe shoulders so as to place the head in extension, a hors
Size: 1496px × 1670px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1920, bookidregionalanes, bookyear1922
