. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. the retromalar tri-angle is palpated with the left hand and the injection is made withthe right, it is advisable to use the left hand for injection on the leftside, according to Peuckarts suggestion, palpating and fixing the re-tromalar triangle with the right. Effect of Injection.—About three minutes after the injection thepatient perceives a slight tingling
. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. the retromalar tri-angle is palpated with the left hand and the injection is made withthe right, it is advisable to use the left hand for injection on the leftside, according to Peuckarts suggestion, palpating and fixing the re-tromalar triangle with the right. Effect of Injection.—About three minutes after the injection thepatient perceives a slight tingling in the lip and tongue on the in-jected side. The tinghng is the best indication as to the correct exe-cution of the injection. The sensation gradually increases, and a certain numbness ofthe entire half of the jaw ensues. The lip on the anesthetized side 568 LOCAL ANESTHESLA. depends slightly, exhibiting symptoms of partial paralysis, and thepatient usually feels as if it were greatly swollen. Difiicult degluti-tion is absent if the technic has been executed correctly. Its pres-ence indicates that the injection has been too far pharyngeally andposteriorly. The concomitant symptoms persist for about one houi, Occipitofrontal Zygomatic arch Parotid gland Masseter m ?External pterygoid m. Ill iltll Lateral plate of ptery-goid processAdipose tissue Internal pterygoid Fig. 196.—Frontal section of temporal region. The solid black line indicate theaponeurosis, the dotted line the periosteum and temporal fascia. At the mandibularforamen a mass of adipose tissue is observed which offers no resistance to the advanceof the needle. (After Merkel.) after which they gradually subside, the former normal conditionbeing reestablished after about three hours. For anesthesia of the hard palate and roof of the mouth advan-tage can be taken of the points of emergence of the palatine nervesupon the hard palate. (See Fig. 166.) These can be easily reachedby injections over the open
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