. Anaesthetics : their uses and administration. oadto spray the skin with ethyl chloride before puncture, or toinfiltrate it with novocain or /3-eucaine lactate. Save inexceptional cases, however, it is best to avoid elaborating theprocedure and fussing the patient, who, if he has neverundergone the process, is naturally somewhat nervous. The patient is now placed in position on the operatingtable. If the crouching posture has been selected (fig. 81),the patient sits upon the table with his buttocks towards theoperator, his feet resting upon a chair, and his body bentforwards and downwards, hi
. Anaesthetics : their uses and administration. oadto spray the skin with ethyl chloride before puncture, or toinfiltrate it with novocain or /3-eucaine lactate. Save inexceptional cases, however, it is best to avoid elaborating theprocedure and fussing the patient, who, if he has neverundergone the process, is naturally somewhat nervous. The patient is now placed in position on the operatingtable. If the crouching posture has been selected (fig. 81),the patient sits upon the table with his buttocks towards theoperator, his feet resting upon a chair, and his body bentforwards and downwards, his hands resting upon his knees. 438 ANAESTHETICS. The lumbar spines should be made prominent, and this willbe effected by the forward arching of the body. If left tohimself the patient will keep his back straight and incline hisaxial line at an acute angle to the table. He must be madeto bow his back out to the requisite degree. In the lateral position, which, although less easy for theoperator, gives a higher and more prolonged analgesia, the. Fig. 8i.—The patient sitting on the table with his buttocks onthe edge, his body bent forwards to bring the spinal curve intoprominence. From a photograph by Dr. Worrall. lower shoulder is carried forwards, the head raised and flexedon the chest, and the thighs strongly flexed upon the whole trunk is made to incline backwards, so that theside which is uppermost is in a plane slightly posterior to thelower, that is, is a trifle nearer the operator, who sits upon astool facing the patients back. In this position the curves ofthe spinal column should be readily traced, and the lumbarspines prominent. In stout persons and in muscular men the SPINAL ANALGESIA. 439 spines are not so easily made out, but by forcible flexion ofthe head and lower extremities they can usually be felt ondeep pressure. In the figure the pelvis is raised upon a block, but thisdegree of elevation is seldom needed unless the pelvis is verynarrow or high r
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