. 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. ebral injections in such regions as the neck mustreceive further experimental study before it can be popularized; thelikelihood of the solution reaching the phrenic nerve in effectivequantity should not be lost sight of; its origin from the third, fourth,and fifth cervical is practically the center of the field, and after forma-tion its course is more supe
. 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. ebral injections in such regions as the neck mustreceive further experimental study before it can be popularized; thelikelihood of the solution reaching the phrenic nerve in effectivequantity should not be lost sight of; its origin from the third, fourth,and fifth cervical is practically the center of the field, and after forma-tion its course is more superficial. If the solution is effectively usedthis nerve should be paralyzed; however, unless the procedure is car- 460 LOCAL ANESTHESIA ried out on both sides, the temporary one-sided paralysis is not bkelyto be of consequence. The paravertebral injection of the cervical region is carried outby Braun in a somewhat different way, following the suggestion ofHeidenhain. The injections are made from the side, between the third and fifthvertebra?, rather freely with a per cent, novocain-adrenalin solu-tion at the point where the nerves he rather close together. A lineis drawn on the neck from the transverse process of the atlas, which. **&*>> . .... ... 1 Fig. 135.—a and b, points of injection on line drawn over transverse processes of cervicalvertebrae. (From Braun.) is felt under the point of the mastoid process downward over the trans-verse process of the sixth cervical vertebra (tuberculum carotidum).This line represents the point at which the long axis of the trans-verse processes reach the surface, and forms a sharp angle with theedge of the sternomastoid as it gradually draws away from this muscle (Fig- I35)- Two points of puncture are made on this line—the upper oneon a level with the lower border of the inferior maxilla, the lower oneon a level with the promontory of the larynx. From these two points of puncture the needle is carried directlyinward, until it c
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
