. Regional anesthesia : its technic and clinical application . ngboth inferior laryngeal nerves for a single-stage operation, and be readyto perform the tracheotomy at the first signal, before any attempt is 3IO REGIONAL ANESTHESIA made to restore breathing by artificial respiration. As soon as thepatient recovers from such a condition, laryngectomy is begun andcompleted with no worse prognosis than if nothing had happened. Regional anesthesia is the method of choice for total has completely changed the aspect of the operation and simplifiedits technic by realizing an almost dr
. Regional anesthesia : its technic and clinical application . ngboth inferior laryngeal nerves for a single-stage operation, and be readyto perform the tracheotomy at the first signal, before any attempt is 3IO REGIONAL ANESTHESIA made to restore breathing by artificial respiration. As soon as thepatient recovers from such a condition, laryngectomy is begun andcompleted with no worse prognosis than if nothing had happened. Regional anesthesia is the method of choice for total has completely changed the aspect of the operation and simplifiedits technic by realizing an almost dry operative field and allowing moretime for a clean dissection. The operative mortality, especially dueto shock and bronchopneumonia, is thus considerably reduced. Sinceits use in Professor Moures clinic, Bordeaux, the death-rate has droppedfrom 60 to 4 per cent. (Canuyt-Rozier). EXCISION OF THE LYMPHATIC GLANDS OF THE NECK After blocking the cervical plexus on both sides the operative fieldis circumscribed by subcutaneous injections made along the posterior. Fig. 231.—Regional bloclc for excision of the lymphatic glands of the neck: 1-1,2-2, Paravertebral cervical block; 5-5, sites of puncture into the submaxillary space;l-2-3-4-3-2-r-5-6-5-l, subcutaneous cicuminjection of the field. margin of the sternocleidomastoid muscle, the clavicle and sternum,and the lower border of the lower jaw. The needle is then passed into OPERATIONS ON THE NECK 31I the submaxillary space and the solution distributed within it if thesubmaxillary gland is involved in the proposed operation. From 60to 80 of the per cent, solution is sufficient, apart from thequantity used for the cervical plexus block, 5 being injected in eachsubmaxillary fossa. The lateral route is the procedure of choice for thecervical plexus block (page 174), provided the distortion due to theenlargement of the cervical lymph-nodes does not render the approachof the transverse processes too difficult or unsafe, i
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