. Regional anesthesia : its technic and clinical application . elfthdorsal vertebra. same direction 2 cm. further than the lower border of the rib. Thedirection of the needle is thus downward, inward, and frontward,across the intercostal space, and its point buried between the inter-costal muscles, half-way between the two ribs and about 1 cm. in frontof the transverse processes. The syringe is then connected with theneedle and the injection made of 5 or 6 of the 1 per cent, solution. 222 REGIONAL ANESTHESIA Half of the anesthetic fluid is injected without moving, the rest beingdistribute
. Regional anesthesia : its technic and clinical application . elfthdorsal vertebra. same direction 2 cm. further than the lower border of the rib. Thedirection of the needle is thus downward, inward, and frontward,across the intercostal space, and its point buried between the inter-costal muscles, half-way between the two ribs and about 1 cm. in frontof the transverse processes. The syringe is then connected with theneedle and the injection made of 5 or 6 of the 1 per cent, solution. 222 REGIONAL ANESTHESIA Half of the anesthetic fluid is injected without moving, the rest beingdistributed with a httle to-and-fro motion while the needle is beingwithdrawn. But the syringe must have been completely dischargedwhen the point of the needle reaches the level of the lower border ofthe rib. Care should be exercised when mong the needle to and fro(a) not to change its direction, (b) not to displace it more than 2 cm.,and (c) not to approach the spine closer than when the injection wasfirst started. These recommendations also apply to Technic No. Fig. 177.—Paravertebral dorsal block. Technic No. 2.—After taking the landmarks as for the precedingtechnic and raising the wheals in their correct places, needle No. 3(8 cm.) is inserted through the wheals in succession and advanced towardthe spine in a direction making an angle of about 25 degrees with thesagittal plane of the body. The needle travels in a horizontal plane,,passing between the ribs and transverse processes, and impinges onthe body of the vertebra just in front of the intervertebral foramen(Fig. 178). It is then slightly drawn back and injection made of from BLOCKING OF SPINAL NERVES 223 5 to 6 of the 1 per cent, solution while the needle is moved a littleto and fro. s^Mi I Sympaihe-t c gatqlon. V ill X ^ Ramus communicans ^g ^ la+eccostal ^- ^ acterv/ ?^ ve a aad
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