. 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. to the rib, injecting as the needle is advanced, re-entering it further on if necessary, until the entire subcutaneous fieldhas been injected; we then return to the skin and finish the injectionintradermallv along the proposed line of incision over the rib. Theobject in making the deeper injections first is to allow ample timefor the solution to diffuse wh
. 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. to the rib, injecting as the needle is advanced, re-entering it further on if necessary, until the entire subcutaneous fieldhas been injected; we then return to the skin and finish the injectionintradermallv along the proposed line of incision over the rib. Theobject in making the deeper injections first is to allow ample timefor the solution to diffuse while making the skin injection and thussave the necessitv of having to wait later. 286 LOCAL ANESTHESIA Less is known about the sensibility of the parts within the thoraxthan about the contents of any other cavity of the body, but it isbelieved that the same general rules governing the sensibility of theabdominal contents hold good here, that is, that the parietal pleurais sensitive and the visceral insensitive; the same with the pericar-dium. The lung is said to have no sensation. After the chest wallsand parietal pleura have been anesthetized, an exploring needle canbe passed freely within its substance without complaint, and it can. Fig. 6g.—i. Method of injecting field for thoracotomy: i and 2, Direction of longneedle to intercostal spaces above and below rib to be resected; 3, crescentic wall ofanesthesia made subcutaneously embracing field; 4, line of incision. 2, Method ofanesthetizing sternal region. also be sutured to the chest wall without pain. The diaphragm isusually not sensitive. The operation of thoracotomy is quite easily performed on almostany part of the thorax wall. After a consideration of the course ofthe nerves, it is seen that an injection proximal to the field of opera-tion will block all nerves entering the area. Suppose we were to do athoracotomy for empyema in the axillary line, with resection of theseventh rib, a point over this rib and just behind
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
