. Regional anesthesia : its technic and clinical application . Fig. 24.—Pyramid field-block: 1-2-3-4 are the points of entrance of the needleon the surface of the skin; 5 is the apex of the pyramid, in the depth. The solution isdistributed fanwise along the planes passing through the sides of the pyramid, as shownby the arrows, always more and more obliquely until the subcutaneous tissue is reached. ficial tumors, or extraction of foreign bodies lying in the superficialstructures. The anesthetic cup may have the shape of an invertedpyramid (Fig. 24), its base being the surface of the skin. By
. Regional anesthesia : its technic and clinical application . Fig. 24.—Pyramid field-block: 1-2-3-4 are the points of entrance of the needleon the surface of the skin; 5 is the apex of the pyramid, in the depth. The solution isdistributed fanwise along the planes passing through the sides of the pyramid, as shownby the arrows, always more and more obliquely until the subcutaneous tissue is reached. ficial tumors, or extraction of foreign bodies lying in the superficialstructures. The anesthetic cup may have the shape of an invertedpyramid (Fig. 24), its base being the surface of the skin. By modify- 52 REGIONAL ANESTHESIA ing the number and direction of the anesthetic walls it is possible toobtain cups of some other shape suitable to the particular case (Fig. 25).3. In certain parts of the body a single wall of anesthesia is suffi-cient to meet the requirements of the proposed operation. For in-stance, by creating a wall of anesthesia along the costal margin (), or between the costal margin and the iliac crest (Fig. 27), or. Fig. 25.—Field-block for reduction of fracture of the humerus: 1-2 are the pointsof entrance of the needle on the surface of the skin. The solution is distributed in thedirection of the arrows. combining both procedures on the same or on both sides, it is possibleto obtain wide areas of anesthesia of the upper, lower, or entire abdom-inal wall (Fig. 28). With an exact knowledge of the nerves crossing theproposed anesthetic wall and of the skin distribution, one can easilytell what will be the anesthetized area. GENERAL PRINCIPLES OF TECHNIC 53 Nerve-block is the physiologic section of a nerve, at any level,produced by an anesthetic fluid and resulting in the anesthesia ofthe territory supplied by that nerve. It may be realized in two
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