. Regional anesthesia : its technic and clinical application . Fig. 212—Caudal block. Simple device for introducing the needle into the sacralcanal. Pressure at the site of puncture is alternately applied and released so as toprevent the needle from striking either wall of the canal part of the shaft inside the canal moves freely in opposite directionwhen the hub outside is oscillated sideways, which is not the case if BLOCKING OF SPINAL NERVES 283 the needle lies on the posterior aspect of the sacrum. The injection ofthe anesthetic fluid into the sacral canal needs no pressure and givesthe im
. Regional anesthesia : its technic and clinical application . Fig. 212—Caudal block. Simple device for introducing the needle into the sacralcanal. Pressure at the site of puncture is alternately applied and released so as toprevent the needle from striking either wall of the canal part of the shaft inside the canal moves freely in opposite directionwhen the hub outside is oscillated sideways, which is not the case if BLOCKING OF SPINAL NERVES 283 the needle lies on the posterior aspect of the sacrum. The injection ofthe anesthetic fluid into the sacral canal needs no pressure and givesthe impression of being made in a free space or in another fluid. Anesthetic Solution.—Novocain hydrochlorid is the anesthetic druguniversaUy employed; the addition of adrenalin (surrenin, epinephrin,. Fig. 213.—Caudal block. The edema produced on the posterior aspect of the sacrum isthe undeniable proof that the needle has not been introduced into the sacral canal. suprarenin, etc.) to its solutions is invariably recommended. Lawenadds sodium bicarbonate to the novocain hydrochlorid in order to obtaina novocain bicarbonate solution which is said to be more active thanthe novocain hydrochlorid solution. He uses from 20 to 25 of a2 per cent, solution, or 40 to 50 of a per cent, solution, andclaims that the anesthesia induced is superior to that following the 284 REGIONAL ANESTHESIA injection of the plain novocain hydrochlorid solution. His solutionsare composed as follows: 2 per cent. per cent, solution. solution. Sodium bicarbonate (pure) 0. 15 0. 20 Sodium chlorid Novocain hydrochlorid Distilled water The powder is dissolved in cold water and allowed to boil, after which5 drops of adrenalin solution (1 : 1000) are added before the
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