. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. d benign growths, a crescentic line of intradermal infiltration is producedaround the base and outer side in the sulcus formed by the attachment of the breastwith the chest wall. The breast is then raised, and with the long needle and largesyringe the cellular space beneath the breast is infiltrated in all directions with theanesthetic solution. The incision i
. Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice. d benign growths, a crescentic line of intradermal infiltration is producedaround the base and outer side in the sulcus formed by the attachment of the breastwith the chest wall. The breast is then raised, and with the long needle and largesyringe the cellular space beneath the breast is infiltrated in all directions with theanesthetic solution. The incision is made in the sulcus and the breast turned up andoperated upon from beneath; it is then dropped back in place and sutured, leavingvery little scar visible. If the operative field involve the upper part of the breastnear its cutaneous covering, this upper part should be surrounded by subcutaneousinfiltration to block the supraclavicular nerves. The nerve-supply of the breast isfrom the intercostals, which approach it from the outer side and beneath, the anteriorthoracic nerves from above and externally, and the supraclavicular nerves from above,these latter supplying only the skin and subcutaneous tissue as far down as the Fig. 73.—Method of creating a zone of anesthesia around a benign mammary tumor. (From Braun.) 312 LOCAL ANESTHESIA surface and the gland dropped back in place and sutured, the resultingscar not being visible. Where a simple growth or other lesion is superficially situatedon the surface of the gland, a wall of infiltration anesthesia is createdaround and beneath it in all directions after the Hackenbuch plan (Fig. 73)- The method of dealing with mammary abscesses will dependsomewhat upon their location; but, as these usually point superfi-cially, they are best opened by direct infiltration over their mostprominent point. THE STERNUM This is blocked by making two vertical intradermal lines of anes-thesia just to the outer side of the costochondral jun
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