. 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. obHque line is fixed with the finger-nail, and theneedle inserted close to the nail into the mucosa near to, yet not im-mediately at, the edge of the bone (Figs. 188, 192, 193). The syringe is pushed forward horizontally and posteriorly fromthe canine, on the opposite side along the internal surface of the man-dibular half to be anesthetized (.Figs. 188, 189,
. 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. obHque line is fixed with the finger-nail, and theneedle inserted close to the nail into the mucosa near to, yet not im-mediately at, the edge of the bone (Figs. 188, 192, 193). The syringe is pushed forward horizontally and posteriorly fromthe canine, on the opposite side along the internal surface of the man-dibular half to be anesthetized (.Figs. 188, 189, 192, 193, 194). The needle should be introduced to a depth of not more thanfrom to 2 cm. under the mucosa, lest it advance too far beyond 564 LOCAL ANESTHESIA the foramen and the correct point for the disposition of the solutionbe missed. The injecting solution is then deposited, beginning to inject soonafter insertion of the needle, in order to anesthetize the lingual nerveat the same time (if this be desirable). The bulk of the solution,however, should be injected in the mandibular foramen. ^^Insertion of the —The point of the injection is selected sothat the needle is introduced in the molar triangle, about i Fig. 192.—Position of syringe for injection at mandibular foramen: ix. Externaloblique line; 2X, retromolar fossa; 3X, internal oblique line; 4, mandibular foramenbehind lingula; 5, incorrect position of syringe, parallel to teeth. (.Vfter Fischer.) above the level of the masticating surfaces of the molars (Figs. 192,193, 195, 197); in children and youthful persons, advancing a Httlefarther posteriorly while shghtly lowering the needle; in old persons,slightly raising the long needle (Fig. 187). ^Difficulties.—The technic of this form of injection offers somedifficulties, which, after some practice are easily overcome; aboveall, it must be observed that the insertion of the neetUe is made not THE HEAD, SCALP, CRANIUM, BRAIX, AND FACE 565 directly
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