. 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. de-sired point by specially constructed depositors made for this purpose(Fig. 102). After using any anesthetic, either solution or tablet, it isnecessary to wait from ten to fifteen minutes for the full effect to befelt. Suprapubic Cystotomy.—When done for drainage, it is ordinarilyunnecessary to anesthetize the interior of the bladder, unless it is 380 LO
. 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. de-sired point by specially constructed depositors made for this purpose(Fig. 102). After using any anesthetic, either solution or tablet, it isnecessary to wait from ten to fifteen minutes for the full effect to befelt. Suprapubic Cystotomy.—When done for drainage, it is ordinarilyunnecessary to anesthetize the interior of the bladder, unless it is 380 LOCAL ANESTHESIA very sensitive or inflamed, but it should be moderately distended withwater to bring the fundus well up to the suprapubic space. Whenfound irritable the anesthetic can be added to the solution. Whenthe operation contemplates the use of retractors or other instrumentswithin the bladder cavity, as for the removal of pedunculated growths,or thorough direct vesical inspection, then the bladder should first beanesthetized. Operation.—The skin and subcutaneous tissues in the middle linejust above the pubes (Fig. 95) are infiltrated and a few drams of solu-tion directed down between the recti muscles. The tissues are then. Fig. 102.—Bransford Lewis depositor (slightly reduced in size) for depositing anes-thetic tablets at neck of bladder and in posterior urethra. The curved figure with theround end is the obturator; the other has a flat end and is intended to push the tablethome after obturator has been withdrawn and tablet dropped into lumen of cannula. divided and the recti muscles retracted. More solution should now beinjected into the perivesical space, and the fat and peritoneum pushedup out of harms way when the fundus of the bladder is recognizedby the large veins coursing over its surface. This is caught withtractors; if found sensitive a superficial injection is made into thewalls with a fine needle. The mucous membrane at this point isusually not sensiti
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
