Interstate medical journal . ewpoint of comfort to the patient it is well nigh moderate doses there seem to be almost no unpleasant effects. The comfort of the patient is further enhanced by careful hand-ling during the trip to and from the operating room, for whichpurpose I have devised an invalid lifter (Fig. 1). The knee-holder(Fig. 2) aids greatly in securing a comfortable position on the table,which is essential; the limbs are brought into position and theknee-holder adjusted to them. Another essential is the presence ofa skilled anesthetist whose duties are to furnish the patien
Interstate medical journal . ewpoint of comfort to the patient it is well nigh moderate doses there seem to be almost no unpleasant effects. The comfort of the patient is further enhanced by careful hand-ling during the trip to and from the operating room, for whichpurpose I have devised an invalid lifter (Fig. 1). The knee-holder(Fig. 2) aids greatly in securing a comfortable position on the table,which is essential; the limbs are brought into position and theknee-holder adjusted to them. Another essential is the presence ofa skilled anesthetist whose duties are to furnish the patient withwater, advice, and every comfort possible; she records the bloodpressure, controls the pneumatic injector, and keeps a written record 1Parr, Robert E.: Narco-Local Anesthesia, St. Paul Med. Jour., May, Anesthesia in Surgical Works, Journal-I,ancet, Sept. 1, 1916. 662 INTERSTATE MEDICAL JOURNAL of the several steps of the operation. Music is not objectionableand makes the time seem to pass more Fig. 3.—Painless method of making secondary wheal. The operations most frequently presenting are curettage, ampu-tation of the cervix, anterior colporrhaphy, perineorrhaphy, removal Farr: Vaginal Operations Under Local Anesthesia 663 of labial cysts, etc., the treatment of infections of the glands ofBartholin, urethral caruncle, the closure of fistulae, and vaginalhysterectomy. With the exception of vaginal hysterectomy, which,under certain conditions, does not readily adapt itself to this formof anesthesia, every one of these operations may be done under localanesthesia with satisfaction. Operations on the labia and on theurethral orifice, or on the skin of the perineum may all be doneunder direct or circumferential (Hackenbruch) infiltration, andpresent nothing different from the removal of growths from theskin on any other part of the body. The points which remain forconsideration are: (1) The repair of the perineum; (2) plasticson the anterior vagina
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