. 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. oint and passed down to the interval between the sixth andseventh rib, injecting lightly as it is advanced, until the plane be-tween the intercostal muscles is reached. This can be fairly accuratelydetermined by placing a finger firmly between the ribs and over thepoint of the advancing needle. It should be remembered that thenerve lies near the lower bord
. 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. oint and passed down to the interval between the sixth andseventh rib, injecting lightly as it is advanced, until the plane be-tween the intercostal muscles is reached. This can be fairly accuratelydetermined by placing a finger firmly between the ribs and over thepoint of the advancing needle. It should be remembered that thenerve lies near the lower border of the rib. When the desired pointis reached, about i or 2 drams of solution is injected. The needle isthen slightly withdrawn and passed in the opposite direction, in thespace between the seventh and eighth ribs, and a similar injectionmade. While we are waiting for the injection to act here, the infiltra-tion of the skin is finished. This is done rather freely, in a crescentic-like course, over the sixth, seventh, and eighth ribs, the horns of thecrescent turned toward the operative area (Fig. 69). The anesthesia resulting from the above injection in the area justin front should be perfect, including the bone and pleura, and the. Fig. 70.—Schematic representation of method of anesthetizing rib for resection inthoracotomy. (From Braun.) operation can be commenced by the time the skin infiltration isfinished. In the event that the operative field is slightly in front of theanterior axillary line a rather free subcutaneous injection is made, inaddition to the above, to meet the anterior divisions of the lateralcutaneous branches of the intercostals given off at this point. Ifpreferred, a rib may be resected in any part of its course by embrac-ing the area by infiltration, which is carried well down into the inter-costal spaces above and below (Fig. 70). Transthoracic hepatotomy for abscess is quite satisfactory underlocal anesthesia; the larger and more superficial the absc
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectanesthe, bookyear1914
