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

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

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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1920 edition. Excerpt: ... in which the supraclavicular anterior and posterior thoracic nerves intermingle in their distribution with branches from the intercostal. Fig. 69.--Shows line of anesthesia and points for entering long needle for blocking intercostal nerves at angle of ribs. In the scapula region behind, the thoracic wall is overhung by this bone and its attached muscles, which will have to be dealt with in any procedure which involves the chest wall at this point; however, this is not often the site of surgical intervention. It will be seen from the above and a study of Fig. 68, which represents diagrammatically the intermingling of the areas of distribution of these nerves, that any methods of regional anesthesia, when applied to the anterior chest wall above or the lateral chest wall behind, must deal with nerves which enter the field from a variety of directions. To block the intercostal nerves over a wide area of distribution is best done behind near the angle of the ribs, where they approach close to the posterior wall and before the lateral branches are given off, though this can be done at any point of their course. A vertical line of cutaneous anesthesia is carried down the back over the angle of the ribs, as seen in Fig. 69; the scapula is carried well forward and the finger locates the rib; a long fine needle is now passed down to the interval between the ribs; this is best done obliquely from below; with a finger pressed firmly on the rib, the needle is made to pass upward and inward, injecting as it is advanced until it strikes the bone; it is then pushed upward and inward for about 1 cm. further into the intercostal space above, and this freely infiltrated. This procedure is similarly carried out for as many spaces as indicated, taking in...show more

Product details

  • Paperback | 226 pages
  • 189 x 246 x 12mm | 413g
  • Rarebooksclub.com
  • United States
  • English
  • black & white illustrations
  • 123690768X
  • 9781236907684