File:Text-book of operative surgery (1911) (14760389081).jpg

Identifier: textbookofoperat01koch (find matches)
Title: Text-book of operative surgery
Year: 1911 (1910s)
Authors: Kocher, Theodor, 1841-1917
Subjects: Surgical Procedures, Operative Surgery, Operative
Publisher: New York : Macmillan Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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de of the neck and the region of the ear can be made insensitive by aninjection along the middle third of the posterior border of the sternomastoid. Thisinvolves the small occipital, great auricular, and superficial cervical nerves. Theregion inunediately below this, in continuation with the upper part of the thoraxanteriorly, can be rendered insensitive by injecting the descending supraclavicularbranches of the cervical nerves (Fig. 13). Anasthesia of the larynx is obtained by perineural cocainisation of the superior THE BEGINNING OF THE OPERATION laryngeal nerve, the injection being made immediately below the posterior end of tliecornu of the hyoid bone down to the thyrohyoid membrane. According to Lennander, the penis is made insensitive by injecting both dorsalnerves close to the Symphysis, by a transverse injection into the subcutaneous tissueon the under surface 2 cm. behind the frenum, and by a similar injection into thecorpus spongiosum at the posterior border of the frenidum.
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Ext. jnguira- v. Fig. 13.—Dissectiou of the riglit side of tlie neck (SpalteLolz) to iUustrateconduction ausesthtsia (Braun). The testicle is rendered insensitive by perineural injection of the nerves in thespermatic cord, and also by Infiltration of the connective tissue behind the epididymis. The rectum may be incised or cauterised by infiltrating the sujrounding connectivetissue and muscles. This, of course, appKes only to the part in the area of the••conduction ansesthesia in the narrower sense (Fig. 14). Braun always prepares the cocain Solution fresh froni a 10 per cent Solution ofthe hydrochloride in absolute alcohol (\ c.c. = f gr. cocain). He obtains a \ percent Solution by placing i c.c. of the above in a watch glass and setting it on fire, the OPERATIVE SURGERY Iminediately before use 1The injection sliould, as a resiclue being clissolvecl in 10 c.c. of pbysiological saline,to 3 drops of a 1 to 1000 Solution of adrenalin are added.rille, be given fully half an hoiir b

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