File:Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose (14781614484).jpg

Identifier: localregionalane00allerich (find matches)
Title: Local and regional anesthesia; with chapters on spinal, epidural, paravertebral, and parasacral analgesia, and other applications of local and regional anesthesia to the surgery of the eye, ear, nose and throat, and to dental practice
Year: 1920 (1920s)
Authors: Allen, Carroll Woolsey, 1874-
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Publisher: Philadelphia, Saunders
Contributing Library: University of California Libraries
Digitizing Sponsor: MSN

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s and effective, may at times be followed by hema-toma, and for that reason is not very popular with the writer. A constrictor is placed around the root of the organ. A syringeand fine needle filled with i per cent, cocain solution (which is the solu-tion recommended by Oberst, though novocain could also be used)is now injected in the following manner: GENITO-URINARY, ANORECTAL, AND GYNECOLOGIC OPERATIONS 385 The needle is thrust well into the corpora cavernosa, and from 5to 7 minims of the solution is injected (Fig. 97). This is repeatedon the opposite side. About 5 minims of the solution is injectedinto the subcutaneous tissues on each side of the organ, and aboutthe same quantity on the undersurface around the urethra. Anesthesia takes place in about fifteen minutes, and is usuallyvery satisfactory and sufhcient for any operation upon the organ. Ithas been especially recommended for circumcision as a substitutefor the direct method of infiltration, on the ground that the edematiza-
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Fig. 97.—The Oberst method of cocain infiltration. A constrictor is first placedaround the root of the organ and the injection made with a very fine needle, as describedbelow. Oberst recommends a i per cent, solution of cocain, but the same strength ofnovocain could also be used. (Miller.) tion of the tissues resulting from infiltration was an objection in thisoperation. The writer, however, has not found this to be the case.Circixmcision.—Solution No. i, with an ordinary hypodermicwith fine needle, is sufficient. The skin is pulled well over the glansand the point of incision determined. The injection is begun justproximal to this point and a circumferential injection is made intothe subcutaneous tissues around the organ. If the prepuce is wellrelaxed and can be freely retracted, a finger is passed up on its innersurface between it and the glans. The needle is now directed downthrough the already anesthetized parts on the surface toward 386 LOCAL ANESTHESIA this point, injecting

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