File:Interstate medical journal (1919) (14577397870).jpg

Identifier: interstatemedica2619unse (find matches)
Title: Interstate medical journal
Year: 1919 (1910s)
Authors:
Subjects: Medicine
Publisher: St. Louis, : Interstate Medical Journal
Contributing Library: The College of Physicians of Philadelphia Historical Medical Library
Digitizing Sponsor: The College of Physicians of Philadelphia and the National Endowment for the Humanities

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less troublesome. To be sure, these little patients may be fright-ened at their new surroundings, and all very young ones have to berestrained by mechanical means (Fig. 1) until they learn thatthey are not to be hurt; but we very early learned that the restraintnecessary during the introduction of novocain did not compare withthat ordinarily found necessary when general anesthesia was beingadministered. A majority of those above 4 years of age submittedwithout mechanical restraint. Many of them, as soon as they found 84 INTERSTATE MEDICAL JOURNAL that they were not to be hurt, began to show off and exhibitclever stunts, of which they were proud. Bribes of various kindshave been used as bait for good behavior, and the results achievedalong these lines are gratifying. Candies, money, and toys areespecially effective. A prize of $1 offered to a boy of 4 took himthrough an operation for inguinal hernia and the excision of ahydrocele sac without shedding a tear. The only one of this group
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Pig. 1.—Illustrating the method of controlling young children in operations underlocal anesthesia. By making traction on the arms, the anesthetist controlsthe child when necessary. who suffered postoperative vomiting was a case of hypertrophicpyloric stenosis, and here vomiting was late and had no relation tothe anesthesia per se. In working upon children the same refined technic is required asthat found necessary in working upon the adult. Sharp dissectionand careful traction and manipulation must be adhered to. Ab-dominal work requires anesthesia which results in negative intra- Farr: Local Anesthesia in Children 85 abdominal pressure. Vertical retraction and tilting of the bodyare used to bring the organs into view. Just as in the adult, pro-trusion of the abdominal viscera through the incision is to be lookedon as evidence of incomplete anesthesia if it occurs in the absenceof vomiting or (in the case of children) crying. In the adult nopacking should be required to prevent this

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