Interstitial presenting as spigelian hernia a review of the literature and case report

✍ Scribed by B. Altman

• Publisher: John Wiley and Sons
• Year: 1960
• Tongue: English
• Weight: 341 KB
• Volume: 48
• Category: Article
• ISSN: 0007-1323
• DOI: 10.1002/bjs.18004820710

✦ Synopsis

This refinement was not attempted, none of the residents having extensive experience of this form of anaesthesia. Various agents for anesthetizing the brachial plexus were tried. One per cent lignocaine with adrenaline (I in ~o o , o o ~t o o , o o o )

was found to be most effective. No toxic symptoms were recorded. On one occasion about 5 ml. of 2 per cent lignocaine was inadvertently injected into a vein with sudden, but temporary, unconsciousness of the patient.

One case of pneumothorax occurred. The rapid onset and marked distress of the patient made it probable that an emphysematous bulla had been ruptured. Recovery was complete in several days. Bonica and Moore (1950) reported 10 pneumothoraces in a series of 1512 blocks. Macintosh and Mushin (1947) had 3 cases in a series of 400 blocks. There was no mortality. Macintosh and Mushin suggest that minor degrees of pneumothorax may be missed as they can occur without obvious symptoms. Partial collapse of the lung may be a sequel to temporary phrenic nerve paralysis which occasionally occurs. It was not noticed in any of the cases described. Horner's syndrome was seen several times, disappearing with the end of anaesthesia. It did not inconvenience the patient.