On the whole, recent literature indicates a vastly widening appreciation of the advantages of local anesthesia. With the general improvement in anesthetic drugs and in the technic as applied to any one operation, many major operations are now performed under local anesthesia. Indications and demands for its use have steadily increased until, in certain fields of surgery, it is regarded as the method of choice, and has been adopted.
Local anesthesia is not of like value in all branches of surgery. On account of the superficial position of the parts, the anatomic arrangement, and the course and distribution of the nerves involved, inguinal herniotomy1 is probably the most common major operation performed by this method. For similar reasons, operations on the neck may be very efficiently and painlessly performed without general narcosis,2 whereas block of the sacral nerves affords a very satisfactory anesthesia of the pelvic floor and