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Although we have for years been gradually widening the field of operation under local anesthesia, the peritoneal cavity has for most surgeons been a deterrent factor. When we consider how often we operate for hernia under local anesthesia (I myself have repeatedly done intestinal resections in strangulated hernias, inguinal, femoral, and umbilical, under local anesthesia), it seems strange that we should not long ago have added appendicitis to the list of operations to be done in this manner. I think the dread of pain in handling the peritoneum and the abdominal contents has in great measure held us back.
In the past eleven months I have operated in fifteen cases of appendicitis under local anesthesia, and the results have been so satisfactory to myself, as well as to the patients, that I venture to report them, with the full expectation of calling forth numerous theoretical objections, and in the end
WIENER J. APPENDECTOMY UNDER LOCAL ANESTHESIA. JAMA. 1916;LXVI(15):1078-1079. doi:10.1001/jama.1916.02580410012004