Lateral infraclavicular plexus block vs. axillary block for hand and forearm surgery.

Background: In the last few years infraclavicular plexus block has become a method of increasing interest. However, this block has been associated with high complication incidences and without advantage in the quality of blockade over the axillary approach. We prospectively studied 40 patients (ASA I-III) undergoing surgery of the forearm and hand, and investigated the performance of the lateral infraclavicular plexus block against an axillary paravascular block to evaluate the success rate as well as the extent and quality of blockade.

[Results of lung-volume reduction surgery in end-stage lung emphysema].

Background: Surgical treatment of diffuse, nonbullous emphysema was first described by Brantigan et al. in 1957 and was reintroduced by Cooper et al. in 1995 as lung-volume reduction surgery (LVRS).

The effects of thoracic epidural anesthesia on intraoperative visceral perfusion and metabolism.

Unlabelled: After institutional approval and informed consent, we studied the effect of epidural bupivacaine 0.5% on visceral perfusion and metabolism by using gastric mucosal tonometry in 30 patients in a placebo-controlled fashion. The maximal intramucosal pH (pHi) decrease was significantly (P < 0.

Lung volume reduction surgery: preoperative functional predictors for postoperative outcome.

Unlabelled: Approximately 20% of patients undergoing lung volume reduction surgery (LVRS) exhibit no functional improvement postoperatively. Therefore, we examined whether variables characterizing ventilatory mechanics before LVRS could serve as predictors for outcome. In 32 patients undergoing LVRS, lung function, dyspnea score, and ventilatory mechanics were assessed preoperatively and 3 mo after LVRS.

Ventilatory mechanics and gas exchange during exercise before and after lung volume reduction surgery.

Many patients with emphysema are able to meet ventilatory demands during resting conditions, but they show severe limitations during exercise. To examine the effect of lung volume reduction (LVR) surgery on exercise performance and the mechanism of possible improvement, we measured ventilatory mechanics (pulmonary resistance [RL], work of breathing [WOB], dynamic intrinsic positive end-expiratory pressure [PEEPi,dyn], peak expiratory flow rate [PEFR]), breathing pattern, oxygen uptake (V O2), and carbon dioxide removal (V CO2) at rest and during cycle ergometry in eight patients before and 3 mo after LVR surgery. Ventilatory mechanics were evaluated assessing esophageal pressure and air flow.