Journal of clinical anesthesia
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Randomized Controlled Trial
Infraclavicular and supraclavicular approaches to brachial plexus for ambulatory elbow surgery: A randomized controlled observer-blinded trial.
To compare the effectiveness of supraclavicular and infraclavicular approaches to brachial plexus block for elbow surgery. ⋯ We found that both blocks were equally effective for elbow surgery with similar procedure and block onset times and failure rates. Lower incidence of paresthesia was associated with the infraclavicular block with no change in other complications compared to the supraclavicular technique.
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Do-not-resuscitate (DNR) status has been shown to be an independent risk factor for mortality in the post-operative period. Patients with DNR orders often undergo elective surgeries to alleviate symptoms and improve quality of life, but there are limited data on outcomes for informed decision making. ⋯ DNR patients, as compared with non-DNR patients, have increased post-operative mortality but not morbidity, which may arise from unmeasured severity of illness or transition to comfort care in accordance with a patient's wishes. The informed consent process for elective surgeries in this patient population should include a discussion of acceptable operative risk.