Journal of clinical anesthesia
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Case Reports
Transient hemidiaphragmatic paresis after ultrasound-guided lateral sagittal infraclavicular block.
As compared with medial approaches for the infraclavicular brachial plexus block, lateral approaches generally have no impact on the phrenic nerve or pulmonary function. A patient experienced transient hemidiaphragmatic paresis after ultrasound-guided lateral sagittal infraclavicular block for lower arm surgery. An accessory phrenic nerve, ie, an anatomical variation, may have been the mechanism of transient hemidiaphragmatic paresis in this patient.
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Glycemic control has received intense scrutiny in the last decade as an important aspect of patient care. Earlier studies suggested that tight glycemic control (target level of 80 - 110 mg/dL) improved outcomes in intensive care unit (ICU) patients. Subsequent trials did not confirm the same benefit. ⋯ Tight glycemic control was associated with a high incidence of hypoglycemia, which may offset some of its potential benefits. Tight glycemic control in the perioperative and intensive care settings should not be totally abandoned either as a clinical practice or as a subject of future research. Beneficial effects of tight glycemic control may be demonstrated when the appropriate glycemic targets are matched to the appropriate population.