Suprascapular nerve block is a safe and extremely effective procedure in shoulder pain therapy. It also has an easy reproducibility and has been very used by professionals of many medical specialties. When it is well-indicated, this method must be taken into consideration.

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Suprascapular nerve block is a safe and extremely effective procedure in shoulder pain therapy. It also has an easy reproducibility and has been very used by professionals of many medical specialties. When it is well-indicated, this method must be taken into consideration.

Background and Objectives: We did not find clinical studies of the alkalization of ropivacaine in the literature. The objectives of this study were: (1) to determine the quantity of sodium bicarbonate (NaHCO 3 ), which alkalinizes 0.75% ropivacaine (with and without adrenaline); (2) to verify the physico-chemical alterations arising from this alkalization; and (3) to determine whether alkalinized ropivacaine produces a higherquality epidural block measured via sensory-motor onset, block spread and anesthesia duration.Methods: It was determined in the laboratory that 0.012 and 0.015 mEq of NaHCO 3 , respectively, alkalinized 10 mL of the 0.75% ropivacaine solutions without and with adrenaline (1:200,000). In the second phase, the study was random and double-blind and involved 60 patients divided into 3 groups of 20 (G1, G2, and G3). Via epidural lumbar blocks, these groups received, respectively, 10 mL of 0.75% ropivacaine plus 0.5 mL of 0.9% NaCl (solution A), 10 mL of 0.75% ropivacaine plus 0.0012 mEq of NaHCO 3 (solution B), and 10 mL of 0.75% ropivacaine (with adrenaline) plus 0.015 mEq of NaHCO 3 (solution C). The pH, PCO 2 (partial CO 2 pressure), and the nonionized fractions of the 0.75% ropivacaine solutions were compared before and after the addition of 0.9% NaCl or NaHCO 3 or adrenaline plus NaHCO 3 . The motor and sensory onsets, block spread, and the duration of the block were evaluated. Results:The values of the pH, PCO 2 , and nonionized fractions increased significantly in solutions B and C in relation to solution A. No differences among the groups were observed in relation to block spread and sensory-motor onset. The duration of the sensory blocks was significantly greater in the patients in groups G2 and G3.Conclusions: This study indicates that the quantity of NaHCO 3 needed to alkalize 10 mL of 0.75% ropivacaine at room temperature is 0.012 mEq. When the solution contains adrenaline 1:200,000 (mg ⅐ mL Ϫ1 ), up to 0.015 mEq of NaHCO 3 may be added. The alkalization of the 0.75% ropivacaine solution did not cause a reduction of sensory-motor onset, but did provide a significant increase in the duration of the epidural block with no significant differences between the solutions with and without adrenaline. Reg Anesth Pain Med 2001;26:357-362.

TCBC-GO 3 ; Enio Chaves de Oliveira, TCBC-GO 4 RESUMO: Objetivo: Avaliar a função pulmonar pós-colecistectomias laparoscópicas e subcostais abertas. Métodos: Tratou-se de um ensaio randomizado, onde se avaliaram espirometrias pós-operatórias de dois grupos, cada qual com 15 pacientes. O grupo GL foi submetido a colecistectomia laparoscópica. O grupo GA foi submetido a colecistectomia por via subcostal, por meio de mini-laparotomia e abreviado tempo anestésico-cirúrgico. As variáveis dos dois grupos foram comparadas entre si por meio da ANOVA. Entre um mesmo grupo, antes e depois das operações, utlizou-se do teste t-Student emparelhado. Um valor de p < 0,05 foi considerado estatisticamente significativo. Resultados: Todas as pacientes, dos dois grupos, apresentaram distúrbios ventilatórios restritivos pós-operatórios, com normalização espirométrica mais rápida nas pacientes operadas por laparoscopia. Grupos GL X GA, no pós-operatório imediato: Capacidade vital forçada (p < 0,001) e Volume Expiratório forçado em 1 segundo (p < 0,001). Conclusões: O prejuízo pós-operatório da função pulmonar foi significativamente menor nas colecistectomias laparoscópicas do que nas abertas, mesmo por meio de minilaparotomia e abreviado tempo anestésico-cirúrgico (Rev. Col. Bras. Cir. 2007; 34(5): 326-330). ABSTRACT Background:To evaluate pulmonary function after laparoscopic and subcostal cholecystectomies . Methods: This was a randomized study, in which postoperative spirometries in two groups of fifteen patients each were evaluated. Group GL underwent laparoscopic chlecystectomies. Group GA underwent open subcostal cholecystectomies by means of mini-laparatomy, in abbreviated anesthetic-surgical time. The two groups´ variables were compared using ANOVA. Within the same group, before and after the operations, the paired Student-t test was used. A value of p < 0.05 was considered statistically significant. Results: All patients from both groups presented restrictive postoperative ventilatory disturbances, with a faster spirometric normalization for those patients operated through laparoscopy. Groups GL vs. GA, in immediate post-operative: Forced Vital Capacity (p < 0.001) and Forced Expiratory Volume in one second (p < 0.001). Conclusion: Postoperative harm to pulmonary function was significantly less in laparoscopic than in open cholecystectomies, even with mini-laparotomies and abbreviated anesthetic-surgical time.