Background: Ultrasound (US)-guided supraclavicular or infraclavicular blocks are commonly used for upper extremity surgery. The aims of this randomized study were to compare the block performance and onset times, effectiveness, incidence of adverse events and patient's acceptance of US-guided supraclavicular or infraclavicular blocks. We hypothesized that the supraclavicular approach, being more superficial and easier to visualize using a 10 MHz transducer, will produce a faster and a more extensive sensory block. Methods: One hundred and twenty patients were randomized to two equal groups: supraclavicular (S) and infraclavicular (I). Each patient received a mixture containing equal volumes of ropivacaine 7.5 mg/ml and mepivacaine 20 mg/ml with adrenaline 5 mg/ml, 0.5 ml/kg body weight (minimum 30 ml, maximum 50 ml). The sensory score (anaesthesia -2 points, analgesia -1 point and pain -0 point) of the seven terminal nerves was assessed every 10 min. Patients were declared ready for surgery when they had an effective surgical block -anaesthesia or analgesia of the five nerves below the elbow. Thirty minutes after the block, the unblocked nerves were supplemented. The block performance and latency times, surgical
We did not find significant differences between the two approaches in procedural pain and patient's acceptance. The choice of approach may depend on the anaesthesiologist's experience and the patient's preferences.
This paper reviews the implementation of EU nitrate policy in seven member states of the European Union. The countries reviewed are Belgium, and the UK. It summarizes the main features of the EU Nitrate Directive, and examines the national nitrate policies formulated by the seven Member States. The analysis shows substantial differences in the interpretation of the directive, and in the size of the affected agricultural area in each country. This discrepancy raises the question of ® nding a platform for future EU nitrate and nutrient policy.
The paper presents a study of how farmers perceive the Danish program implementing the EU Directive 2078/92 (part of the CAP Accompanying Measures) concerning improvements in connection with agricultural practices and environment. Focus groups were used as a qualitative method for eliciting farmers' own experiences and views on the measures of this program. The results indicate that a greater emphasis is needed on methods and content of information. A stronger focus on payment and priorities in relation to environmental effects, and the communication of the environmental significance of these measures, should give better results from the program. The results from this small-scale study are compared to results from a largescale questionnaire study of the same program, to exemplify the usefulness of focus group studies in the decision making process. The purpose of the paper is thus twofold: to present the results from the focus group study, and to evaluate the more qualitative approach of focus group techniques in connection with the studies of agri-environmental regulations.
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