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This review explains the different approaches to the brachial plexus (posterior cervical, interscalene, supra- and infraclavicular, and axillary) and their advantages and disadvantages (indications, contraindications, and complications) for surgery and postoperative or chronic pain management. One of the focussed areas of this review is the use of continuous catheter techniques. Information about the most commonly used local anesthetics as well as adjuncts suggested in the literature is summarized. As essential components for the success of those techniques, organizational and documentation requirements are described. In summary, regional techniques for single shot or continuous block of the brachial plexus are an efficient and safe way of providing anesthesia and analgesia for surgery or pain in the region of the shoulder, arm, or hand.

Traditional Western biomedicine emphasizes changes in structure as explanations of disease, that are produced by single causes. It seeks to understand the proximate, molecular mechanisms of disease. The consequences of this line of thought are varied and many, and are not the purpose of this essay. Psychosomatic medicine research has always been more concerned with a broader and more integrated perspective in health, illness and disease. It has attempted to study and understand persons in terms of the behaviors of interacting systems - the physiology of the organism. In the past 20 years a language has evolved that speaks of the organism's functions in dynamic, time-related terms. Both phenomenologically and mathematically functions can be described in terms of rhythms which with disease undergo change. Each function has its own characteristic features (amplitude, frequency and form) it is frequency modulated. These rhythms are the product of oscillators, and/or positive and negative or mixed feedback systems. When perturbed they undergo changes in features. Many rhythms (e.g. circadian ones) are under environmental control, or are entrained by the environment and by social relationships.

First of all some information will be given on history, methods and the actual situation of the research in aging. Aging ist not a disease but a physiologic process characterized by growth and maturity events which legally change the functional performances and the anatomical structures of the human beings in time. This aging trend depends on the metabolism of the living cells whose metabolism changes over the years. This will be demonstrated by the example of the connective tissue metabolism. Even if aging in itself is not a disease at all there still is the fact that morbidity, a multimorbidity, is certainly higher in old age than in the youth. These diseases which are almost continually existing with old age individually vary the length of life which is determined by genetic factors. The whole mode of procedure of the pathogenesis of a chronical disease will be treated on the basis of the most frequent disease in aging: arteriosclerosis.