Introduction: Orexin is a potent orexigenic agent in rodents and humans. Some research shows that orexin participates in the adaptive response to weight loss and its levels rise with dieting. On the other hand, weight loss and fasting is accompanied by increased levels of epinephrine and cortisol. In this study we investigated the effects of epinephrine (EN) and cortisol on fastinginduced orexin secretion in rats fed different levels of their energy requirements.Materials and Methods: Forty-five male wistar rats (300-350 g, 15 per group) were fed a diet containing 100%, 50% and 25% of their energy requirement for 10 days, rats were anesthetized following 48 hour prolonged fasting and then cannulated in the carotid artery for drug injection and blood sampling. Animals were divided into 3 treatment groups that received either (3 mg/Kg BW) EN, cortisol or a combination of those two (0.1 mg in 1 ml of PBS). Orexin and glucose levels were analyzed before (time 0), and 30, 60 and 120 min after injection.Results: In the 50% and 100% food restricted groups, fasting orexin levels fell after EN and the combination of EN and cortisol injection respectively (p£0.05). In contrast, the group that had 25% food restriction showed no response to cortisol, EN or the combination of both (p>0.05).Conclusion: These results indicate that injection of EN suppresses starvation-induced secretion of orexin in normal (100%) and starved (50%) rats, and that orexin secretion response to EN might be affected by weight loss.

Infraclavicular plexus block has recently become a technique with increasing interest. However, no approach has provided easily identifiable landmarks and lack of complications (mainly pneumothorax). In this study we performed the infraclavicular block with modified approach of the Raj technique.The block was performed in 30 pateints (Mean age 22.64±0.96 years) based on the identification of the acromial process of the scapula, jugular notch, and emergence of the axillary artery within the axillary fossa, with the arm abducted to 90. and elevated by approximately 30° We performed this approach by injecting 40-50 ml mixture of lidocain 1% and bupivacain 0.25% with epinephrin 1.200000. Success was define as a sensory block of the 5 nerves of the forearm within 30 min after performeing the block.The success rate was 100% when a distal response (flexion or extension of the wrist or fingers) was elicited and 72.7% when a proximal (contraction of the triceps, biceps) was obtained using a nerve stimulator. Complications were rate. Aspiration of blood was seen in 3% of patients and 11% complained sever pain during the procedure; no pneumothorax or hematoma was occured.In Conclusion the modified approach of the Raj technique for infraclavicular block is very effective when a distal nerve stimulator response is obtained with a small complication rate.