CARDIOVASCULAR ANESTHESIA:

S. Mierdl, C. Byhahn, V. Lischke, T. Aybek, G. Wimmer-Greinecker, S. Dogan, S. Viehmeyer, P. Kessler, and Klaus Westphal

Segmental Myocardial Wall Motion During Minimally Invasive Coronary Artery Bypass Grafting Using Open and Endoscopic Surgical Techniques
Anesth Analg 2005 100: 306-314. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Beating heart procedures without cardiopulmonary bypass (CPB) via minithoracotomy and totally endoscopic robot-assisted techniques (TECAB) with CPB for coronary revascularization cause intraoperative segmental wall motion abnormalities (SWMA) that resolved after bypass in both groups. Robotic procedures had more intraoperative SWMA in the right ventricle, suggesting a higher risk for right ventricular dysfunction during TECAB procedures.

Mikael Persson and Jan van der Linden

Can Wound Desiccation Be Averted During Cardiac Surgery? An Experimental Study
Anesth Analg 2005 100: 315-320. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Desiccation of a cardiothoracic wound model was studied with and without CO2 delivered via two different devices at 10 L/min. Humidified CO2 insufflated through a gas diffuser decreased the desiccation rate by more than 90%. Conversely, when humidified CO2 was supplied via an open-ended tube it increased the desiccation rate.

Crina L. Burlacu, David Healy, Donal J. Buggy, Ciaran Twomey, David Veerasingam, Andrew Tierney, and Denis C. Moriarty

Continuous Gastric Decompression for Postoperative Nausea and Vomiting After Coronary Revascularization Surgery
Anesth Analg 2005 100: 321-326. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Continuous gastric decompression during cardiac surgery does not reduce the risk of postoperative vomiting or nausea, although, in this prospective cohort study, its incidence was less frequent than previously reported.

Manabu Kakinohana, Osamu Kakinohana, Jong Hun Jun, Martin Marsala, Kenneth J. Davison, and Kazuhiro Sugahara

The Activation of Spinal N-Methyl-d-Aspartate Receptors May Contribute to Degeneration of Spinal Motor Neurons Induced by Neuraxial Morphine After a Noninjurious Interval of Spinal Cord Ischemia
Anesth Analg 2005 100: 327-334. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: On the basis of the results from a rodent spinal ischemic model, degeneration of {alpha}-motoneurons might be aggravated by the neuraxial administration of opioids after spinal cord ischemia.

Konrad Schwarzkopf, Torsten Schreiber, Elke Gaser, Niels-Peter Preussler, Lars Hueter, Harald Schubert, Helga Rek, and Waheedullah Karzai

The Effects of Xenon or Nitrous Oxide Supplementation on Systemic Oxygenation and Pulmonary Perfusion During One-Lung Ventilation in Pigs
Anesth Analg 2005 100: 335-339. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Supplementation of 60% xenon or nitrous oxide (N2O) does not affect oxygenation or lung perfusion during one-lung anesthesia with propofol in pigs. Xenon, a more potent anesthetic than N2O, can therefore safely replace N2O during one-lung ventilation.

Rainer Meierhenrich, Albrecht Gauss, Peter Vandenesch, Michael Georgieff, Bertram Poch, and Wolfram Schütz

The Effects of Intraabdominally Insufflated Carbon Dioxide on Hepatic Blood Flow During Laparoscopic Surgery Assessed by Transesophageal Echocardiography
Anesth Analg 2005 100: 340-347. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Blood flow in the right and middle hepatic veins was studied by use of transesophageal echocardiography in 24 patients undergoing laparoscopic surgery. CO2 pneumoperitoneum induced a significant increase in hepatic venous blood flow. This finding is in contrast to results of experimental studies suggesting that CO2 pneumoperitoneum may be harmful to liver function as a result of impaired perfusion.

C. A. Volta, V. Alvisi, S. Petrini, S. Zardi, E. Marangoni, R. Ragazzi, M. Capuzzo, and R. Alvisi

The Effect of Volatile Anesthetics on Respiratory System Resistance in Patients with Chronic Obstructive Pulmonary Disease
Anesth Analg 2005 100: 348-353. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Isoflurane and sevoflurane produce bronchodilation in patients with chronic obstructive pulmonary disease (COPD) who are undergoing lung surgery. COPD does not alter responsiveness to volatile anesthetics, but rather increases the possibility that patients will not respond to either sevoflurane or isoflurane.

Thomas M. Hemmerling, Jean-François Olivier, Fadi Basile, Nien Le, and Ignatio Prieto

Bispectral Index as an Indicator of Cerebral Hypoperfusion During Off-Pump Coronary Artery Bypass Grafting (Case Report)
Anesth Analg 2005 100: 354-356. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We present a case of possible cerebral hypoperfusion during beating heart surgery as shown by processed electroencephalographic monitoring of the bispectral index.

PEDIATRIC ANESTHESIA:

A. von Goedecke, J. Brimacombe, C. Hörmann, H. -C. Jeske, A. Kleinsasser, and C. Keller

Pressure Support Ventilation Versus Continuous Positive Airway Pressure Ventilation with the ProSeal^TM Laryngeal Mask Airway: A Randomized Crossover Study of Anesthetized Pediatric Patients
Anesth Analg 2005 100: 357-360. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pressure support ventilation improves gas exchange and reduces work of breathing compared with continuous positive airway pressure ventilation in anesthetized ASA physical status I children aged 1-7 yr using the ProSealTM laryngeal mask airway.

Erik Shank, Naveen Manohar, and Ulrich Schmidt

Anesthetic Management for Thoracopagus Twins with Complex Cyanotic Heart Disease in the Magnetic Resonance Imaging Suite (Case Report)
Anesth Analg 2005 100: 361-364. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this article we discuss the approach to and management of conjoined twins in the magnetic resonance imaging scanner. The twins shared a complex cardiac circulation, making the choice of anesthetic technique very important. In addition, their position--facing each other and attached chest to chest--made airway management difficult.

Darryl Berkowitz, Robin D. Kaye, Scott D. Markowitz, and Scott D. Cook-Sather

Inadvertent Extra-Epidural Catheter Placement in an Infant (Case Report)
Anesth Analg 2005 100: 365-366. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Epidural catheters threaded from the caudal space in infants may exit the vertebral canal. Radiographic confirmation of proper catheter position is recommended.

AMBULATORY ANESTHESIA:

Paul F. White, Mohamed A. Hamza, Alejandro Recart, Jayne E. Coleman, Amy R. Macaluso, Lyndsey Cox, Omar Jaffer, Dajun Song, and Rod Rohrich

Optimal Timing of Acustimulation for Antiemetic Prophylaxis as an Adjunct to Ondansetron in Patients Undergoing Plastic Surgery
Anesth Analg 2005 100: 367-372. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Acustimulation was more effective when applied after (versus before) plastic surgery for antiemetic prophylaxis in combination with ondansetron. Application of acustimulation both before and after surgery offered little additional advantage compared with postoperative administration alone.

Tricia A. Meyer, Charles R. Roberson, Mohammed H. Rajab, Jad Davis, and Charles H. McLeskey

Dolasetron Versus Ondansetron for the Treatment of Postoperative Nausea and Vomiting
Anesth Analg 2005 100: 373-377. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared the two leading antiemetic drugs (ondansetron and dolasetron) from the 5-hydroxytryptamine-3 receptor antagonist class of drugs for the treatment of nausea and vomiting after surgery. We conclude that dolasetron, when used for the treatment of nausea and vomiting, is as effective as ondansetron and at a reduced cost.

Yunan Zhang, Paul F. White, Larry Thornton, Lisa Perdue, and Michael Downing

The Use of Nicardipine for Electroconvulsive Therapy: A Dose-Ranging Study (Brief Report)
Anesth Analg 2005 100: 378-381. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A single bolus dose of nicardipine (40 {micro}g/kg IV) is effective in attenuating the acute autonomic response that occurs after electroconvulsive therapy (ECT) without producing residual hypotensive effects when it is administered immediately before application of the ECT stimulus.

ANESTHETIC PHARMACOLOGY:

Georg A. Petroianu, Mohammed Y. Hasan, Syed M. Nurulain, Kholoud Arafat, Rajan Sheen, Ayman Saleh, and Andrea Schmitt

Protective Drugs in Acute Large-Dose Exposure to Organophosphates: A Comparison of Metoclopramide and Tiapride with Pralidoxime in Rats
Anesth Analg 2005 100: 382-386. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Tiapride, but not metoclopramide, significantly reduces mortality in rats after organophosphate exposure. The protection conferred by tiapride is comparable to that of the "gold standard," pralidoxime.

Grigory Chernyak, Papiya Sengupta, Rainer Lenhardt, Edwin Liem, Anthony G. Doufas, Daniel I. Sessler, and Ozan Akça

The Timing of Acupuncture Stimulation Does Not Influence Anesthetic Requirement
Anesth Analg 2005 100: 387-392. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Electro-stimulation of the Zusanli (St36), Sanyinjiao (Sp6), Liangqiu (Sp34), and Hegu (LI4) acupuncture points, whether initiated 30 min before or at the induction of anesthesia, did not reduce desflurane requirements in healthy volunteers. This type of acupuncture is thus unlikely to facilitate general anesthesia or decrease the requirement for anesthetic drugs.

Marie-Josée Caron, François Girard, Dominique C. Girard, Daniel Boudreault, Bernard Brais, Edgard Nassif, Philippe Chouinard, Monique Ruel, and André Duranceau

Cisatracurium Pharmacodynamics in Patients with Oculopharyngeal Muscular Dystrophy
Anesth Analg 2005 100: 393-397. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oculopharyngeal muscular dystrophy does not affect the recovery profile of cisatracurium-induced neuromuscular block.

Carmen Dominguez, Earl Carstens, and Joseph F. Antognini

Carbon Dioxide Depresses the F Wave by a Central, Not Peripheral, Mechanism During Isoflurane Anesthesia
Anesth Analg 2005 100: 398-403. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The F wave, a measure of motoneuron excitability, is depressed when CO2 is selectively delivered to the torso, but not when CO2 is delivered to the hindlimb. CO2 depression of the F wave during isoflurane anesthesia is the result of CO2 action in the central nervous system and not in the periphery.

Martín Santos, Viviana Kuncar, Fernando Martínez-Taboada, and Francisco J. Tendillo

Large Concentrations of Nitrous Oxide Decrease the Isoflurane Minimum Alveolar Concentration Sparing Effect of Morphine in the Rat
Anesth Analg 2005 100: 404-408. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: At zero or small nitrous oxide concentrations, morphine reduces isoflurane's minimum alveolar anesthetic concentration but not at large nitrous oxide concentrations.

Wei Lan, Dominic C. Harmon, Jiang H. Wang, George D. Shorten, and Paul H. Redmond

Activated Endothelial Interleukin-1ß, -6, and -8 Concentrations and Intercellular Adhesion Molecule-1 Expression Are Attenuated by Lidocaine
Anesth Analg 2005 100: 409-412. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ischemia reperfusion injury is an important cause of perioperative morbidity. Endothelial cells play a key role in ischemia reperfusion injury. Lidocaine, at larger clinically relevant plasma concentrations, decreased in vitro endothelial intercellular adhesion molecule-1 expression and cytokine concentrations. This may be a protective mechanism of lidocaine at sites of increased concentrations in ischemia reperfusion injury.

Shirley M.E. Wong, Sarah M. Sweitzer, Michael C. Peters, and Joan J. Kendig

Hyperresponsiveness on Washout of Volatile Anesthetics from Isolated Spinal Cord Compared to Withdrawal from Ethanol
Anesth Analg 2005 100: 413-436. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Emergence from inhaled anesthesia is accompanied by symptoms suggesting heightened nervous excitability. A spinal neuronal response increases after halothane, isoflurane, and ethanol. For the inhaled anesthetics this is an excitatory effect different from ethanol withdrawal hyperresponsiveness and, unlike the latter, independent of protein kinase C.

Mikiyo Yamaguchi, Yoshinobu Tomiyama, Toshiko Katayama, Hiroshi Kitahata, and Shuzo Oshita

Involvement of Adenosine Triphosphate-Sensitive Potassium Channels in the Response of Membrane Potential to Hyperosmolality in Cultured Human Aorta Endothelial Cells
Anesth Analg 2005 100: 419-426. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Adenosine triphosphate-sensitive potassium channels participate in hyperosmotic mannitol- and hyperosmotic sucrose-induced membrane hyperpolarization and do not participate in hypertonic saline-induced membrane hyperpolarization in human aorta endothelial cells.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Takahiro Suzuki, Ichiro Uchida, and Takashi Mashimo

Sorptive Loss of Volatile and Gaseous Anesthetics from In Vitro Drug Application Systems
Anesth Analg 2005 100: 427-430. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In in vitro experimental settings, the delivered anesthetic concentration in solutions can decrease to the extent that one cannot determine exact effective concentration values. We observed the dissolved anesthetic concentrations decreased after passing through polyvinyl chloride and silicon tubes but not through tubes made of glass, Teflon, or polyethylene.

Jonathan S. Jahr, Stephen Osgood, Stephen J. Rothenberg, Qiao-Ling Li, Anthony W. Butch, Robert Gunther, Anthony Cheung, and Bernd Driessen

Lactate Measurement Interference by Hemoglobin-Based Oxygen Carriers (Oxyglobin®, Hemopure®, and Hemolink^TM)
Anesth Analg 2005 100: 431-436. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Three blood substitutes were analyzed to determine if they interfere with the accuracy of lactate, and we found them to be underestimated in most cases.

Stephen L. Osgood, Jonathan S. Jahr, Poonam Desai, Jessica Tsukamoto, and Bernd Driessen

Does Methemoglobin from Oxidized Hemoglobin-Based Oxygen Carrier (Hemoglobin Glutamer-200) Interfere with Lactate Measurement (YSI 2700 SELECT^TM Biochemistry Analyzer)?
Anesth Analg 2005 100: 437-439. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Hemoglobin glutamer-200 (Oxyglobin(R)), a hemoglobin-based oxygen carrier, interferes with the accuracy of measured lactate levels when using the YSI 2700 SELECTTM Biochemisty Analyzer.

Kai M. Scheufler, Peter C. Reinacher, Winfried Blumrich, Josef Zentner, and Hans-Joachim Priebe

The Modifying Effects of Stimulation Pattern and Propofol Plasma Concentration on Motor-Evoked Potentials
Anesth Analg 2005 100: 440-447. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The reliability of intraoperative motor-evoked potentials (MEP) recorded during propofol and remifentanil anesthesia depends mainly on the stimulation pattern. Increases in stimulation frequency, stimulus intensity, and number of stimuli improve MEP amplitude and recording success. Variation of target-controlled propofol plasma concentrations between 2 and 6 {micro}g/mL allows stable intraoperative recording of MEP.

PAIN MEDICINE:

Ching-Tang Wu, Cecil O Borel, Meei-Shyuan Lee, Jyh-Cherng Yu, Hang-Seng Liou, Haun-De Yi, and Chih-Ping Yang

The Interaction Effect of Perioperative Cotreatment with Dextromethorphan and Intravenous Lidocaine on Pain Relief and Recovery of Bowel Function After Laparoscopic Cholecystectomy
Anesth Analg 2005 100: 448-453. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The combination of preincisional intramuscular injection of dextromethorphan (DM) 40 mg and IV lidocaine (3 mg {middle dot} kg-1 {middle dot} h-1) enhances the analgesic effect and facilitates recovery of bowel function after laparoscopic cholecystectomy. This result might be due to an additional effect of lidocaine at the N-methyl-d-aspartate receptors already targeted by DM.

T. Philip Malan, Jr, Stephen Gordon, Richard Hubbard, and Michael Snabes

The Cyclooxygenase-2-Specific Inhibitor Parecoxib Sodium Is as Effective as 12 mg of Morphine Administered Intramuscularly for Treating Pain After Gynecologic Laparotomy Surgery
Anesth Analg 2005 100: 454-460. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Parecoxib sodium 40 mg as a single dose provides effective analgesia that is superior to a single dose of morphine 6 mg and is comparable to a single dose of morphine 12 mg in patients after major gynecologic surgery.

Jai-Hyun Hwang, Gyu-Sam Hwang, Sung-Kang Cho, and Sung-Min Han

Morphine Can Enhance the Antiallodynic Effect of Intrathecal R-PIA in Rats with Nerve Ligation Injury
Anesth Analg 2005 100: 461-468. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using isobolographic analysis, the antiallodynic interaction between intrathecal morphine and adenosine A1 receptor agonist, N6-(2-phenylisopropyl)-adenosine R-(-)isomer (R-PIA), was examined in a rat model of nerve ligation injury. Intrathecal morphine produced a synergistic interaction with R-PIA when administered concurrently.

Thi Aurore Marcou, Sophie Marque, Jean-Xavier Mazoit, and Dan Benhamou

The Median Effective Dose of Tramadol and Morphine for Postoperative Patients: A Study of Interactions
Anesth Analg 2005 100: 469-474. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The pharmacologic interaction between tramadol and morphine was studied in the postoperative period. Their potency ratio was 10:3 (morphine:tramadol) and the combination showed infra-additivity. We do not recommend the combination of morphine and tramadol for postoperative analgesia.

Frédéric Adam, Marcel Chauvin, Bertrand Du Manoir, Mathieu Langlois, Daniel I. Sessler, and Dominique Fletcher

Small-Dose Ketamine Infusion Improves Postoperative Analgesia and Rehabilitation After Total Knee Arthroplasty
Anesth Analg 2005 100: 475-480. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Adding an IV infusion of small-dose ketamine to a continuous femoral block for 48 h after surgery decreased morphine consumption by 35% and improved early rehabilitation with a similar incidence of adverse effects.

Michael A. Frölich, Donald D. Price, Michael E. Robinson, Jonathan J. Shuster, Douglas W. Theriaque, and Marc W. Heft

The Effect of Propofol on Thermal Pain Perception
Anesth Analg 2005 100: 481-486. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: The effect of sedative-hypnotic drugs on pain perception is controversial. We studied the effects of propofol, a commonly used sedative-hypnotic drug, on pain perception in volunteers. Subjects rated both pain intensity and unpleasantness higher under sedation when compared to no sedation.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Ronald D. Miller

Academic Anesthesia Faculty Salaries: Incentives, Availability, and Productivity (Editorial)
Anesth Analg 2005 100: 487-489. [Full Text] [PDF] [Request Permissions]  

David A. Lubarsky

Incentivize Everything, Incentivize Nothing (Editorial)
Anesth Analg 2005 100: 490-492. [Full Text] [PDF] [Request Permissions]  

Amr E. Abouleish, Jeffrey L. Apfelbaum, Donald S. Prough, John P. Williams, Jay A. Roskoph, William E. Johnston, and Charles W. Whitten

The Prevalence and Characteristics of Incentive Plans for Clinical Productivity Among Academic Anesthesiology Programs
Anesth Analg 2005 100: 493-501. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Administrators of academic medical centers advocate changing compensation for academic physicians from straight salaries to productivity-based incentive programs. The results of this survey characterize current incentive programs in academic anesthesiology departments.

David G. Metro, Joseph F. Talarico, Rita M. Patel, and Amy L. Wetmore

The Resident Application Process and Its Correlation to Future Performance as a Resident
Anesth Analg 2005 100: 502-505. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Given the amount of time, money, and effort spent on resident recruitment, interviewing, and selection, we should be able to select the best applicants who apply to our programs. We compared how applicants were rated after the interview process to how they later performed within our residency.

Alexander Avidan, Charles Weissman, and Charles L. Sprung

An Internet Web Site as a Data Collection Platform for Multicenter Research
Anesth Analg 2005 100: 506-511. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A Web site for data collection of a large-scale, international multicenter study on ethical decision-making was built using an inexpensive commercially available web authoring tool.

CRITICAL CARE AND TRAUMA:

James M. Riopelle, Darren P. Ruiz, John P. Hunt, Mark R. Mitchell, J. Carlos Mena, Jason A. Rigol, Bruno C. Jubelin, Arthur J. Riopelle, Valeriy V. Kozmenko, and Matthew K. Miller

Circumferential Adjustment of Ultrasound Probe Position to Determine the Optimal Approach to the Internal Jugular Vein: A Noninvasive Geometric Study in Adults
Anesth Analg 2005 100: 512-519. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: Circumferential adjustment of a two-dimensional ultrasonic imaging device's probe position permits identification of an approach to the internal jugular vein that minimizes venoarterial overlap, maximizes venous target angular width, or optimizes a combination of the two.

Nicola A. Horn, Denisa M. Anastase, Klaus E. Hecker, Jan H. Baumert, Tilo Robitzsch, and Rolf Rossaint

Epinephrine Enhances Platelet-Neutrophil Adhesion in Whole Blood In Vitro
Anesth Analg 2005 100: 520-526. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Catecholamines have immunomodulatory side effects. We showed, by means of flow cytometry, that epinephrine enhances platelet-neutrophil adhesion. Our data show that epinephrine-induced immunomodulation affects platelet-neutrophil interactions, which could increase organ dysfunction in critically ill patients.

Gordon S. Doig, Fiona Simpson, and Anthony Delaney

A Review of the True Methodological Quality of Nutritional Support Trials Conducted in the Critically Ill: Time for Improvement
Anesth Analg 2005 100: 527-533. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: The true methodological quality of feeding studies conducted in critically ill patients was assessed. The quality of feeding studies was consistently rated worse than sepsis trials, which have previously been described as "poor." To reliably detect differences in clinically meaningful outcomes, the quality of future feeding studies must be improved.

Virendra K. Arya, Arun Kumar, Surinder S. Makkar, and Ramesh K. Sharma

Retrograde Submental Intubation by Pharyngeal Loop Technique in a Patient with Faciomaxillary Trauma and Restricted Mouth Opening (Case Report)
Anesth Analg 2005 100: 534-537. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Submental intubation is useful for airway management during maxillofacial surgery, especially to avoid tracheostomy. It has never been reported in a patient with inability to open the mouth. We describe the technique of retrograde submental intubation with the help of a pharyngeal loop assembly in a patient with maxillofacial trauma in whom oral and nasal intubations were not possible.

NEUROSURGICAL ANESTHESIA:

Anouk Richard, François Girard, Dominique C. Girard, Daniel Boudreault, Philippe Chouinard, Robert Moumdjian, Alain Bouthilier, Monique Ruel, Johanne Couture, and France Varin

Cisatracurium-Induced Neuromuscular Blockade Is Affected by Chronic Phenytoin or Carbamazepine Treatment in Neurosurgical Patients
Anesth Analg 2005 100: 538-544. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Patients treated with anticonvulsants need a more rapid speed of infusion of cisatracurium to steadily maintain a given twitch depression. Changes in pharmacokinetics (increased clearance) and pharmacodynamics (reduced sensitivity) are equally responsible for this phenomenon.

Ehab Farag, Amgad Abdou, Ihab Riad, Sam R. Borsellino, and Armin Schubert

Cerebellar Hemorrhage Caused by Cerebrospinal Fluid Leak After Spine Surgery (Case Report)
Anesth Analg 2005 100: 545-546. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This report describes a rare case of cerebellar hemorrhage after spine surgery. Postoperative vigilance and early management are the most important factors for avoiding adverse outcomes.

OBSTETRIC ANESTHESIA:

Gary Peters and Nigel P. Hinds

Inherited Neuropathy Can Cause Postpartum Foot Drop (Case Report)
Anesth Analg 2005 100: 547-548. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthesiologists are often blamed for neurological complications after anesthetic procedures during childbirth, with medicolegal implications. A genetically determined predisposition to compression-induced neuropathies is not rare and is probably underdiagnosed, but a clinical history can provide clues.

REGIONAL ANESTHESIA:

Kenneth Drasner

Chloroprocaine Spinal Anesthesia: Back to the Future? (Editorial)
Anesth Analg 2005 100: 549-552. [Full Text] [PDF] [Request Permissions]  

Jessica R. Yoos and Dan J. Kopacz

Spinal 2-Chloroprocaine for Surgery: An Initial 10-Month Experience
Anesth Analg 2005 100: 553-558. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal 2-chloroprocaine is an effective alternative to spinal lidocaine and procaine for ambulatory procedures in this review of the first 122 patients at our institution. All patients tolerated short operations (mean, <40 min), and none described symptoms of transient neurologic symptoms.

Brad R. Davis and Dan J. Kopacz

Spinal 2-Chloroprocaine: The Effect of Added Clonidine
Anesth Analg 2005 100: 559-565. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal 2-chloroprocaine (2-CP) (30 mg) provides rapid-onset anesthesia and reliable blockade without signs of transient neurological symptoms and thereby possesses characteristics ideal for ambulatory surgery. The addition of small-dose clonidine (15 {micro}g) increases the duration and improves the quality of 2-CP spinal anesthesia without producing side effects.

Jessica R. Yoos and Dan J. Kopacz

Spinal 2-Chloroprocaine: A Comparison with Small-Dose Bupivacaine in Volunteers
Anesth Analg 2005 100: 566-572. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal 2-chloroprocaine (2-CP) (40 mg) provides rapid onset, and reliable blockade, without signs of transient neurologic symptoms. Compared with spinal bupivacaine (7.5 mg), 2-CP produces more reliable motor blockade and faster block resolution. Spinal 2-CP is an excellent choice for outpatient procedures in which rapid fulfillment of discharge criteria is desired.

Aaron F. Gonter and Dan J. Kopacz

Spinal 2-Chloroprocaine: A Comparison with Procaine in Volunteers
Anesth Analg 2005 100: 573-579. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal 2-chloroprocaine (2-CP; 30 mg) provides rapid onset and reliable spinal anesthesia blockade. Compared with spinal procaine (80 mg), 2-CP may be a better choice for short outpatient procedures because it provides similar efficacy but more rapid fulfillment of discharge criteria.

GENERAL ARTICLES:

Sylvain Gander, Philippe Frascarolo, Michel Suter, Donat R. Spahn, and Lennart Magnusson

Positive End-Expiratory Pressure During Induction of General Anesthesia Increases Duration of Nonhypoxic Apnea in Morbidly Obese Patients
Anesth Analg 2005 100: 580-584. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Application of positive end-expiratory pressure during induction of general anesthesia in morbidly obese patients increases nonhypoxic apnea duration by 50%.

Andranik Ovassapian, Meltem Tuncbilek, Erik K. Weitzel, and Chandrashekhar W. Joshi

Airway Management in Adult Patients with Deep Neck Infections: A Case Series and Review of the Literature
Anesth Analg 2005 100: 585-589. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Securing the airway in patients with advanced upper airway infections is challenging and dangerous. This report demonstrates the value and success of the flexible bronchoscope in airway management in these patients.

Sarah Doneley, Joseph Brimacombe, Christian Keller, and Achim von Goedecke

The ProSeal^TM Has a Shorter Life-Span than the Classic^TM Laryngeal Mask Airway
Anesth Analg 2005 100: 590-593. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The life-span of the ProSealTM laryngeal mask airway is shorter than the ClassicTM laryngeal mask airway. Reusable laryngeal mask airway devices should be discarded when they fail the pre-use check tests rather than after a specific number of uses.

Janet B. Quinn, Lex W. Schultheis, and Gary E. Schumacher

A Tooth Broken After Laryngoscopy: Unlikely to Be Caused by the Force Applied by the Anesthesiologist (Case Report)
Anesth Analg 2005 100: 594-596. [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report suggests that some tooth fractures attributed to the intubation procedure might actually be the result of biting on the endotracheal tube during the recovery period. Precautions such as the use of protective mouth guards or increased monitoring may be prudent for susceptible patients, such as bruxers.

LETTER TO THE EDITOR:

Jacques E. Chelly and Laurent Delaunay

Block of the Posterior Femoral Cutaneous Nerve
Anesth Analg 2005 100: 597. [Full Text] [PDF] [Request Permissions]  

Carole Barbero, Régis Fuzier, and Kamran Samii

Block of the Posterior Femoral Cutaneous Nerve
Anesth Analg 2005 100: 597. [Full Text] [PDF] [Request Permissions]  

W. John Russell

Anaphylaxis Is Not a Dose/Response Effect
Anesth Analg 2005 100: 597-598. [Full Text] [PDF] [Request Permissions]  

Juraj Sprung, Damir Matesic, and James R. Hebl

Anaphylaxis Is Not a Dose/Response Effect
Anesth Analg 2005 100: 598. [Full Text] [PDF] [Request Permissions]  

James P. Zacny

Differential Effects of Morphine and Codeine on Pupil Size: Dosing Issues
Anesth Analg 2005 100: 598. [Full Text] [PDF] [Request Permissions]  

Gregory J. Hobbs and Roger D. Knaggs

Differential Effects of Morphine and Codeine on Pupil Size: Dosing Issues
Anesth Analg 2005 100: 598. [Full Text] [PDF] [Request Permissions]  

Xuan Au-Truong and M. Ramez Salem

Radiologic-Assisted Endotracheal Intubation
Anesth Analg 2005 100: 598-599. [Full Text] [PDF] [Request Permissions]  

Charles E. Reier and Allan R. Reier

Radiologic-Assisted Endotracheal Intubation
Anesth Analg 2005 100: 599. [Full Text] [PDF] [Request Permissions]  

Govind R. Rajan

Fiberoptic Wire-Guided Transoral and Through the LMA Intubation Technique Using Modified Gum Elastic Bougie
Anesth Analg 2005 100: 599-600. [Full Text] [PDF] [Request Permissions]  

Gordon T. Linklater and Lisa Macaulay

Epidural Analgesia in Advanced Cancer Patients
Anesth Analg 2005 100: 600. [Full Text] [PDF] [Request Permissions]  

Matthias Eikermann and Jürgen Peters

Epidural Analgesia in Advanced Cancer Patients
Anesth Analg 2005 100: 600-601. [Full Text] [PDF] [Request Permissions]  

Aaron A. Tebbs and Paul F. Lennon

Visualization of Pulmonary Thromboemboli Using Epicardial Ultrasound
Anesth Analg 2005 100: 601. [Full Text] [PDF] [Request Permissions]  

Peter Rosenberger, Stanton K. Shernan, Simon C. Body, and Holger K. Eltzschig

Visualization of Pulmonary Thromboemboli Using Epicardial Ultrasound
Anesth Analg 2005 100: 601. [Full Text] [PDF] [Request Permissions]  

Babita Ghai, A. Naik, S. Rupal, and R. Madan

Toe Gangrene in an Infant Subsequent to Use of Pulse Oximeter for Short Duration
Anesth Analg 2005 100: 602. [Full Text] [PDF] [Request Permissions]  

James F. Mayhew

Caudal Morphine for Pain Relief in Pediatric Liver Transplantation: Did It Help?
Anesth Analg 2005 100: 602-603. [Full Text] [PDF] [Request Permissions]  

Tae W. Kim

Caudal Morphine for Pain Relief in Pediatric Liver Transplantation: Did It Help?
Anesth Analg 2005 100: 603. [Full Text] [PDF] [Request Permissions]  

J. Brimacombe and C. Keller

The Elisha Airway Device: Supraglottic and Infraglottic, or Simply Extraglottic?
Anesth Analg 2005 100: 603. [Full Text] [PDF] [Request Permissions]  

Luis A. Gaitini, Sonia J. Vaida, and Carin A. Hagberg

The Elisha Airway Device: Supraglottic and Infraglottic, or Simply Extraglottic?
Anesth Analg 2005 100: 603. [Full Text] [PDF] [Request Permissions]  

Gail A. Van Norman, Susan K. Palmer, and Stephen H. Jackson

The Ethical Role of Medical Journal Editors
Anesth Analg 2005 100: 603-604. [Full Text] [PDF] [Request Permissions]  

Sheng K. Lin

More on the Dilemma of Intrathecal Midazolam
Anesth Analg 2005 100: 604. [Full Text] [PDF] [Request Permissions]  

Ronald D. Miller

More on the Dilemma of Intrathecal Midazolam
Anesth Analg 2005 100: 604. [Full Text] [PDF] [Request Permissions]  

Louise Walker

Intrathecal Midazolam: Adverse Effects and Sources of Bias
Anesth Analg 2005 100: 604-605. [Full Text] [PDF] [Request Permissions]  

Adam P. Tucker, Joseph Mezzatesta, Raymond Nadeson, and Colin S. Goodchild

Intrathecal Midazolam: Adverse Effects and Sources of Bias
Anesth Analg 2005 100: 605. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Elizabeth Sinz

Textbook of Neurointensive Care.
Anesth Analg 2005 100: 606. [Full Text] [PDF] [Request Permissions]  

Adam R. Burkey and Dell R. Burkey

Neurosurgical Pain Management.
Anesth Analg 2005 100: 606. [Full Text] [PDF] [Request Permissions]  

Robert E. Johnstone

Evidence-Based Practice of Anesthesiology.
Anesth Analg 2005 100: 606-607. [Full Text] [PDF] [Request Permissions]  

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