CARDIOVASCULAR ANESTHESIA:

Kevin K. Tremper

Hemoglobin-Based Oxygen Carrying Solutions: Will They Replace Red Blood Cells? (Editorial)
Anesth Analg 2005 100: 910-911. [Full Text] [PDF] [Request Permissions]  

Ivo P. Torres Filho, Bruce D. Spiess, R. Wayne Barbee, Kevin R. Ward, John Oldenhof, and Roland N. Pittman

Systemic Responses to Hemodilution After Transfusion with Stored Blood and with a Hemoglobin-Based Oxygen Carrier
Anesth Analg 2005 100: 912-920. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The systemic effects of exchanges with blood or hemoglobin raffimer under conditions of critical oxygen delivery were assessed in rats subjected to isovolemic hemodilution. The data suggest that tolerance to critical levels of oxygen delivery is not altered by 50% replacement of native hemoglobin by stored blood or hemoglobin raffimer.

Michael J. Barrington, Roman Kluger, Robert Watson, David A. Scott, and Karen J. Harris

Epidural Anesthesia for Coronary Artery Bypass Surgery Compared with General Anesthesia Alone Does Not Reduce Biochemical Markers of Myocardial Damage
Anesth Analg 2005 100: 921-928. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Epidural anesthesia for coronary artery bypass surgery does not reduce biochemical markers of myocardial damage compared with general anesthesia alone.

Irina V. Balyasnikova, David J. Visintine, Helena B. Gunnerson, Chanannait Paisansathan, Verna L. Baughman, Richard D. Minshall, and Sergei M. Danilov

Propofol Attenuates Lung Endothelial Injury Induced by Ischemia-Reperfusion and Oxidative Stress
Anesth Analg 2005 100: 929-936. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Propofol attenuated oxidative lung injury induced by ischemia/reperfusion or by hydrogen peroxide in the isolated perfused rat lung. Endothelial dysfunction and lung injury were quantified by measuring angiotensin-converting enzyme release from the cell surface.

Nagara Ono, Takayuki Ono, Teiji Asakura, Takeki Ohashi, and Tomoyasu Sin

Usefulness of Unipolar Epicardial Ventricular Electrogram for Triggering of Intraaortic Balloon Counterpulsation During Off-Pump Coronary Artery Bypass Surgery in Patients with Hemodynamic Instability Complicating Acute Coronary Syndromes (Technical Communication)
Anesth Analg 2005 100: 937-941. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During off-pump coronary-artery-bypass surgery (OPCAB), errors in timing of intraaortic balloon counterpulsation (IABP) caused by mobilization of the heart could induce hemodynamic instability. We have used a temporary epicardial electrode to trigger the IABP accurately during OPCAB. This technique is useful for performing OPCAB safely when hemodynamic stability depends on effective IABP support.

Azriel Perel, Leonid Minkovich, Sergey Preisman, Michel Abiad, Eran Segal, and Pierre Coriat

Assessing Fluid-Responsiveness by a Standardized Ventilatory Maneuver: The Respiratory Systolic Variation Test (Brief Report)
Anesth Analg 2005 100: 942-945. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The slope created by the minimal systolic blood pressures plotted against the respective airway pressures during a ventilatory maneuver consisting of four incremental successive breaths was shown to predict the response of the cardiac output intravascular to fluid administration better than frequently used variables in ventilated patients after vascular surgery.

Sarah E. Hallman, Latha Hebbar, Jay Robison, and Walter E. Uber

The Use of Argatroban for Carotid Endarterectomy in Heparin-Induced Thrombocytopenia (Case Report)
Anesth Analg 2005 100: 946-948. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Advances are being made to provide adequate anticoagulation when required in patients with heparin-induced thrombocytopenia. Direct thrombin inhibitors, such as argatroban, are increasingly being used for this purpose. We present a case during which we successfully used argatroban for carotid endarterectomy in such a patient.

PEDIATRIC ANESTHESIA:

Young-Chang P. Arai, Kayo Fukunaga, Wasa Ueda, Masashi Hamada, Hiroyuki Ikenaga, and Kei Fukushima

The Endoscopically Measured Effects of Airway Maneuvers and the Lateral Position on Airway Patency in Anesthetized Children with Adenotonsillar Hypertrophy
Anesth Analg 2005 100: 949-952. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the effects of body position shifting and common airway maneuvers on airway patency (stridor score and airway dimensions by endoscopy) in anesthetized children scheduled for adenotonsillectomy. Lateral positioning not only improved airway patency but also increased the effect of airway maneuvers.

Lynne G. Maxwell, Sandra C. Kaufmann, Sally Bitzer, Eric V. Jackson, Jr, John McGready, Sabine Kost-Byerly, Lori Kozlowski, Sharon K. Rothman, and Myron Yaster

The Effects of a Small-Dose Naloxone Infusion on Opioid-Induced Side Effects and Analgesia in Children and Adolescents Treated with Intravenous Patient-Controlled Analgesia: A Double-Blind, Prospective, Randomized, Controlled Study
Anesth Analg 2005 100: 953-958. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In children and adolescents, a small dose naloxone infusion (0.25 {micro}g {middle dot} kg-1 {middle dot} h-1) can significantly reduce the incidence and severity of opioid-induced side effects without affecting opioid-induced analgesia. When initiating morphine IV patient-controlled analgesia for the treatment of moderate to severe postoperative pain, clinicians should strongly consider starting a concomitant small-dose naloxone infusion.

Hilary R. Glaisyer and Michael R. J. Sury

Recovery After Anesthesia for Short Pediatric Oncology Procedures: Propofol and Remifentanil Compared with Propofol, Nitrous Oxide, and Sevoflurane
Anesth Analg 2005 100: 959-963. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study compared the recovery characteristics of two anesthetic techniques in children undergoing short painful oncology procedures. Discharge readiness from the recovery ward was achieved on average 19 min earlier after propofol with remifentanil compared with the combination of propofol, sevoflurane, and nitrous oxide. Parents more often preferred propofol with remifentanil.

Kahoru Nishina, Katsuya Mikawa, Yumiko Takao, and Hidefumi Obara

The Efficacy of Fluorocarbon, Surfactant, and Their Combination for Improving Acute Lung Injury Induced by Intratracheal Acidified Infant Formula
Anesth Analg 2005 100: 964-971. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Partial liquid ventilation with fluorocarbon after exogenous surfactant using volume-controlled and pressure-controlled ventilation produced better improvement than each therapy alone in acidified infant formula-induced lung damage, although fluorocarbon followed by surfactant provided the smallest improvement.

J. William Sparks, Christian Seefelder, Robert C. Shamberger, and Francis X. McGowan

The Perioperative Management of a Patient with Complex Single Ventricle Physiology and Pheochromocytoma (Case Report)
Anesth Analg 2005 100: 972-975. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Both pheochromocytoma and single ventricle physiology are challenging conditions for anesthesiologists. We report the perioperative management of a patient with single ventricle, cavo-pulmonary and aorto-pulmonary lung perfusion who presented for resection of a pheochromocytoma. Careful {alpha}-adrenergic receptor blockade using doxazosin contributed to a successful preoperative, intraoperative, and postoperative course.

AMBULATORY ANESTHESIA:

Admir Hadzic, Pelin Emine Karaca, Paul Hobeika, George Unis, Jeffrey Dermksian, Marina Yufa, Richard Claudio, Jerry D. Vloka, Alan C. Santos, and Daniel M. Thys

Peripheral Nerve Blocks Result in Superior Recovery Profile Compared with General Anesthesia in Outpatient Knee Arthroscopy
Anesth Analg 2005 100: 976-981. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A combination of lumbar plexus and sciatic blocks with short-acting local anesthetic is associated with a superior recovery profile compared with general anesthesia in outpatients having outpatient knee arthroscopy.

Girish P. Joshi

The Society for Ambulatory Anesthesia: 19th Annual Meeting Report (Meeting Report)
Anesth Analg 2005 100: 982-986. [Full Text] [PDF] [Request Permissions]  

ANESTHETIC PHARMACOLOGY:

Norezalee Ahmad, Choy Yin Choy, Esa Ab Aris, and Subrahmanyam Balan

Preventing the Withdrawal Response Associated with Rocuronium Injection: A Comparison of Fentanyl with Lidocaine
Anesth Analg 2005 100: 987-990. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pretreatment with IV fentanyl given without tourniquet 2 min before rocuronium injection is more effective in attenuating withdrawal response when compared with IV lidocaine.

Thomas J. Rowley, Danette Daniel, and Pamela Flood

The Role of Adrenergic and Cholinergic Transmission in Volatile Anesthetic-Induced Pain Enhancement
Anesth Analg 2005 100: 991-995. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We have shown that the pronociceptive and antinociceptive actions of isoflurane can be separated by concentration and have identified relevant concentration ranges in studies on mice. We have implicated both spinal {alpha}2-adrenergic and nicotinic receptors in the pronociceptive action of isoflurane.

Harald G. Fritz, Martin Holzmayr, Bernd Walter, Klaus-Uwe Moeritz, Amelie Lupp, and Reinhard Bauer

The Effect of Mild Hypothermia on Plasma Fentanyl Concentration and Biotransformation in Juvenile Pigs
Anesth Analg 2005 100: 996-1002. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The study was conducted to investigate the effect of hypothermia on the plasma fentanyl concentration during continuous long-term administration in piglets. Hypothermia induced a marked increase in plasma fentanyl concentration which remained increased for several hours after rewarming. A strong temperature dependency of CYP3A4 was found as one possible mechanism for this phenomenon.

Mireille A. Neumann, Edmond I Eger, II, and Richard B. Weiskopf

Solubility of Volatile Anesthetics in Bovine White Matter, Cortical Gray Matter, Thalamus, Hippocampus, and Hypothalamic Area
Anesth Analg 2005 100: 1003-1006. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Consistent with their differences in lipid content, white matter has a higher capacity for modern volatile inhaled anesthetics than does gray matter.

Zhu Biao, Xue Zhanggang, Jiang Hao, Miao Changhong, and Cang Jing

The In Vitro Effect of Desflurane Preconditioning on Endothelial Adhesion Molecules and mRNA Expression
Anesth Analg 2005 100: 1007-1013. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Human umbilical venous endothelial cells (HUVEC) were preconditioned with desflurane for 60 min, then the protein and mRNA expression of cell adhesion molecule of HUVEC were quantified. Adhesion rate reduction of neutrophils with desflurane-treated HUVEC correlates well with expression inhibition of intercellular adhesion molecule-1, vascular adhesion molecule-1 and E-selectin. Thus reduced reperfusion injury by desflurane may be via this underlying mechanism.

Denise Tabacchi Fantoni, Denise Aya Otsuki, Aline Magalhães Ambrósio, Eunice Yuriko Tamura, and José Otávio Costa Auler, Jr

A Comparative Evaluation of Inhaled Halothane, Isoflurane, and Sevoflurane During Acute Normovolemic Hemodilution in Dogs
Anesth Analg 2005 100: 1014-1019. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The hemodynamic response to hemodilution can be affected by the anesthetics used during surgery. We studied the inhaled anesthetics halothane, isoflurane, and sevoflurane and found that they did not affect the hemodynamic response to hemodilution in 18 mongrel dogs randomized to undergo acute normovolemic hemodilution.

Edmond I. Eger, II and Lawrence J. Saidman

Illustrations of Inhaled Anesthetic Uptake, Including Intertissue Diffusion to and from Fat (Special Article)
Anesth Analg 2005 100: 1020-1033. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The factors governing the pharmacokinetics of inhaled anesthetics are described with drawings in which capacity to hold (take up) anesthetic is depicted by area and in which the extent of anesthetic movement is depicted by the length and breadth of arrows to and from the areas depicting capacity.

Guo-xi Xie and Pamela Pierce Palmer

RGS Proteins: New Players in the Field of Opioid Signaling and Tolerance Mechanisms (Review Article)
Anesth Analg 2005 100: 1034-1042. [Abstract] [Full Text] [PDF] [Request Permissions]  

TECHNOLOGY, COMPUTING, AND SIMULATION:

Thomas N. Spackman, Martin D. Abel, and Todd T. Schlegel

Twelve-Lead High-Frequency QRS Electrocardiography During Anesthesia in Healthy Subjects
Anesth Analg 2005 100: 1043-1047. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The authors measured the high-frequency electrocardiogram before and after the induction of general anesthesia in healthy patients and found that it was potentially useful for monitoring during anesthesia.

Mark A. Lovich, Jason Doles, and Robert A. Peterfreund

The Impact of Carrier Flow Rate and Infusion Set Dead-Volume on the Dynamics of Intravenous Drug Delivery
Anesth Analg 2005 100: 1048-1055. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The impact of infusion set dead-volume, drug flow rate, and carrier flow rate on the dynamics of drug delivery by infusion were studied with mathematical models and experimental simulations. These studies will help guide the safe and rational design of drug infusion systems in a variety of clinical environments.

Joho Tokumine, Kazuhiro Sugahara, Kouji Gushiken, Minoru Ohta, Tomoaki Matsuyama, and Satoko Saikawa

Non-Zero Basal Oxygen Flow a Hazard to Anesthesia Breathing Circuit Leak Test
Anesth Analg 2005 100: 1056-1058. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We found that the non-zero basal oxygen flow setting in certain anesthesia machines interferes with the detection of small breathing circuit leaks, but the clinical significance of such a small leak is still unknown.

Roy Soto, Tam C. Nguyen, and Robert A. Smith

A Comparison of Bispectral Index and Entropy, or How to Misinterpret Both (Case Report)
Anesth Analg 2005 100: 1059-1061. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Entropy is a new form of intraoperative consciousness monitoring that has potential advantages over Bispectral Index. In this report we present a case of a patient monitored with both; but more importantly we point out the importance of vigilance, especially when using new technology.

Aneesh K. Singla, Jason A. Campagna, Cameron D. Wright, and Warren S. Sandberg

Surgical Field Fire During a Repair of Bronchoesophageal Fistula (Case Report)
Anesth Analg 2005 100: 1062-1064. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a fire during the use of a common maneuver to augment oxygenation during one-lung ventilation. This event highlights unique safety concerns during anesthesia for thoracic surgery and also of the importance of recognizing that the actions of all persons in the operating room contribute to increased fire risk.

PAIN MEDICINE:

David Gambling, Thomas Hughes, Gavin Martin, William Horton, Garen Manvelian for the Single-Dose EREM Study Group

A Comparison of Depodur^TM, a Novel, Single-Dose Extended-Release Epidural Morphine, with Standard Epidural Morphine for Pain Relief After Lower Abdominal Surgery
Anesth Analg 2005 100: 1065-1074. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This randomized, controlled, dose-ranging study evaluated the analgesic efficacy of a novel encapsulated single-dose extended-release epidural morphine (EREM) in 487 patients undergoing lower abdominal surgery. The study demonstrated that single-dose EREM (DepodurTM) produces 48 h of improved analgesia compared with standard epidural morphine and provides a useful option for treating postoperative pain.

Motoyasu Takenaka, Hiroki Iida, Mami Iida, Kazuyuki Sumi, Masahiko Kumazawa, Shigeaki Tanahashi, and Shuji Dohi

Intrathecal Neostigmine Prevents Intrathecal Clonidine from Attenuating Hypercapnic Cerebral Vasodilation in Rabbits
Anesth Analg 2005 100: 1075-1080. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lumbar intrathecal clonidine attenuates hypercapnic cerebral vasodilation, but pretreatment with neostigmine completely prevents this effect of clonidine.

Hélène Beloeil, Karim Asehnoune, Pierre Moine, Dan Benhamou, and Jean-Xavier Mazoit

Bupivacaine’s Action on the Carrageenan-Induced Inflammatory Response in Mice: Cytokine Production by Leukocytes After Ex-Vivo Stimulation
Anesth Analg 2005 100: 1081-1086. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Carrageenan induces a leukocyte sensitization to in vitro stimulation, which is partly inhibited by bupivacaine, when injected IM before carrageenan injection, in mice.

Natsuko Nozaki-Taguchi and Tatsuo Yamamoto

Spinal Opioid Receptor Like1 Receptor Agonist, but Not N-Methyl-D-Aspartic Acid Antagonist, Reverses the Secondary Mechanical Allodynia Induced by Intradermal Injection of Capsaicin in Rats
Anesth Analg 2005 100: 1087-1092. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The secondary mechanical allodynia induced by intradermal injection of 0.03% capsaicin was attenuated by the activation of the spinal ORL1 receptor but not by the antagonism of the spinal N-methyl-D-aspartic acid receptor.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Michael P. W. Grocott, Michael G. Mythen, and Tong J. Gan

Perioperative Fluid Management and Clinical Outcomes in Adults (Review Article)
Anesth Analg 2005 100: 1093-1106. [Abstract] [Full Text] [PDF] [Request Permissions]  

CRITICAL CARE AND TRAUMA:

Marc P. Buise, Can Ince, Hugo W. Tilanus, Jan Klein, Diederik Gommers, and Jasper van Bommel

The Effect of Nitroglycerin on Microvascular Perfusion and Oxygenation During Gastric Tube Reconstruction
Anesth Analg 2005 100: 1107-1111. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Gastric microvascular perfusion, but not oxygenation, was observed to decrease during gastric tube reconstruction. This decrease could partly be reversed with topical nitroglycerin. This was attributed to venous congestion and indicates that further research into the effect of vasodilators on tissue perfusion is required.

Camila Savian, Pamela Chan, and Jennifer Paratz

The Effect of Positive End-Expiratory Pressure Level on Peak Expiratory Flow During Manual Hyperinflation
Anesth Analg 2005 100: 1112-1116. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: It is uncertain whether the use of a positive end-expiratory pressure valve connected to the manual resuscitation circuit would reduce the peak expiratory flow to a level where pulmonary secretions may not be effectively mobilized. This study is relevant to intensive care practice, as it examines a technique commonly used by physiotherapists in several countries.

Binnur E. Tuncali, Buhar Kuvaki, Bahattin Tuncali, and Emine Capar

A Comparison of the Efficacy of Heparinized and Nonheparinized Solutions for Maintenance of Perioperative Radial Arterial Catheter Patency and Subsequent Occlusion
Anesth Analg 2005 100: 1117-1121. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Radial arterial catheters are frequently used in anesthesia practice. The occlusion rate within the first 24 h after decannulation is remarkably frequent but fortunately without consequences. The results of our study do not support the perioperative use of heparinized flush solutions for radial arterial catheters used for short-term monitoring.

Matthias Hübler, Axel R. Heller, Jörg U. Bleyl, Marcelo Gama de Abreu, Tobias Kroll, Thomas Rössel, and Thea Koch

Perfluorohexane Vapor Has Only Minor Effects on Spatial Pulmonary Blood Flow Distribution in Isolated Rabbit Lungs
Anesth Analg 2005 100: 1122-1128. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Application of perfluorohexane vapor does not redistribute spatial pulmonary blood flow in noninjured isolated rabbit lungs.

NEUROSURGICAL ANESTHESIA:

Michael B. Lukins and Pirjo H. Manninen

Hyperglycemia in Patients Administered Dexamethasone for Craniotomy
Anesth Analg 2005 100: 1129-1133. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study showed that nondiabetic patients undergoing craniotomy developed hyperglycemia if they had been administered dexamethasone during surgery, but this did not happen if they were taking preoperative dexamethasone or had no dexamethasone. We should routinely monitor these patients' blood glucose for 12 h from the start of surgery.

Ying-Chou Hsieh, Wen-Yi Liang, Shen-Kou Tsai, and Chih-Shung Wong

Intrathecal Ketorolac Pretreatment Reduced Spinal Cord Ischemic Injury in Rats
Anesth Analg 2005 100: 1134-1139. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intrathecal nonselective COX inhibitor ketorolac pretreatment provided a neuroprotective effect in a rat spinal cord ischemia model.

Roger Hartl, Shailendra Joshi, Sean Levine, Mei Wang, and Robert R. Sciacca

Pial Arterial Response to Topical Verapamil in Acute Closed Cranial Windows in Rabbits
Anesth Analg 2005 100: 1140-1146. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In acute cranial windows, topical verapamil, a slow calcium channel blocking drug, increased pial arterial diameters by 32%-69%. The vasodilator effect was more robust on the smaller than on the larger pial arterioles. In the 10-3 to 10-8 M range, topical verapamil was a more potent pial arterial dilator than nitroglycerin. Roger Hartl, Shailendra Joshi, Sean Levine, Mei Wang, and Robert R. Sciacca

Ives de Chazal, William M. Parham, III, Panayota Liopyris, and Eelco F. M. Wijdicks

Delayed Cardiogenic Shock and Acute Lung Injury After Aneurysmal Subarachnoid Hemorrhage (Case Report)
Anesth Analg 2005 100: 1147-1149. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cardiac injury after subarachnoid hemorrhage is common. However, when cardiogenic shock occurs, definitive management of the aneurysm is often deferred. In our patient, the delayed onset of severe cardiac injury, cardiogenic shock with normal coronary arteries, and neurogenic pulmonary edema were all remarkable features, as was the capacity for full cardiac recovery.

OBSTETRIC ANESTHESIA:

Brendan Carvalho, Edward Riley, Sheila E. Cohen, David Gambling, Craig Palmer, H. Jane Huffnagle, Linda Polley, Holly Muir, Scott Segal, Christine Lihou, Garen Manvelian for the DepoDur Study Group

Single-Dose, Sustained-Release Epidural Morphine in the Management of Postoperative Pain After Elective Cesarean Delivery: Results of a Multicenter Randomized Controlled Study
Anesth Analg 2005 100: 1150-1158. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this multicenter, randomized, controlled study, we compared a single dose of morphine sulfate extended-release liposome injection (EREM) with standard epidural morphine for postoperative analgesia after cesarean delivery. EREM is potentially a promising new epidural analgesic.

Stephen P. Hallworth, Roshan Fernando, Malachy O. Columb, and Gary M. Stocks

The Effect of Posture and Baricity on the Spread of Intrathecal Bupivacaine for Elective Cesarean Delivery
Anesth Analg 2005 100: 1159-1165. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The baricity of bupivacaine significantly influences the level of sensory block when spinal anesthesia is induced in the sitting, but not the lateral, position.

REGIONAL ANESTHESIA:

Fatis Altintas, Funda Gumus, Guner Kaya, Ismail Mihmanli, Fatih Kantarci, Kamil Kaynak, and M. Serif Cansever

Interscalene Brachial Plexus Block with Bupivacaine and Ropivacaine in Patients with Chronic Renal Failure: Diaphragmatic Excursion and Pulmonary Function Changes
Anesth Analg 2005 100: 1166-1171. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study was performed to compare the anesthetic characteristics and pulmonary function changes of 0.33% bupivacaine and 0.33% ropivacaine for interscalene brachial plexus block in patients with chronic renal failure. The overall success rate was 80.9%. Block quality was similar in both groups. The decreases in pulmonary function variables were less in patients given ropivacaine 0.33%.

Brian M. Ilfeld, Timothy E. Morey, Lisa J. Thannikary, Thomas W. Wright, and F. Kayser Enneking

Clonidine Added to a Continuous Interscalene Ropivacaine Perineural Infusion to Improve Postoperative Analgesia: A Randomized, Double-Blind, Controlled Study
Anesth Analg 2005 100: 1172-1178. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Clonidine is often added to long-acting local anesthetic perineural infusions in an effort to improve postoperative analgesia. This randomized, double-blind, controlled study did not find a decrease in breakthrough pain intensity the day after surgery by adding clonidine (2 {micro}g/mL) to an interscalene perineural ropivacaine infusion after moderately painful shoulder surgery.

Gabriella Iohom, Adnane Machmachi, Désiré-Pascal Diarra, Mohammed Khatouf, Sylvie Boileau, François Dap, Stéphanie Boini, Paul-Michel Mertes, and Herve Bouaziz

The Effects of Clonidine Added to Mepivacaine for Paronychia Surgery Under Axillary Brachial Plexus Block
Anesth Analg 2005 100: 1179-1183. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The findings of this prospective study on patients undergoing paronychia surgery under axillary brachial plexus block suggest that infected tissues are resistant to anesthesia and that clonidine added to mepivacaine enhances the quality and duration of both anesthesia and postoperative analgesia.

Philip B. Cornish and Michael Nowitz

A Magnetic Resonance Imaging Analysis of the Infraclavicular Region: Can Brachial Plexus Depth Be Estimated Before Needle Insertion?
Anesth Analg 2005 100: 1184-1188. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study, using magnetic resonance imaging, demonstrates that the depth of the infraclavicular brachial plexus can, in theory, be determined before needle insertion. The clavicle and the coracoid process provide easy surface landmarks from which to make this estimate. A needle inserted to this depth does not reach the lung.

Alparslan Turan, Dilek Memis, Beyhan Karamanlioglu, Turhan Güler, and Zafer Pamukçu

Intravenous Regional Anesthesia Using Lidocaine and Magnesium
Anesth Analg 2005 100: 1189-1192. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Magnesium added to local anesthetics for central block has a beneficial effect in different pain situations. This study was conducted to evaluate the effects of magnesium when added to lidocaine for IV regional anesthesia (IVRA). Magnesium as an adjunct to lidocaine improves the quality of anesthesia and analgesia in IVRA.

Feng Liu, Guozhong Xu, Zheli Liu, Yan Zhao, Xiaojun Lv, and Junke Wang

The Effects of Stellate Ganglion Block on Visual Evoked Potential and Blood Flow of the Ophthalmic and Internal Carotid Arteries in Patients with Ischemic Optic Neuropathy
Anesth Analg 2005 100: 1193-1196. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ischemic optic neuropathy (ION) is an acute disease without effective methods for treatment. Our study demonstrates that stellate ganglion block has significant effects on picture visual evoked potential (P-VEP) and ophthalmic artery (OA) and internal carotid artery (ICA) blood flow in ION eyes, and this will be helpful to the recovery of ION.

Philip D. Bamberger and Daniel M. Thys

Guillain-Barré Syndrome in a Patient with Pancreatic Cancer After an Epidural-General Anesthetic (Case Report)
Anesth Analg 2005 100: 1197-1199. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Guillain-Barre Syndrome is an unusual postoperative complication that may be related to diseases of the pancreas such as pancreatitis. We report a case in a patient with pancreatic cancer that presented in an atypical manner involving the upper extremities and sparing the lower extremities.

GENERAL ARTICLES:

Kristian Thorn, Sven-Egron Thorn, and Magnus Wattwil

The Effects of Cricoid Pressure, Remifentanil, and Propofol on Esophageal Motility and the Lower Esophageal Sphincter
Anesth Analg 2005 100: 1200-1203. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cricoid pressure significantly decreased lower esophageal sphincter pressure in awake volunteers. This could not be seen during the infusion of remifentanil. Remifentanil per se or together with a bolus dose of propofol did not change baseline values. This shows the importance of when to apply cricoid pressure during rapid-sequence induction.

Sahar M Siddik-Sayyid, Marie T. Aouad, Samar K. Taha, Dima G. Daaboul, Patricia G. Deeb, Faraj M. Massouh, Marie-Rose A. Muallem, and Anis S. Baraka

A Comparison of Sevoflurane-Propofol Versus Sevoflurane or Propofol for Laryngeal Mask Airway Insertion in Adults
Anesth Analg 2005 100: 1204-1209. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this randomized, controlled trial, we compared the ease of insertion of the laryngeal mask airway (LMA) in adults after induction of anesthesia with either sevoflurane, sevoflurane-propofol, or propofol IV. We conclude that sevoflurane-propofol provides frequent successful LMA insertion at the first attempt that is associated with infrequent apnea.

Naveen Eipe

The Chewing of Betel Quid and Oral Submucous Fibrosis and Anesthesia (Case Report)
Anesth Analg 2005 100: 1210-1213. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oral submucous fibrosis (OSMF) is a premalignant lesion of the buccal mucosa caused by chewing betel quid. It results in the progressive inability to open the mouth. The anesthetic management of four patients with OSMF is described and the features of this disease of the upper airway are discussed.

LETTER TO THE EDITOR:

Scott A. Lang

Asleep at the Wheel?
Anesth Analg 2005 100: 1214. [Full Text] [PDF] [Request Permissions]  

Jonathan L. Benumof

Regional Anesthesia Under General Anesthesia and Spinal Cord Injury
Anesth Analg 2005 100: 1214. [Full Text] [PDF] [Request Permissions]  

Kenneth Drasner

Regional Anesthesia Under General Anesthesia and Spinal Cord Injury
Anesth Analg 2005 100: 1215. [Full Text] [PDF] [Request Permissions]  

Henry Liu

Cerebrospinal Lavage Seems to Be Safe and Effective in the Reversal of Inadvertent Spinal Anesthetic Injection
Anesth Analg 2005 100: 1215. [Full Text] [PDF] [Request Permissions]  

Ban C. H. Tsui

Cerebrospinal Lavage Seems to Be Safe and Effective in the Reversal of Inadvertent Spinal Anesthetic Injection
Anesth Analg 2005 100: 1215. [Full Text] [PDF] [Request Permissions]  

Wilhelm Ruppen and Guido Karl Schüpfer

Exacerbation of Carpal Tunnel Syndrome Under Treatment with Valdecoxib
Anesth Analg 2005 100: 1215-1216. [Full Text] [PDF] [Request Permissions]  

Robert P. S. Introna, John R. Blair, and Dan C. Martin

Reflex Vagal Withdrawal After Sympathetic Blockade
Anesth Analg 2005 100: 1216. [Full Text] [PDF] [Request Permissions]  

Makoto Tanaka

Reflex Vagal Withdrawal After Sympathetic Blockade
Anesth Analg 2005 100: 1216. [Full Text] [PDF] [Request Permissions]  

A. Khader, R. Srivastava, and N. Parekh

Intravascular Catheter-Associated Infection
Anesth Analg 2005 100: 1216-1217. [Full Text] [PDF] [Request Permissions]  

Mathias Zürcher, Martin Tramèr, and Bernhard Walder

Intravascular Catheter-Associated Infection
Anesth Analg 2005 100: 1217. [Full Text] [PDF] [Request Permissions]  

Kanta Kido, Hajime Shimoda, and Masahiko Takahashi

Bronchoconstriction Induced by Carotid Sinus Stimulation During Radical Neck Dissection
Anesth Analg 2005 100: 1217. [Full Text] [PDF] [Request Permissions]  

A. Choudhury, A. Agarwal, and S. Dhiraaj

An Unusual Case of Guidewire Impaction During Internal Jugular Venous Cannulation
Anesth Analg 2005 100: 1217-1218. [Full Text] [PDF] [Request Permissions]  

Stephen Halpern and Pamela Angle

Identification of the Epidural Space
Anesth Analg 2005 100: 1218. [Full Text] [PDF] [Request Permissions]  

Shmuel Evron and Tiberiu Ezri

Identification of the Epidural Space
Anesth Analg 2005 100: 1218. [Full Text] [PDF] [Request Permissions]  

V. Dimitriou, J. Brimacombe, G. S. Voyagis, and C. Iatrou

Lightwand-Assisted Intubation of Patients in the Lateral Decubitus Position
Anesth Analg 2005 100: 1219. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

Kuang-I Cheng, Koung-Shing Chu, Siu-Wah Chau, and Chao-Shun Tang

Lightwand-Assisted Intubation of Patients in the Lateral Decubitus Position
Anesth Analg 2005 100: 1219. [Full Text] [PDF] [Request Permissions]  

Aki Sato, Yuki Sato, Yukio Sato, Yasunori Sohara, Norimasa Seo, and Eiji Kobayashi

Leukocytes with Bright Fluorescence in Rats
Anesth Analg 2005 100: 1219-1220. [Full Text] [PDF] [Request Permissions]  

John K. Hayes, Dmytro M. Havaleshko, Roman V. Plachinta, and George F. Rich

Leukocytes with Bright Fluorescence in Rats
Anesth Analg 2005 100: 1220-1221. [Full Text] [PDF] [Request Permissions]  

Timothy James McCulloch

Use of BIS Monitoring Was Not Associated with a Reduced Incidence of Awareness
Anesth Analg 2005 100: 1221. [Full Text] [PDF] [Request Permissions]  

Peter S. Sebel, T. Andrew Bowdle, Mohamed M. Ghoneim, Ira J. Rampil, Roger E. Padilla, Tong Joo Gan, and Karen B. Domino

Use of BIS Monitoring Was Not Associated with a Reduced Incidence of Awareness
Anesth Analg 2005 100: 1221-1222. [Full Text] [PDF] [Request Permissions]  

T. Volk, R. Hebecker, G. Ruecker, C. Perka, N. Haas, and C. Spies

Subdural Empyema Combined with Paraspinal Abscess After Epidural Catheter Insertion
Anesth Analg 2005 100: 1222-1223. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Denise J. Wedel

Regional Anesthesia. The Requisites in Anesthesiology series.
Anesth Analg 2005 100: 1224. [Full Text] [PDF] [Request Permissions]  

Bruce D. Spiess

Hematologic Issues in Anesthesia, Vol. 42, No. 3 of International Anesthesia Clinics.
Anesth Analg 2005 100: 1224-1225. [Full Text] [PDF] [Request Permissions]  

Books and Multimedia Received
Anesth Analg 2005 100: 1225. [Full Text] [PDF] [Request Permissions]  

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