EDITORIALS:

J. G. Reves

Nicholas Greene: An Academician’s Academician (Editorial)
Anesth Analg 2005 100: 1227-1228. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Barbara Steinlechner, Herbert Koinig, Georg Grubhofer, Martin Ponschab, Silvia Eislmeir, Martin Dworschak, and Angela Rajek

Postoperative Analgesia with Remifentanil in Patients Undergoing Cardiac Surgery
Anesth Analg 2005 100: 1230-1235. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Postoperative continuation of remifentanil infusion in combination with a nonsteroidal antiinflammatory drug provides sufficient analgesia to patients after cardiac surgery without major side effects.

Makoto Seki, Satoshi Kashimoto, Osamu Nagata, Hitoshi Yoshioka, Toshihiko Ishiguro, Kinya Nishimura, Osamu Honda, Atsuhiro Sakamoto, Akibumi Omi, Yukihiko Ogihara, Keiko Fujimoto, Motoyo Iwade, Tatsuya Yamada, Minoru Nomura, and Junzo Takeda

Are the Incidences of Cardiac Events During Noncardiac Surgery in Japan the Same as in the United States and Europe?
Anesth Analg 2005 100: 1236-1240. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: An ever-present problem in the preoperative evaluation of patients with ischemic heart disease is that although such evaluations are based on Western data, these data must serve as the basis for determining perioperative risk in Japanese patients. To remedy this problem, we investigated perioperative complications in noncardiac surgery in Japan. We found that the incidence of perioperative cardiac complications and risk factors are similar to those of European and American patients, although it is generally very low among Japanese people.

Balachundhar Subramaniam, Frank Pomposelli, Daniel Talmor, and Kyung W. Park

Perioperative and Long-Term Morbidity and Mortality After Above-Knee and Below-Knee Amputations in Diabetics and Nondiabetics
Anesth Analg 2005 100: 1241-1247. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Above-knee amputations are a high-risk surgery, whereas below-knee amputations are an intermediate-risk surgery, as defined by the American College of Cardiology/American Heart Association guidelines. Their perioperative mortality is independent of diabetes mellitus but is predicted by renal insufficiency and the site of amputation.

Claude Lentschener, Karine Roche, and Yves Ozier

A Review of Aprotinin in Orthotopic Liver Transplantation: Can Its Harmful Effects Offset Its Beneficial Effects? (Review Article)
Anesth Analg 2005 100: 1248-1255. [Abstract] [Full Text] [PDF] [Request Permissions]  

Milen P. Petkov, Charles A. Napolitano, H. Gareth Tobler, Thomas J. Ferrer, J. Mauricio Palacios, and Michael D. Wangler

A Rupture of Both Atrioventricular Valves After Blunt Chest Trauma: The Usefulness of Transesophageal Echocardiography for a Life-Saving Diagnosis (Case Report)
Anesth Analg 2005 100: 1256-1258. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Traumatic rupture of both atrioventricular valves was revealed by transesophageal echocardiography in the operating room. Prompt diagnosis and timely surgery were critical for the favorable outcome in this patient.

Wanda M. Popescu, Edward Prokop, John A. Elefteriades, Kevin Kett, and Paul G. Barash

Phantom Aortic Valve Pressure Gradient: Discrepancies Between Cardiac Catheterization and Doppler Echocardiography (Case Report)
Anesth Analg 2005 100: 1259-1262. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Significant discrepancies for a transvalvular aortic gradient can exist between cardiac catheterization and Doppler echocardiographic data. There are instances when the echocardiographic calculations require validation through a different method.

Luisa G. Santambrogio, Simonetta Mencherini, Marinella Fuardo, Flavia Caramella, and Antonio Braschi

The Surgical Patient with Brugada Syndrome: A Four-Case Clinical Experience (Case Report)
Anesth Analg 2005 100: 1263-1266. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Many factors (medications, bradycardia, temperature changes) during general anesthesia could precipitate a malignant dysrhythmia in a patient with Brugada Syndrome. We describe four cases during general anesthesia in our hospital. The data for patients with Brugada syndrome during surgery are minimal. Based on the literature and experience, we propose minimal monitoring requirements intraoperatively and postoperatively.

Marsha J. Peterson, Luke M. Havemann, E. Dean McKenzie, and Wanda C. Miller-Hance

Unusual Presentation of Postcardiotomy Hemorrhage in an Infant with Congenital Heart Disease (Echo Rounds)
Anesth Analg 2005 100: 1267-1268. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

Marek Brzezinski, Rebecca Keller, Katherine P. Grichnik, and Madhav Swaminathan

Persistent Left Superior Vena Cava in a Patient with a History of Tetralogy of Fallot (Echo Rounds)
Anesth Analg 2005 100: 1269-1270. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

PEDIATRIC ANESTHESIA:

Dominique A. Bettex, René Prêtre, Rolf Jenni, and Edith R. Schmid

Cost-Effectiveness of Routine Intraoperative Transesophageal Echocardiography in Pediatric Cardiac Surgery: A 10-Year Experience
Anesth Analg 2005 100: 1271-1275. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Routine intraoperative use of transesophageal echocardiography in children undergoing congenital heart surgery is cost-effective.

Nina A. Guzzetta, Bruce E. Miller, Kathy Todd, Fania Szlam, Renee H. Moore, and Steven R. Tosone

An Evaluation of the Effects of a Standard Heparin Dose on Thrombin Inhibition During Cardiopulmonary Bypass in Neonates
Anesth Analg 2005 100: 1276-1282. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Neonates experience preoperative activation of their coagulation systems. Thrombin generation and activity is poorly inhibited in neonates by 400 U/kg of heparin compared with what is seen in older children. These data argue for more investigations into appropriate anticoagulation management for neonates undergoing cardiopulmonary bypass.

Gregory B. Hammer, Chandra Ramamoorthy, Hong Cao, Glyn D. Williams, M. Gail Boltz, Komal Kamra, and David R. Drover

Postoperative Analgesia After Spinal Blockade in Infants and Children Undergoing Cardiac Surgery
Anesth Analg 2005 100: 1283-1288. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The addition of spinal anesthesia with tetracaine and morphine to a remifentanil-based general anesthetic resulted in satisfactory analgesia without increasing the incidence of adverse effects in pediatric patients anesthetized with remifentanil and isoflurane during open-heart surgery.

Clifford L. Cua, Kristi Thomas, David Zurakowski, and Peter C. Laussen

A Comparison of the Vasotrac with Invasive Arterial Blood Pressure Monitoring in Children After Pediatric Cardiac Surgery
Anesth Analg 2005 100: 1289-1294. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The agreement between the Vasotrac and invasive arterial blood pressure monitoring indicates this device may be an alternative for postoperative arterial blood pressure measurements in the pediatric population.

Robert D. Sanders, Mariangella Giombini, Daqing Ma, Yoko Ohashi, Mahmuda Hossain, Masahiko Fujinaga, and Mervyn Maze

Dexmedetomidine Exerts Dose-Dependent Age-Independent Antinociception but Age-Dependent Hypnosis in Fischer Rats
Anesth Analg 2005 100: 1295-1302. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dexmedetomidine (Dex) provides antinociception at various developmental stages from neonatal ages onwards. Extrapolation of our results suggests that Dex may be an effective analgesic and sedative drug in the pediatric patient population, although potent sedation is likely to be encountered in the very young.

Tae W. Kim, Cheryl L. Rognerud, and Ching-Nan Ou

Accuracy in the Alteration of Acetaminophen Suppositories (Brief Report)
Anesth Analg 2005 100: 1303-1305. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Contrary to popular belief, our study found acetaminophen to be uniformly distributed in 80 mg, 120 mg, and 325 mg suppositories. However, the difficulty of accurately altering rectal acetaminophen suppositories makes for a compelling argument to restrict their use to intact samples or to have suppositories custom-tailored by the hospital pharmacy.

AMBULATORY ANESTHESIA:

Paul F. White

Changing Role of COX-2 Inhibitors in the Perioperative Period: Is Parecoxib Really the Answer? (Editorial)
Anesth Analg 2005 100: 1306-1308. [Full Text] [PDF] [Request Permissions]  

M. Beaussier, H. Weickmans, C. Paugam, S. Lavazais, J. P. Baechle, P. Goater, A. Buffin, J. F. Loriferne, J. F. Perier, J. P. Didelot, A. Mosbah, R. Said, and A. Lienhart

A Randomized, Double-Blind Comparison Between Parecoxib Sodium and Propacetamol for Parenteral Postoperative Analgesia After Inguinal Hernia Repair in Adult Patients
Anesth Analg 2005 100: 1309-1315. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Within the first 12 h after open herniorrhaphy in adults, a single dose of IV parecoxib 40 mg compares favorably to propacetamol 2 g given twice. No difference was observed in side effects but patient satisfaction was better after parecoxib.

Chakib M. Ayoub, Laudi B. Rizk, Chadi I. Yaacoub, Dorothy Gaal, and Zeev N. Kain

Music and Ambient Operating Room Noise in Patients Undergoing Spinal Anesthesia (Brief Report)
Anesth Analg 2005 100: 1316-1319. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intraoperative music decreases sedative requirements of patients who undergo surgery under spinal anesthesia. This finding was confirmed in both American and Lebanese patients.

ANESTHETIC PHARMACOLOGY:

Asokumar Buvanendran, Jeffrey S. Kroin, Kenneth J. Tuman, Timothy R. Lubenow, Dalia Elmofty, and Pauline Luk

Cerebrospinal Fluid and Plasma Pharmacokinetics of the Cyclooxygenase 2 Inhibitor Rofecoxib in Humans: Single and Multiple Oral Drug Administration
Anesth Analg 2005 100: 1320-1324. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: When the selective cyclooxygenase 2 inhibitor rofecoxib is given orally at 50 mg, the cerebrospinal fluid concentration of the drug is 15% of the plasma concentration. Daily dosing to reach steady-state more than doubles the amount of rofecoxib in the cerebrospinal fluid.

Makoto Tanaka and Toshiaki Nishikawa

The Concentration-Dependent Effects of General Anesthesia on Spontaneous Baroreflex Indices and Their Correlations with Pharmacological Gains
Anesth Analg 2005 100: 1325-1332. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spontaneous sequence baroreflex response was depressed in a concentration-dependent manner during, and remained depressed for 30 min after, sevoflurane anesthesia in humans. Spontaneous sequence gains and {alpha}-index correlated well, but did not agree, with pharmacological baroreflex gains, suggesting that the utility of a spontaneous index as a surrogate for pharmacological gain is limited during sevoflurane anesthesia.

James M. Sonner, Yilei Xing, Yi Zhang, Anya Maurer, Michael S. Fanselow, Robert C. Dutton, and Edmond I. Eger, II

Administration of Epinephrine Does Not Increase Learning of Fear to Tone in Rats Anesthetized with Isoflurane or Desflurane
Anesth Analg 2005 100: 1333-1337. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Administration of epinephrine does not affect fear conditioned learning in rats inhaling isoflurane or desflurane.

Sylvie Passot, Frédérique Servin, Jean Pascal, Françoise Charret, Christian Auboyer, and Serge Molliex

A Comparison of Target- and Manually Controlled Infusion Propofol and Etomidate/Desflurane Anesthesia in Elderly Patients Undergoing Hip Fracture Surgery
Anesth Analg 2005 100: 1338-1342. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The combination etomidate/desflurane resulted in better hemodynamic stability than a manually controlled infusion of propofol in elderly patients undergoing hip fracture surgery. Target-controlled infusion of propofol improved the time course of propofol's hemodynamic effects.

Aaron F. Kopman, Wanda A. Chin, Jimmy Moe, and Rawshan Malik

The Effect of Nitrous Oxide on the Dose-Response Relationship of Rocuronium
Anesth Analg 2005 100: 1343-1347. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The potency of rocuronium is approximately 20% less after 15 min of nitrous oxide than after 15 min of total IV anesthesia. Thus, estimates of drug potency that are obtained under nitrous oxide anesthesia may underestimate drug requirements at the time of induction.

A. A. d’Hollander, A. V. Pytel, B. M. Merzouga, and C.-E. Klopfenstein

The Quantitative Distinction Between Train-of-Four "Counts of 2" and Posttetanic "Counts of 2" Evidenced by a Stable Paralysis/Stable Infusion Rate Method in Anesthetized Patients Receiving Mivacurium
Anesth Analg 2005 100: 1348-1351. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In anesthetized patients receiving mivacurium (MIV) infusion, the use of the stable paralysis/stable infusion rate method established that, for obtaining and maintaining a posttetanic count of 2, MIV administration must be far more (>200%) than the recommendations mentioned in the literature for MIV infusion management.

Klaus T. Olkkola, Mika H. Isohanni, Katri Hamunen, and Pertti J. Neuvonen

The Effect of Erythromycin and Fluvoxamine on the Pharmacokinetics of Intravenous Lidocaine
Anesth Analg 2005 100: 1352-1356. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The administration of fluvoxamine (CYP1A2 inhibitor) increases the plasma concentrations of lidocaine by decreasing its clearance. The coadministration of erythromycin (CYP3A4 inhibitor) increased the plasma concentrations even further. The inhibition of CYP1A2 by fluvoxamine may increase the risk of lidocaine toxicity.

Anna A. Uskova, Bryan P. Matusic, and Barbara W. Brandom

Desflurane, Malignant Hyperthermia, and Release of Compartment Syndrome (Case Report)
Anesth Analg 2005 100: 1357-1360. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe an episode of suspected malignant hyperthermia during desflurane anesthesia for treatment of traumatic injury.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Keith J. Ruskin and Kirk H. Shelley

Patent Medicine and The "Black Box" (Editorial)
Anesth Analg 2005 100: 1361-1362. [Full Text] [PDF] [Request Permissions]  

Sally E. Rampersad and Michael F. Mulroy

A Case of Awareness Despite an "Adequate Depth of Anesthesia" as Indicated by a Bispectral Index® Monitor (Case Report)
Anesth Analg 2005 100: 1363-1364. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Although the use of processed brain wave monitoring may help reduce the chance of patient recall resulting from inadequate depth of anesthesia during surgery, our patient illustrates that this cannot universally be predicted or avoided.

Christian Jeleazcov, Jörg Fechner, and Helmut Schwilden

Electroencephalogram Monitoring During Anesthesia with Propofol and Alfentanil: The Impact of Second Order Spectral Analysis
Anesth Analg 2005 100: 1365-1369. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The estimation of bicoherence allows us to determine whether a given time series represents a linear random process. This study investigates the proportion of electroencephalogram (EEG) epochs with nonzero and nonconstant bicoherence during surgical anesthesia with propofol and alfentanil as an indicator for the degree of nonlinearity in the EEG.

Yasuhiro Morimoto, Akiko Matsumoto, Yumika Koizumi, Toru Gohara, Takefumi Sakabe, and Satoshi Hagihira

Changes in the Bispectral Index During Intraabdominal Irrigation in Patients Anesthetized with Nitrous Oxide and Sevoflurane
Anesth Analg 2005 100: 1370-1374. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bispectral index and 95% spectral edge frequency decreased significantly during intraabdominal irrigation. The stimulation occurring during intraabdominal irrigation might cause a paradoxical suppression of the electroencephalogram. Pretreatment with fentanyl prevents these changes.

Richard H. Blum, Daniel B. Raemer, John S. Carroll, Ronald L. Dufresne, and Jeffrey B. Cooper

A Method for Measuring the Effectiveness of Simulation-Based Team Training for Improving Communication Skills
Anesth Analg 2005 100: 1375-1380. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In a controlled simulator setting, a method for measuring communication among team members was developed using information probes placed in a clinical scenario with trainees participating in an Anesthesia Crisis Resource Management course. Knowledge of the probes was used as a measure of team information-sharing.

Manzo Suzuki, Syusuke Koda, Yoshihisa Nakamura, Naoki Kawamura, and Yoichi Shimada

The Relationship Between Cardiac Output Measured by the Thermodilution Method and That Measured by the Carbon Dioxide Rebreathing Technique During Laparoscopic Surgery (Case Report)
Anesth Analg 2005 100: 1381-1383. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cardiac output can be monitored by the carbon dioxide rebreathing technique during laparoscopic surgery.

PAIN MEDICINE:

Chun-Chang Yeh, Shu-Wen Jao, Billy K. Huh, Chih-Shung Wong, Chih-Ping Yang, William D. White, and Ching-Tang Wu

Preincisional Dextromethorphan Combined with Thoracic Epidural Anesthesia and Analgesia Improves Postoperative Pain and Bowel Function in Patients Undergoing Colonic Surgery
Anesth Analg 2005 100: 1384-1389. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The combination of preincisional dextromethorphan (40 mg IM), intraoperative thoracic epidural anesthesia, and postoperative patient-controlled epidural analgesia enhances analgesia and facilitates recovery of bowel function, suggesting possible synergistic interaction with local anesthetics and opioids.

Xiaoying Zhu, Dawn R. Conklin, and James C. Eisenach

Preoperative Inhibition of Cyclooxygenase-1 in the Spinal Cord Reduces Postoperative Pain
Anesth Analg 2005 100: 1390-1393. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal administration of ketorolac in humans is under investigation, and these data in animals suggest that spinal ketorolac injection before surgery could reduce postoperative pain.

Christophe Ménigaux, Frédéric Adam, Bruno Guignard, Daniel I. Sessler, and Marcel Chauvin

Preoperative Gabapentin Decreases Anxiety and Improves Early Functional Recovery from Knee Surgery
Anesth Analg 2005 100: 1394-1399. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Gabapentin premedication decreases preoperative anxiety and improves postoperative analgesia and early knee mobilization without increasing the incidence of adverse effects after arthroscopic anterior cruciate ligament repair.

Koji Hara, Kouichiro Minami, and Takeyoshi Sata

The Effects of Tramadol and Its Metabolite on Glycine, -Aminobutyric Acid_A, and N-Methyl-d-Aspartate Receptors Expressed in Xenopus Oocytes
Anesth Analg 2005 100: 1400-1405. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effects of tramadol and its metabolite on neurotransmitter-gated ion channels expressed in Xenopus oocytes were studied. Tramadol was found to noncompetitively inhibit N-methyl-d-aspartate (NMDA) receptors at clinical concentrations and to inhibit {gamma}-aminobutyric acidA receptors at large concentrations. NMDA receptor inhibition may contribute to the antinociceptive property of tramadol.

Hideaki Obata, Shigeru Saito, Shiro Koizuka, Koichi Nishikawa, and Fumio Goto

The Monoamine-Mediated Antiallodynic Effects of Intrathecally Administered Milnacipran, a Serotonin Noradrenaline Reuptake Inhibitor, in a Rat Model of Neuropathic Pain
Anesth Analg 2005 100: 1406-1410. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intrathecal administration of a new type of antidepressant, milnacipran, a serotonin noradrenaline reuptake inhibitor, mediates antiallodynic effects in rats with neuropathic pain, and spinal monoamine receptors are involved in this action. Intrathecal administration of milnacipran might be effective for suppression of neuropathic pain.

Allan Gottschalk and Steven M. Frank

Prolonged Differential Wound Hyperalgesia After an Interval of Unilateral Epidural Blockade During Lower Abdominal Surgery (Case Report)
Anesth Analg 2005 100: 1411-1413. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: When local anesthetics administered through an epidural catheter were able to block sensation over only half of the operative site for a patient under general anesthesia, pain assessment for several weeks after surgery demonstrated increased pain and hyperalgesia on the side that was not effectively blocked during surgery.

Sibel Kahraman, Siyavus M. Rezai, Hatem Dogu, Mehmet A. Sayan, and Ziya Akar

Painful Traumatic Neuroma After a Finger Stick (Case Report)
Anesth Analg 2005 100: 1414-1415. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this case report we present a patient with a painful traumatic neuroma after a finger stick. The patient benefited from surgical excision of the lesion, and her symptoms were completely abolished with additional sympathetic nerve blocks.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Eric W. G. Weber, Robert Slappendel, Martin H. Prins, Dick B. van der Schaaf, Marcel E. Durieux, and Danja Strümper

Perioperative Blood Transfusions and Delayed Wound Healing After Hip Replacement Surgery: Effects on Duration of Hospitalization
Anesth Analg 2005 100: 1416-1421. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Allogeneic blood transfusion during elective orthopedic surgery is associated with an increase in minor wound-healing disturbances. Requirement for transfusion and presence of wound-healing disturbances are the main factors that predict duration of hospitalization in these patients.

Anton A. van den Berg, Dudley A. Chitty, Ramoun D. Jones, Mir S. Sohel, and Ali Shahen

Intravenous or Inhaled Induction of Anesthesia in Adults? An Audit of Preoperative Patient Preferences
Anesth Analg 2005 100: 1422-1424. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The majority of adult American patients presenting for ambulatory surgery to a university teaching hospital in Texas choose an inhaled rather than IV induction of anesthesia.

Franklin Dexter, Johannes Ledolter, and Ruth E. Wachtel

Tactical Decision Making for Selective Expansion of Operating Room Resources Incorporating Financial Criteria and Uncertainty in Subspecialties' Future Workloads
Anesth Analg 2005 100: 1425-1432. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Financial information can be coupled with estimates of future surgical demand to predict the operating room (OR) workload of various subspecialties, providing valuable tactical information necessary for the design and outfitting of additional ORs. We show that data predicting future demand are needed for only a small percentage of surgeons, making this method practical for routine use.

CRITICAL CARE AND TRAUMA:

Paul C. Hébert, Ian Chin-Yee, Dean Fergusson, Morris Blajchman, Raymond Martineau, Jennifer Clinch, Bernhard Olberg, and the Canadian Critical Care Trials Group

A Pilot Trial Evaluating the Clinical Effects of Prolonged Storage of Red Cells
Anesth Analg 2005 100: 1433-1458. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Despite concerns regarding old blood, there is little evidence of adverse clinical consequences.

David T. Wong, Kevin Lai, Frances F. Chung, and Ranee Y. Ho

Cannot Intubate–Cannot Ventilate and Difficult Intubation Strategies: Results of a Canadian National Survey
Anesth Analg 2005 100: 1439-1446. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our survey showed that cricothyroidotomy by IV catheter and percutaneous cricothyroidotomy were the preferred infraglottic airways in a cannot-intubate-cannot-ventilate scenario. Respondents were comfortable with these two techniques but not with an open surgical airway. Practice on mannequins was associated with improved comfort in using infraglottic airways in patients.

Mark A. Hamilton, Miriam V. Chapman, Maj Mutch, Elliott Bennett-Guerrero, and Monty G. Mythen

The Relationship Between a Pentagastrin-Stimulated Gastric Luminal Acid Production Test (Gastrotest) and Enteral Feeding-Related Gastrointestinal Complications in Critically Ill Patients
Anesth Analg 2005 100: 1447-1452. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Gastrointestinal feeding-related complications are common in critically ill patients. Unfortunately, patients at risk for these complications cannot be easily identified. In a cohort study of 20 patients, we describe how a functional stress test of the gut using pentagastrin can help identify patients at higher risk for gastrointestinal complications.

Koichiroh Nandate, Masanori Ogata, Hitomi Tamura, Takashi Kawasaki, Takeyoshi Sata, and Akio Shigematsu

N-Acetyl-Cysteine Attenuates Endotoxin-Induced Adhesion Molecule Expression in Human Whole Blood
Anesth Analg 2005 100: 1453-1457. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The regulation of the leukocyte response may be crucial to the prevention of organ dysfunction during endotoxin shock. N-acetyl-cysteine (NAC) was found to attenuate CD11b expression in lipopolysaccharide-stimulated human whole blood. These results suggest the possibility of a therapeutic effect of NAC in endotoxin shock.

NEUROSURGICAL ANESTHESIA:

Ryukichi Takayama, Rumiko Uda, Naofumi Isono, Motomasa Furuse, Tomio Ohta, Toshihiko Kuroiwa, and Hidemaro Mori

Selective Brain Hypothermia Suppresses Noxious-Evoked Movement in Canines
Anesth Analg 2005 100: 1458-1462. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Systemic hypothermia suppresses noxious-evoked movement at 20{degrees}C. We found, using a selective brain cooling system, that brain hypothermia at 20{degrees}C has an anesthetic effect similar to systemic hypothermia in canines.

Timothy J. McCulloch, Tillman W. Boesel, and Arthur M. Lam

The Effect of Hypocapnia on the Autoregulation of Cerebral Blood Flow During Administration of Isoflurane
Anesth Analg 2005 100: 1463-1467. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Twelve healthy patients were anesthetized with 1.6% {+/-} 0.2% isoflurane. Cerebral autoregulation was tested at both normocapnia and hypocapnia. Autoregulation was impaired in eight subjects when normocapnic but was intact in all patients when hypocapnic, indicating that hyperventilation counteracts the effect of isoflurane on cerebral autoregulation.

Sethuraman Manikandan, Prabhat K. Sinha, Praveen K. Neema, and Ramesh C. Rathod

Severe Seizures During Propofol Induction in a Patient with Syringomyelia Receiving Baclofen (Case Report)
Anesth Analg 2005 100: 1468-1469. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe the occurrence of seizures caused by an anesthetic drug, propofol, probably attributable to an interaction with baclofen, a drug used for reliving spasms.

Koichi Nakazawa, Mamoru Yamamoto, Kunihiko Murai, Seiji Ishikawa, Tokujiro Uchida, and Koshi Makita

Delayed Emergence from Anesthesia Resulting from Cerebellar Hemorrhage During Cervical Spine Surgery (Case Report)
Anesth Analg 2005 100: 1470-1471. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We encountered a case of cerebellar hemorrhage presenting with delayed emergence from anesthesia after cervical spine surgery. Loss of cerebrospinal fluid during the surgical procedure may play an important role in the pathogenesis of this complication.

OBSTETRIC ANESTHESIA:

Paul W. Davies, Manuel C. Vallejo, Kelly T. Shannon, Antonio J. Amortegui, and Sivam Ramanathan

Oral Herpes Simplex Reactivation After Intrathecal Morphine: A Prospective Randomized Trial in an Obstetric Population
Anesth Analg 2005 100: 1472-1476. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study demonstrated a more frequent incidence of herpes simplex labialis reactivation and pruritus among patients receiving intrathecal morphine.

Asif S. H. Zaidi and Ian F. Russell

Is Transcutaneous Electrical Stimulation a Realistic Surrogate for Genuine Surgical Stimulation During Spinal Anesthesia for Cesarean Delivery?
Anesth Analg 2005 100: 1477-1481. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: When using spinal anesthesia for cesarean delivery, we have shown that the block level to a nonpainful transcutaneous electrical stimulation (TES) has no relationship to pain-free surgery. Suggestions that touch sensation cannot predict the adequacy of spinal anesthesia for cesarean delivery because touch cannot predict the level of block to TES are unsound.

REGIONAL ANESTHESIA:

John C. Rowlingson and Peter B. Hanson

Neuraxial Anesthesia and Low-Molecular-Weight Heparin Prophylaxis in Major Orthopedic Surgery in the Wake of the Latest American Society of Regional Anesthesia Guidelines (Medical Intelligence)
Anesth Analg 2005 100: 1482-1488. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal hematoma, although a rare complication, remains a concern of clinicians contemplating the use of regional anesthesia with low-molecular-weight heparin, one of the class of drugs indicated for preventing blood clots during orthopedic surgery. This article reviews the latest practice guidelines to show how this combination treatment can be used safely and reflects a specific clinical application.

Kenneth D. Candido, Radha Sukhani, Robert Doty, Jr, Antoun Nader, Mark C. Kendall, Edward Yaghmour, Tripti C. Kataria, and Robert McCarthy

Neurologic Sequelae After Interscalene Brachial Plexus Block for Shoulder/Upper Arm Surgery: The Association of Patient, Anesthetic, and Surgical Factors to the Incidence and Clinical Course (Medical Intelligence)
Anesth Analg 2005 100: 1489-1495. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Neurologic sequelae after interscalene block (ISB) for shoulder/upper arm surgery using levobupivacaine with epinephrine were identified in 56 of 660 patients. In 29 patients, there was a likely association with the ISB, whereas 27 patients were not likely ISB-related. In all but three cases, transient sensory symptoms resolved (4-12 wk) without intervention.

Ignace Sandefo, J.-M. Bernard, Van Elstraete, T. Lebrun, B. Polin, F. Alla, C. Poey, and L. Savorit

Patient-Controlled Interscalene Analgesia After Shoulder Surgery: Catheter Insertion by the Posterior Approach (Medical Intelligence)
Anesth Analg 2005 100: 1496-1498. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A catheter can be inserted into the brachial plexus sheath at the cervical level by a posterior approach and be used for providing efficient patient-controlled interscalene analgesia after shoulder surgery. No complications with this method were noticed in a preliminary study of 120 patients.

Raymond Wee-Lip Goy, Yoong Chee-Seng, Alex Tiong-Heng Sia, Koay Choo-Kok, and Shen Liang

The Median Effective Dose of Intrathecal Hyperbaric Bupivacaine Is Larger in the Single-Shot Spinal as Compared with the Combined Spinal-Epidural Technique (Medical Intelligence)
Anesth Analg 2005 100: 1499-1502. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A combined spinal-epidural technique is likely to result in prolonged sensory and motor block as compared with the single-shot spinal technique for the same dose of intrathecal local anesthetic. The combined spinal-epidural technique required 20% less hyperbaric bupivacaine than the single-shot spinal technique to achieve the same level and duration of sensory blockade.

Astrid M. Morin, Leopold H. J. Eberhart, Hagen K. E. Behnke, Stefanie Wagner, Tilo Koch, Udo Wolf, Walter Nau, Clemens Kill, Götz Geldner, and Hinnerk Wulf

Does Femoral Nerve Catheter Placement with Stimulating Catheters Improve Effective Placement? A Randomized, Controlled, and Observer-Blinded Trial (Medical Intelligence)
Anesth Analg 2005 100: 1503-1510. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The conventional technique of blind femoral nerve catheter advancement after nerve localization using a stimulating needle was compared with the new technique of stimulating catheter positioning using continuous stimulation. There were no differences in onset time of primary block, postoperative pain scores, or functional outcome after major knee surgery.

Régis Fuzier, Pierre Hoffreumont, Sophie Bringuier-Branchereau, Xavier Capdevila, and François Singelyn

Does the Sciatic Nerve Approach Influence Thigh Tourniquet Tolerance During Below-Knee Surgery? (Medical Intelligence)
Anesth Analg 2005 100: 1511-1514. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We demonstrate that the posterior popliteal approach of the sciatic nerve provides comparable thigh tourniquet tolerance and is as efficient, but more comfortable, for the patient than the Labat approach. It would thus be the preferred technique for below-knee surgery.

Shruti Shah, Admir Hadzic, Jerry D. Vloka, Maureen S. Cafferty, Calin S. Moucha, and Alan C. Santos

Neurologic Complication After Anterior Sciatic Nerve Block (Case Report)
Anesth Analg 2005 100: 1515-1517. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intraneural injection and nerve injury can occur in the absence of pain on injection, and it may be heralded by high pressure (resistance) during an injection of local anesthetic.

GENERAL ARTICLES:

Catherine M. N. O’Malley, Robert J. Frumento, Mark A. Hardy, Alan I. Benvenisty, Tricia E. Brentjens, John S. Mercer, and Elliott Bennett-Guerrero

A Randomized, Double-Blind Comparison of Lactated Ringer’s Solution and 0.9% NaCl During Renal Transplantation
Anesth Analg 2005 100: 1518-1524. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lactated Ringer's solution (LR) caused less hyperkalemia and acidemia than 0.9% NaCl when administered for intraoperative fluid therapy during kidney transplantation. Therefore, LR may be a safe and superior choice for IV fluid replacement therapy during kidney transplant surgery.

Jolanda E. Van den Bosch, Karel G. Moons, Gouke J. Bonsel, and Cor J. Kalkman

Does Measurement of Preoperative Anxiety Have Added Value for Predicting Postoperative Nausea and Vomiting?
Anesth Analg 2005 100: 1525-1532. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Preoperative anxiety is associated with postoperative nausea and vomiting, but the association is weak. Routine measurement of anxiety does not seem warranted if other predictors have been considered.

Dong Woo Han, Yon Hee Shim, Cheung Soo Shin, Youn-Woo Lee, Jong Seok Lee, and So Woon Ahn

Estimation of the Length of the Nares-Vocal Cord
Anesth Analg 2005 100: 1533-1535. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The length of the nares-vocal cord can be predicted using the body height or the distance from the lateral border of the nares to the tragus of the ear.

COCHRANE CORNER:

T. Werawatganon and S. Charuluxananan

Patient Controlled Intravenous Opioid Analgesia Versus Continuous Epidural Analgesia for Pain After Intra-Abdominal Surgery
Anesth Analg 2005 100: 1536. [Full Text] [PDF] [Request Permissions]  

A. Avenell, D. W. Noble, J. Barr, and T. Engelhardt

Selenium Supplementation for Critically Ill Adults
Anesth Analg 2005 100: 1536. [Full Text] [PDF] [Request Permissions]  

LETTER TO THE EDITOR:

Philip Edward Lane

AIS' Current Role in Anesthesiology Risk Management Remains Uncertain
Anesth Analg 2005 100: 1537. [Full Text] [PDF] [Request Permissions]  

Jeffrey M. Feldman

AIS' Current Role in Anesthesiology Risk Management Remains Uncertain
Anesth Analg 2005 100: 1537-1538. [Full Text] [PDF] [Request Permissions]  

Vance G. Nielsen

Effects of Hydroxyethyl Starch and Calcium on Platelet Activation
Anesth Analg 2005 100: 1538. [Full Text] [PDF] [Request Permissions]  

E. Deusch and S. Kozek-Langenecker

Effects of Hydroxyethyl Starch and Calcium on Platelet Activation
Anesth Analg 2005 100: 1538-1539. [Full Text] [PDF] [Request Permissions]  

P. M. Mertes, M. C. Laxenaire, J. M. Malinovsky, E. Florvaag, and D. A. Moneret-Vautrin

Skin Sensitivity to Rocuronium and Vecuronium: Prick-Tests Are Not Intradermal Test
Anesth Analg 2005 100: 1539. [Full Text] [PDF] [Request Permissions]  

Gilles Dhonneur

Skin Sensitivity to Rocuronium and Vecuronium: Prick-Tests Are Not Intradermal Test
Anesth Analg 2005 100: 1539-1540. [Full Text] [PDF] [Request Permissions]  

Sebastiano Mercadante, Patrizia Ferrera, Patrizia Villari, and Edoardo Arcuri

Local Anesthetics for Breakthrough Pain in Patients Receiving Intrathecal Treatment for Cancer Pain Management
Anesth Analg 2005 100: 1540. [Full Text] [PDF] [Request Permissions]  

Zeynep Eti, Tunç Laçin, Bedrettin Yildizeli, Varlik Dogan, F. Yilmaz Gögüs, and Mustafa Yüksel

An Uncommon Complication of Thoracic Epidural Anesthesia: Pleural Puncture
Anesth Analg 2005 100: 1540-1541. [Full Text] [PDF] [Request Permissions]  

Marshall B. Dunning, III and Harvey J. Woehlck

Measurement of Isoflurane and Desflurane Degradation
Anesth Analg 2005 100: 1541-1542. [Full Text] [PDF] [Request Permissions]  

Michael J. Laster, Patricia Roth, and Edmond I. Eger, II

Measurement of Isoflurane and Desflurane Degradation
Anesth Analg 2005 100: 1542. [Full Text] [PDF] [Request Permissions]  

Daniel S. Choi, Arthur Atchabahian, and Anthony R. Brown

Cervical Plexus Block Provides Postoperative Analgesia After Clavicle Surgery
Anesth Analg 2005 100: 1542-1543. [Full Text] [PDF] [Request Permissions]  

George Mychaskiw, II and Steve Morris

Dangerous Design Flaw in the Ohmeda Aespire Anesthesia System
Anesth Analg 2005 100: 1543-1544. [Full Text] [PDF] [Request Permissions]  

Edmond I. Eger, II and James M. Sonner

How Likely Is Awareness During Anesthesia?
Anesth Analg 2005 100: 1544. [Full Text] [PDF] [Request Permissions]  

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

How Likely Is Awareness During Anesthesia?
Anesth Analg 2005 100: 1545. [Full Text] [PDF] [Request Permissions]  

Claude Abdallah

Concern About the Safety of Introcan Safety® Intravenous Catheters
Anesth Analg 2005 100: 1545-1546. [Full Text] [PDF] [Request Permissions]  

Quentin A. Fisher

Can Capnography Substitute for Auscultation in Sedation Cases?
Anesth Analg 2005 100: 1546. [Full Text] [PDF] [Request Permissions]  

Janjira Krataijan and Nawal Laeni

Accidental Epidural Injection of Pancuronium
Anesth Analg 2005 100: 1546-1547. [Full Text] [PDF] [Request Permissions]  

Joanne Guay

Peripheral Nerve Blocks for Postoperative Pain Relief After Total Knee Replacement: More Questions Than Answers
Anesth Analg 2005 100: 1547. [Full Text] [PDF] [Request Permissions]  

Bruce Ben-David and Jacques E. Chelly

Peripheral Nerve Blocks for Postoperative Pain Relief After Total Knee Replacement: More Questions Than Answers
Anesth Analg 2005 100: 1547-1548. [Full Text] [PDF] [Request Permissions]  

Samuel Metz

Does Paralysis Contribute to Awareness Under Anesthesia?
Anesth Analg 2005 100: 1548. [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

Does Paralysis Contribute to Awareness Under Anesthesia?
Anesth Analg 2005 100: 1548. [Full Text] [PDF] [Request Permissions]  

Ali Movafegh, Farid Abolhasan Gharehdaghi, Zahid Hussain Khan, and Gita Shoeibi

Dexamethasone Dose Attenuates Pain on Injection Following Diazepam Hydrochloride
Anesth Analg 2005 100: 1548-1549. [Full Text] [PDF] [Request Permissions]  

Takashi Asai

Airway Obstruction Due to a Damage to the Laryngeal Mask
Anesth Analg 2005 100: 1549. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Alfonso Casta and Franklyn Cladis

Problems in Pediatric Anesthesia.
Anesth Analg 2005 100: 1550. [Full Text] [PDF] [Request Permissions]  

Michael Schaefer

Principles and Practice of Pain Medicine, 2nd ed.
Anesth Analg 2005 100: 1550-1551. [Full Text] [PDF] [Request Permissions]  

ERRATA:

Erratum
Anesth Analg 2005 100: 1551. [Full Text] [PDF] [Request Permissions]  

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