CARDIOVASCULAR ANESTHESIA:

Takeshi Omae, Yasuyuki Kakihana, Akira Mastunaga, Isao Tsuneyoshi, Kouichi Kawasaki, Yuichi Kanmura, and Ryuzo Sakata

Hemodynamic Changes During Off-Pump Coronary Artery Bypass Anastomosis in Patients with Coexisting Mitral Regurgitation: Improvement with Milrinone
Anesth Analg 2005 101: 2-8. [Abstract] [Full Text]  

IMPLICATIONS: During anastomosis of the left coronary artery branches and the left circumflex artery, in particular, we demonstrated that treatment with milrinone prevents increased mitral regurgitation and mean pulmonary artery pressures and decreased cardiac index in patients with mitral regurgitation undergoing off-pump coronary artery bypass.

Masayoshi Uchida, Hiroki Iida, Mami Iida, Masahiko Kumazawa, Kazuyuki Sumi, Motoyasu Takenaka, and Shuji Dohi

Both Milrinone and Colforsin Daropate Attenuate the Sustained Pial Arteriolar Constriction Seen After Unclamping of an Abdominal Aortic Cross-Clamp in Rabbits
Anesth Analg 2005 101: 9-16. [Abstract] [Full Text]  

IMPLICATIONS: In rabbits, abdominal aortic unclamping after a 20-min clamp caused an initial dilation followed by a sustained constriction of both large and small cerebral pial arterioles. Clinical doses of milrinone and colforsin daropate attenuated this vasoconstriction, an effect that may be favorable in the clinical setting.

Manuel L. Fontes, Joseph P. Mathew, Henry M. Rinder, Daniel Zelterman, Brian R. Smith, Christine S. Rinder, and the Multicenter Study of Perioperative Ischemia (McSPI) Reasearch Group

Atrial Fibrillation After Cardiac Surgery/Cardiopulmonary Bypass Is Associated with Monocyte Activation
Anesth Analg 2005 101: 17-23. [Abstract] [Full Text]  

IMPLICATIONS: Patients who develop atrial fibrillation after cardiac surgery/cardio pulmonary bypass (CPB) have increased morbidity. This study demonstrated that the monocyte inflammatory response during surgery/CPB was greater in patients who developed postoperative atrial fibrillation. Cellular inflammation may be a potential therapeutic target to prevent this complication.

Alberto Zangrillo, Giuseppe Crescenzi, Giovanni Landoni, Stefano Benussi, Martina Crivellari, Federico Pappalardo, Enrica Dorigo, Carlo Pappone, and Ottavio Alfieri

The Effect of Concomitant Radiofrequency Ablation and Surgical Technique (Repair Versus Replacement) on Release of Cardiac Biomarkers During Mitral Valve Surgery
Anesth Analg 2005 101: 24-29. [Abstract] [Full Text]  

IMPLICATIONS: One-hundred-forty-two patients undergoing mitral valve surgery were investigated. We found no difference in cardiac troponin and creatine kinase-MB levels after mitral valve surgery alone compared with surgery with concomitant radiofrequency ablation. Myocardial injury after cardiac surgery is not significantly increased by radiofrequency ablation of atrial fibrillation.

Peter E. Frasco, Karl A. Poterack, Joseph G. Hentz, and David C. Mulligan

A Comparison of Transfusion Requirements Between Living Donation and Cadaveric Donation Liver Transplantation: Relationship to Model of End-Stage Liver Disease Score and Baseline Coagulation Status
Anesth Analg 2005 101: 30-37. [Abstract] [Full Text]  

IMPLICATIONS: Because of shortages of cadaveric donor organs, living donation is an important option for patients awaiting liver transplantation. Living donation liver transplant recipients bypass the normal prioritization procedures and are transplanted with lower Model for End-stage Liver Disease scores, with better preserved coagulation function, and with reduced transfusion of red blood cells and component therapy compared with cadaveric donation liver transplant recipients.

Stavros G. Memtsoudis, Peter Rosenberger, and Nicholas Sadovnikoff

Chest Tube Suction-Associated Unilateral Negative Pressure Pulmonary Edema in a Lung Transplant Patient (Case Report)
Anesth Analg 2005 101: 38-40. [Abstract] [Full Text]  

IMPLICATIONS: Negative pressure pulmonary edema may occur secondary to high levels of negative pressure applied to the intrapleural space via chest tubes in the presence of partial large airway obstruction. Post-lung transplant patients may be especially at risk because of compromised lymphatic drainage.

PEDIATRIC ANESTHESIA:

David B. Waisel

Moral Permissibility as a Guide for Decision Making About Conjoined Twins (Editorial)
Anesth Analg 2005 101: 41-43. [Full Text]  

Christopher F. Tirotta, Richard Lagueruela, Hamish M. Munro, Evan M. Zahn, Leo Lopez, and Redmond P. Burke

Anesthetic Management of Conjoined Twins Presenting for Palliative Open-Heart Surgery (Case Report)
Anesth Analg 2005 101: 44-47. [Abstract] [Full Text]  

IMPLICATIONS: Anesthetic management of conjoined twins when one has single ventricle physiology presents unique challenges to the anesthesia team. Because of the shared circulation in this case, isolating the physiological and pharmacological management of the two babies was not possible, and a synchronized dual anesthetic management strategy was essential to achieve and maintain a safe anesthetic state.

George T. Blike, Klaus Christoffersen, Joseph P. Cravero, Steven K. Andeweg, and Jens Jensen

A Method for Measuring System Safety and Latent Errors Associated with Pediatric Procedural Sedation
Anesth Analg 2005 101: 48-58. [Abstract] [Full Text]  

IMPLICATIONS: We describe a method of using available human simulation to test for actual latent errors (accidents waiting to happen). In this study, the rare event studied was that of apnea secondary to sedation. However, the implications go beyond sedation to represent a generic patient safety problem: that of suboptimal rescue capabilities.

Ira Todd Cohen, Denise Joffe, Kelly Hummer, and Alice Soluri

Ondansetron Oral Disintegrating Tablets: Acceptability and Efficacy in Children Undergoing Adenotonsillectomy
Anesth Analg 2005 101: 59-63. [Abstract] [Full Text]  

IMPLICATIONS: Ondansetron oral disintegrating tablets were accepted by school-age children undergoing adenotonsillectomy and decreased the incidence of postoperative vomiting.

George R. Kracke, Katherine A. Uthoff, and Joseph D. Tobias

Sugar Solution Analgesia: The Effects of Glucose on Expressed Mu Opioid Receptors
Anesth Analg 2005 101: 64-68. [Abstract] [Full Text]  

IMPLICATIONS: Orally administered glucose or sucrose is an effective means to decrease the pain response to mildly invasive procedures in newborns. Because sugar-solution analgesia is blocked by opioid receptor antagonists, we tested the hypothesis that glucose directly activates expressed opioid receptors. The hypothesis was not supported by the data.

P. Kumar, A. Rudra, A. K. Pan, and A. Acharya

Caudal Additives in Pediatrics: A Comparison Among Midazolam, Ketamine, and Neostigmine Coadministered with Bupivacaine
Anesth Analg 2005 101: 69-73. [Abstract] [Full Text]  

IMPLICATIONS: The addition of opioids and non-opioids to local anesthetics can prolong the duration of pain relief of caudal epidural blocks. Each of the three non-opioids compared in this double-blind study prolonged the duration of analgesia. However, neostigmine and midazolam were more effective than ketamine.

Ellen D. Iannoli, Michael P. Eaton, and Janine R. Shapiro

Bidirectional Glenn Shunt Surgery Using Lepirudin Anticoagulation in an Infant with Heparin-Induced Thrombocytopenia with Thrombosis (Case Report)
Anesth Analg 2005 101: 74-76. [Abstract] [Full Text]  

IMPLICATIONS: We present a case of a patient successfully managed using lepirudin; however, we advise caution in the use of this drug because it is difficult to appropriately measure the degree of anticoagulation.

AMBULATORY ANESTHESIA:

Gianluca Cappelleri, Giorgio Aldegheri, Giorgio Danelli, Chiara Marchetti, Massimiliano Nuzzi, Gabriella Iannandrea, and Andrea Casati

Spinal Anesthesia with Hyperbaric Levobupivacaine and Ropivacaine for Outpatient Knee Arthroscopy: A Prospective, Randomized, Double-Blind Study
Anesth Analg 2005 101: 77-82. [Abstract] [Full Text]  

IMPLICATIONS: Comparing unilateral spinal block using 7.5 mg of 0.5% hyperbaric ropivacaine with 7.5 mg or 5 mg of 0.5% hyperbaric levobupivacaine, this prospective, randomized, double-blind study showed that 5 mg levobupivacaine and 7.5 mg ropivacaine provide adequate spinal block for outpatient knee arthroscopy with a faster home discharge as compared with 7.5 mg levobupivacaine.

Dorothy J. Pavlin, Edward G. Pavlin, Karen D. Horvath, Laurie B. Amundsen, David R. Flum, and Kristine Roesen

Perioperative Rofecoxib Plus Local Anesthetic Field Block Diminishes Pain and Recovery Time After Outpatient Inguinal Hernia Repair
Anesth Analg 2005 101: 83-89. [Abstract] [Full Text]  

IMPLICATIONS: Treatment before and after surgery with rofecoxib in patients with a local anesthetic field block decreased in-hospital recovery time, and reduced pain scores and analgesic use in the first 24 h after open inguinal hernia repair.

Philip Lange Moller, Gitte Irene Juhl, Catherine Payen-Champenois, and Lasse Ansgar Skoglund

Intravenous Acetaminophen (Paracetamol): Comparable Analgesic Efficacy, but Better Local Safety than Its Prodrug, Propacetamol, for Postoperative Pain After Third Molar Surgery
Anesth Analg 2005 101: 90-96. [Abstract] [Full Text]  

IMPLICATIONS: Acetaminophen (paracetamol) IV 1 g and propacetamol 2 g were superior to placebo regarding analgesic efficacy in this double-blind, randomized study in patients with moderate to severe pain after third molar surgery. Significantly more patients in the propacetamol group had pain at the infusion site.

Ni Ni Win, Haruhisa Fukayama, Hikaru Kohase, and Masahiro Umino

The Different Effects of Intravenous Propofol and Midazolam Sedation on Hemodynamic and Heart Rate Variability
Anesth Analg 2005 101: 97-102. [Abstract] [Full Text]  

IMPLICATIONS: Propofol enhances the dominance of parasympathetic activity, which is associated with decreased heart rate (HR) and arterial blood pressure (BP). Midazolam enhances the dominance of sympathetic activity, which is associated with increased HR and decreased BP. These differences in effects on cardiac autonomic nervous system activity during conscious sedation are important in patients at risk of cardiovascular complications.

Suleyman Ganidagli, Mustafa Cengiz, Medaim Yanik, Cevdet Becerik, and Bahriye Unal

The Effect of Music on Preoperative Sedation and the Bispectral Index (Brief Report)
Anesth Analg 2005 101: 103-106. [Abstract] [Full Text]  

IMPLICATIONS: In patients who received midazolam for premedication, listening to music during the preoperative period was associated with an increased level of sedation and lower bispectral index values.

ANESTHETIC PHARMACOLOGY:

Shuichi Kaneko, Mishiya Matsumoto, Shunsuke Tsuruta, Takao Hirata, Toshikazu Gondo, and Takefumi Sakabe

The Nerve Root Entry Zone Is Highly Vulnerable to Intrathecal Tetracaine in Rabbits
Anesth Analg 2005 101: 107-114. [Abstract] [Full Text]  

IMPLICATIONS: The myelin sheaths made by oligodendrocytes at the nerve root entry zone into the spinal cord are highly vulnerable to large concentrations of tetracaine administered intrathecally in rabbits. This vulnerability might be related to the neurological symptoms observed clinically after spinal anesthesia.

Carlos A. Dias-Junior, Debora C. Souza-Costa, Talita Zerbini, Joao B. T. da Rocha, Raquel F. Gerlach, and Jose E. Tanus-Santos

The Effect of Sildenafil on Pulmonary Embolism-Induced Oxidative Stress and Pulmonary Hypertension
Anesth Analg 2005 101: 115-120. [Abstract] [Full Text]  

IMPLICATIONS: We evaluated the effects of IV sildenafil in two animal models of acute pulmonary embolism. IV sildenafil selectively decreased pulmonary vascular resistance and pulmonary artery pressure and attenuated the increase in oxidative stress after acute pulmonary embolism in both models.

Emmanuel Boselli, Marion Guillier, Jean Freney, Marie-Andrée Mazoyer, Emmanuelle Casoli, François R. N. Renaud, Thomas Rimmelé, Dominique Chassard, and Bernard Allaouchiche

Antibacterial Activity of Clonidine and Neostigmine In Vitro
Anesth Analg 2005 101: 121-124. [Abstract] [Full Text]  

IMPLICATIONS: The results of this study show that clonidine possesses a concentration-dependent and time-dependent bactericidal activity on Staphylococcus aureus and Staphylococcus epidermidis. No bactericidal activity of clonidine was observed on Escherichia coli, and no bactericidal activity of neostigmine was observed on any tested strains.

Andrea Albertin, Andrea Casati, Lombardo Federica, Valeri Roberto, Vittorino Travaglini, Piercarlo Bergonzi, and Giorgio Torri

The Effect-Site Concentration of Remifentanil Blunting Cardiovascular Responses to Tracheal Intubation and Skin Incision During Bispectral Index-Guided Propofol Anesthesia
Anesth Analg 2005 101: 125-130. [Abstract] [Full Text]  

IMPLICATIONS: We determined the effect-site concentration of remifentanil blocking the sympathetic responses to tracheal intubation and skin incision in 50% of patients. We found that during a bispectral index-guided target controlled infusion of propofol, effect-site concentrations of remifentanil of 5 ng/mL and 2 ng/mL are required to blunt sympathetic responses to tracheal intubation and skin incision in 50% of patients, respectively.

Mark Liao, James M. Sonner, S. Shaukat Husain, Keith W. Miller, Rachel Jurd, Uwe Rudolph, and Edmond I. Eger, II

R (+) Etomidate and the Photoactivable R (+) Azietomidate Have Comparable Anesthetic Activity in Wild-Type Mice and Comparably Decreased Activity in Mice with a N265M Point Mutation in the Gamma-Aminobutyric Acid Receptor ß3 Subunit
Anesth Analg 2005 101: 131-135. [Abstract] [Full Text]  

IMPLICATIONS: The photoactivable compound azietomidate has anesthetic properties similar to those of etomidate, and its potency is comparably sensitive to the N265M {beta}3 subunit point mutation in gamma-aminobutyric acid (GABA)A. This finding, and the capacity of azietomidate to photolabel, may make it useful in locating the binding site at which etomidate and similar compounds act to produce general anesthesia and enhancement of GABAA receptors.

Caroline Duracher, François-Xavier Blanc, Pierre-Yves Gueugniaud, Jean Stéphane David, Bruno Riou, Yves Lecarpentier, and Catherine Coirault

The Effects of Isoflurane on Airway Smooth Muscle Crossbridge Kinetics in Fisher and Lewis Rats
Anesth Analg 2005 101: 136-142. [Abstract] [Full Text]  

IMPLICATIONS: The effects of volatile anesthetics on crossbridges i.e., ultimate contractile targets in airway smooth muscle (ASM), are unknown. Our results provide new insights into the intracellular effects of volatile anesthetics on ASM and showed that isoflurane modulated mechanics and crossbridge kinetics of isolated tracheal smooth muscle differently depending on the level of airway responsiveness.

James M. Sonner, Bryce Vissel, Gordon Royle, Anya Maurer, Diane Gong, Nicole V. Baron, Neil Harrison, Michael Fanselow, and Edmond I. Eger, II

The Effect of Three Inhaled Anesthetics in Mice Harboring Mutations in the GluR6 (Kainate) Receptor Gene
Anesth Analg 2005 101: 143-148. [Abstract] [Full Text]  

IMPLICATIONS: Absence of the kainate subunit GluR6 does not affect the capacity of three inhaled anesthetics to produce immobility or of isoflurane to interfere with fear conditioning. A dominant negative mutation in this subunit may modulate minimum alveolar concentration.

Pascale Dewachter, Claudie Mouton-Faivre, Philippe Tréchot, Jean-Claude Lleu, and Paul Michel Mertes

Severe Anaphylactic Shock with Methylene Blue Instillation (Case Report)
Anesth Analg 2005 101: 149-150. [Abstract] [Full Text]  

IMPLICATIONS: Anaphylaxis involving any drug or substance used during surgery is possible. We diagnosed an anaphylactic reaction resulting from methylene blue instillation used for detection of tubal permeability. The diagnosis was supported by the recognition of clinical symptoms associated with biological assessment and cutaneous tests.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Samsun Lampotang, Justin C. Sanchez, BaiXi Chen, and Nikolaus Gravenstein

The Effect of a Bellows Leak in an Ohmeda 7810 Ventilator on Room Contamination, Inspired Oxygen, Airway Pressure, and Tidal Volume
Anesth Analg 2005 101: 151-154. [Abstract] [Full Text]  

IMPLICATIONS: With a bellows leak in an O2-driven Ohmeda 7810 ventilator, room contamination occurred but inspired oxygen fraction (Fio2), airway pressure, and tidal volume (Vt) were unaffected. Room contamination is likely in designs without scavenging of drive gas. Fio2, airway pressure, and Vt results may not apply to ventilators, e.g., Drager AV-E, where drive gas contains entrained air.

Y. Y. Poon, Alice Y. W. Chang, S. F. Ko, and Samuel H. H. Chan

An Improved Procedure for Catheterization of the Thoracic Spinal Subarachnoid Space in the Rat
Anesth Analg 2005 101: 155-160. [Abstract] [Full Text]  

IMPLICATIONS: Trauma or improper placement or anchorage of spinal subarachnoid catheterization introduces bias in ensuing experiments. We report a modified procedure for catheterization of the rat thoracic spinal subarachnoid space that compares favorably to previously reported methods and greatly reduces these confounding factors.

Penelope M. Sanderson, Marcus O. Watson, and W. John Russell

Advanced Patient Monitoring Displays: Tools for Continuous Informing (Medical Intelligence)
Anesth Analg 2005 101: 161-168. [Abstract] [Full Text]  

IMPLICATIONS: This paper presents a critical review of advanced display technologies to support anesthesia monitoring. We review laboratory, simulator, and clinical studies of configural graphic displays, head-mounted displays, and continuous auditory displays, noting the advantages and disadvantages of each technology for the anesthesiologist and pointing to further research needs.

Manabu Kakinohana, Seiya Nakamura, Yuji Miyata, and Kazuhiro Sugahara

Emergence from Propofol Anesthesia in a Nonagenarian at a Bispectral Index of 52 (Case Report)
Anesth Analg 2005 101: 169-170. [Abstract] [Full Text]  

IMPLICATIONS: In this case report, we describe a nonagenarian patient who could respond completely to verbal commands at a Bispectral Index (BIS) value of 52 after epidural lidocaine and IV propofol anesthesia. Intraoperative awareness can occur even in the recommended BIS range 40-60.

PAIN MEDICINE:

Leonardo Kapural, Nagy Mekhail, Salim M. Hayek, Michael Stanton-Hicks, and Osama Malak

Occipital Nerve Electrical Stimulation via the Midline Approach and Subcutaneous Surgical Leads for Treatment of Severe Occipital Neuralgia: A Pilot Study
Anesth Analg 2005 101: 171-174. [Abstract] [Full Text]  

IMPLICATIONS: We investigated a modified subcutaneous approach using bilateral surgical leads for occipital nerve electrical stimulation and found improvements in visual analog scale pain scores and functional capacity in patients treated with this technique.

Aldric T. Hama and David Borsook

The Effect of Antinociceptive Drugs Tested at Different Times After Nerve Injury in Rats
Anesth Analg 2005 101: 175-179. [Abstract] [Full Text]  

IMPLICATIONS: The efficacy of antineuropathic pain drugs varies from patient to patient. To understand the mechanism of this phenomenon, gabapentin and imipramine were tested in rats with neuropathic pain at various times after nerve injury. The results indicate that drug efficacy may depend on the length of time between injury and administration.

Motohiro Nakamura, Kouichiro Minami, Yasuhito Uezono, Takafumi Horishita, Junichi Ogata, Munehiro Shiraishi, Takashi Okamoto, Tadanori Terada, and Takeyoshi Sata

The Effects of the Tramadol Metabolite O-Desmethyl Tramadol on Muscarinic Receptor-Induced Responses in Xenopus Oocytes Expressing Cloned M₁ or M₃ Receptors
Anesth Analg 2005 101: 180-186. [Abstract] [Full Text]  

IMPLICATIONS: O-desmethyl tramadol is one of the main metabolites of tramadol. O-desmethyl tramadol inhibited M1 receptors functions, whereas it did not suppress that of M3 receptors. The present findings help to unveil the pharmacological basis of tramadol and O-desmethyl tramadol and to better understand its neuronal action and anticholinergic effects.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Martin Schuster, Thomas Standl, Hajo Reissmann, Ludwig Kuntz, and Jochen Schulte am Esch

Reduction of Anesthesia Process Times After the Introduction of an Internal Transfer Pricing System for Anesthesia Services
Anesth Analg 2005 101: 187-194. [Abstract] [Full Text]  

IMPLICATIONS: Budgeting based on transfer pricing for delivered anesthesia services is a new tool for economic steering of an academic anesthesia department. In this study, we show that such a transfer pricing system can lead to significant reductions of anesthesia process times in a large variety of different anesthesia techniques.

Ronald D. Miller and Neal H. Cohen

The Impact of Productivity-Based Incentives on Faculty Salary-Based Compensation
Anesth Analg 2005 101: 195-199. [Abstract] [Full Text]  

IMPLICATIONS: Academic anesthesia departments have provided faculty compensation in the form of rank-based salaries. Gradually, some departments have provided incentives and bonus systems. The authors' department (University of California, San Francisco) found that adding incentives and bonus payments, mostly based on clinical productivity, induced increased variability in total faculty compensation and narrowed the financial difference between assistant and full professors. The potential impact on the mission of the department is discussed.

CRITICAL CARE AND TRAUMA:

Michael Hüpfl, Andreas Duma, Thomas Uray, Christina Maier, Nikolaus Fiegl, Norbert Bogner, and Peter Nagele

Over-the-Head Cardiopulmonary Resuscitation Improves Efficacy in Basic Life Support Performed by Professional Medical Personnel with a Single Rescuer: A Simulation Study
Anesth Analg 2005 101: 200-205. [Abstract] [Full Text]  

IMPLICATIONS: In this manikin study, a new basic life support technique designed for a single professional rescuer, over-the-head cardiopulmonary resuscitation (CPR), provided superior ventilation and was more effective than standard one-rescuer basic life support. Although two-rescuer CPR is considered optimal, the new technique could have advantages in situations where one professional rescuer has to start CPR alone.

Cecilia Olegård, Sören Söndergaard, Erik Houltz, Stefan Lundin, and Ola Stenqvist

Estimation of Functional Residual Capacity at the Bedside Using Standard Monitoring Equipment: A Modified Nitrogen Washout/Washin Technique Requiring a Small Change of the Inspired Oxygen Fraction
Anesth Analg 2005 101: 206-212. [Abstract] [Full Text]  

IMPLICATIONS: Presently there is no clinical method for measuring the functional residual capacity (FRC) in mechanically ventilated patients with acute respiratory failure. We have developed a nitrogen washin/washout method for FRC measurements using standard monitors requiring only a 0.1 change in inspiratory oxygen fraction (Fio2). The method can be used up to an Fio2 of 1.0.

Nader D. Nader, Bruce A. Davidson, Alan R. Tait, Bruce A. Holm, and Paul R. Knight

Serine Antiproteinase Administration Preserves Innate Superoxide Dismutase Levels After Acid Aspiration and Hyperoxia but Does Not Decrease Lung Injury
Anesth Analg 2005 101: 213-219. [Abstract] [Full Text]  

IMPLICATIONS: Both protease activity and oxidative stress are increased in neutrophil-dependent acute lung injury after acid aspiration. We studied the interaction of increased protease activity with innate antioxidant capacity of the lung (superoxide dismutase) as a potential therapeutic strategy to decrease the extent of the acute injury and pulmonary cytokine response.

Chandra Kant Pandey, Mehdi Raza, Mukesh Tripathi, Deepa V. Navkar, Abhishek Kumar, and Uttam K. Singh

The Comparative Evaluation of Gabapentin and Carbamazepine for Pain Management in Guillain-Barré Syndrome Patients in the Intensive Care Unit
Anesth Analg 2005 101: 220-225. [Abstract] [Full Text]  

IMPLICATIONS: Gabapentin, an antiepileptic and an adjuvant for pain management, offers better pain control and requires less supplemental fentanyl than the antiepileptic carbamazepine when used for pain management in Guillain-Barre syndrome patients.

Wen-Chou Lin, Pei-Shan Tsai, and Chun-Jen Huang

Catecholamines' Enhancement of Inducible Nitric Oxide Synthase-Induced Nitric Oxide Biosynthesis Involves CAT-1 and CAT-2A
Anesth Analg 2005 101: 226-232. [Abstract] [Full Text]  

IMPLICATIONS: L-arginine transport is crucial to the regulation of nitric oxide (NO) production. This study provides the first evidence to indicate that catecholamines enhance L-arginine transport and NO production through mechanisms that involve CAT-1 and CAT-2A but not CAT-2 or CAT-2B.

Boris Nohé, Ulrike Ernemann, Gunnar Tepe, Rainer Ritz, and Dorothee Bail

Aortic Dissection Mimicking Subarachnoidal Hemorrhage (Case Report)
Anesth Analg 2005 101: 233-234. [Abstract] [Full Text]  

IMPLICATIONS: Although aortic dissection may present with transient neurological symptoms such as syncope, it rarely presents with coma or headache. This case shows that aortic dissection may mimic subarachnoidal hemorrhage. Because prompt diagnosis is essential in reducing mortality, aortic dissection should be considered in comatose patients until computed tomography has excluded it.

NEUROSURGICAL ANESTHESIA:

Haren Heller, Raheleh Hatami, Paul Mullin, Robert R. Sciacca, Alexander G. Khandji, Marla Hamberger, Ronald Emerson, and Eric J. Heyer

Bilateral Bispectral Index Monitoring During Suppression of Unilateral Hemispheric Function
Anesth Analg 2005 101: 235-341. [Abstract] [Full Text]  

IMPLICATIONS: Bispectral Index (BIS) values recorded by a BIS monitor reflect the patient's level of sedation. These values are unaffected by injection of a short-acting barbiturate into the internal carotid artery if the patient's level of sedation is unimpaired even when the patient develops a hemiparesis and the electroencephalogram changes.

Tomoki Nishiyama

Spinal Cord Blood Flow Change by Intravenous Midazolam During Isoflurane Anesthesia
Anesth Analg 2005 101: 242-245. [Abstract] [Full Text]  

IMPLICATIONS: Spinal cord blood flow was measured by the hydrogen clearance method after IV administration of midazolam during isoflurane anesthesia in cats. Midazolam 1 mg/kg increased spinal cord blood flow without changes in blood pressure. Larger-dose midazolam (4 mg/kg) did not change spinal cord blood flow but caused decreased arterial blood pressure during isoflurane anesthesia.

OBSTETRIC ANESTHESIA:

Elaine M. Hart and Harry Owen

Errors and Omissions in Anesthesia: A Pilot Study Using a Pilot’s Checklist
Anesth Analg 2005 101: 246-250. [Abstract] [Full Text]  

IMPLICATIONS: We considered whether a verbal checklist would help in preparing to give a general anesthetic for Cesarean delivery. An anesthesia simulator was used. We found that a checklist may improve patient safety and that many anesthesiologists would be prepared to use them.

Marc Van de Velde, Dominique Van Schoubroeck, Liesbeth E. Lewi, Marco A.E. Marcus, Jacques C. Jani, Carlo Missant, An Teunkens, and Jan A. Deprest

Remifentanil for Fetal Immobilization and Maternal Sedation During Fetoscopic Surgery: A Randomized, Double-Blind Comparison with Diazepam
Anesth Analg 2005 101: 251-258. [Abstract] [Full Text]  

IMPLICATIONS: This trial tested the use of remifentanil for maternal sedation and fetal immobilization during endoscopic intrauterine surgery on the cord and placenta. Remifentanil was superior to diazepam for inducing adequate sedation and fetal immobilization and also facilitated faster surgery.

REGIONAL ANESTHESIA:

Stephen Mannion, Sheila O'Callaghan, Mary Walsh, Damian B. Murphy, and George D. Shorten

In with the New, Out with the Old? Comparison of Two Approaches for Psoas Compartment Block
Anesth Analg 2005 101: 259-264. [Abstract] [Full Text]  

IMPLICATIONS: Winnie's and Capdevila's approaches for psoas compartment block both successfully anesthetize the lumbar plexus with similar postoperative analgesic efficacy. There is no difference between approaches in the incidence of bilateral anesthesia. Bilateral anesthesia occurs more frequently after psoas compartment block than previously reported.

Shizuko Kosugi, Hiroshi Morisaki, Tomoyuki Satoh, Kimiaki Ai, Michiko Yamamoto, Junko Soejima, Ryohei Serita, Yoshifumi Kotake, Akitoshi Ishizaka, and Junzo Takeda

Epidural Analgesia Prevents Endotoxin-Induced Gut Mucosal Injury in Rabbits
Anesth Analg 2005 101: 265-272. [Abstract] [Full Text]  

IMPLICATIONS: Epidural analgesia prevented both endotoxin-induced functional and structural alterations of gut mucosa in rabbits without modulating injured endothelial cells. Although further investigation is warranted, epidural analgesia could be applied to critically ill patients at risk of gut barrier dysfunction as a therapeutic option to preserve its functional integrity.

Øivind Klaastad, Örjan Smedby, Trygve Kjelstrup, and Hans-Jørgen Smith

The Vertical Infraclavicular Brachial Plexus Block: A Simulation Study Using Magnetic Resonance Imaging
Anesth Analg 2005 101: 273-278. [Abstract] [Full Text]  

IMPLICATIONS: An infraclavicular brachial plexus block technique, without needle insertion, was examined by magnetic resonance imaging in volunteers. Although the recommended needle direction is close to the target (the nerves), contact with the pleura or subclavian vessels may occur.

Henri Iskandar, Nicolas Wakim, Antoine Benard, Bertrand Manaud, Joelle Ruel-Raymond, Gyslaine Cochard, and Chris Huber

The Effects of Interscalene Brachial Plexus Block on Humeral Arterial Blood Flow: A Doppler Ultrasound Study (Brief Report)
Anesth Analg 2005 101: 279-281. [Abstract] [Full Text]  

IMPLICATIONS: A Doppler ultrasound of the humeral artery was performed before, and 30 min after, interscalene block. After interscalene block, the resistance index decreased and humeral artery blood flow increased significantly.

Eric Meaudre, Georges Pernod, Pierre-Emmanuel Gaillard, Eric Kaiser, Emmanuel Cantais, Jacques Ripart, and Bruno Palmier

Mandibular Nerve Blocks for the Removal of Dentures During Trismus Caused by Tetanus (Case Report)
Anesth Analg 2005 101: 282-283. [Abstract] [Full Text]  

IMPLICATIONS: We report a case of trismus caused by tetanus in a conscious patient who developed severe and painful masseter spasms during which she violently bit the tip of her tongue with her dentures. We performed bilateral mandibular nerve blocks via a lateral extraoral approach to successfully remove the dentures.

GENERAL ARTICLES:

Leopold H. J. Eberhart, Christian Arndt, Thomas Cierpka, Judith Schwanekamp, Hinnerk Wulf, and Caroline Putzke

The Reliability and Validity of the Upper Lip Bite Test Compared with the Mallampati Classification to Predict Difficult Laryngoscopy: An External Prospective Evaluation
Anesth Analg 2005 101: 284-289. [Abstract] [Full Text]  

IMPLICATIONS: The Upper-Lip-Bite test (ULBT) is a bedside screening test to detect difficult laryngoscopy, which was evaluated and compared with the Mallampati score in 1425 patients. The ULBT did not sufficiently discriminate between patients presenting with easy and difficult laryngoscopy and was less sensitive than the Mallampati score.

Junchi Ogata, Kouichiro Minami, Takafumi Horishita, Munehiro Shiraishi, Takashi Okamoto, Tadanori Terada, and Takeyoshi Sata

Gargling with Sodium Azulene Sulfonate Reduces the Postoperative Sore Throat After Intubation of the Trachea
Anesth Analg 2005 101: 290-293. [Abstract] [Full Text]  

IMPLICATIONS: Postoperative sore throat (POST) is a complication that remains to be resolved in patients undergoing endotracheal intubation. In this study we found that preoperative gargling with Azunol reduces POST after endotracheal intubation. This finding suggests that gargling with Azunol would be effective for attenuating POST with no adverse reactions

Kajari Roy, Pankaj Kundra, and M. Ravishankar

Unusual Foreign Body Airway Obstruction After Laryngeal Mask Airway Insertion (Case Report)
Anesth Analg 2005 101: 294-295. [Abstract] [Full Text]  

IMPLICATIONS: Life-threatening airway obstruction can occur after laryngeal mask airway insertion under general anesthesia as a result of a nematode migrating from the esophagus to the pharynx. The incidence is likely to increase with more people returning or migrating from endemic areas.

LETTER TO THE EDITOR:

Olubukola O. Nafiu

Is a Desflurane-Remifentanil Based Anesthetic Really the Best for the Wake-Up Test?
Anesth Analg 2005 101: 296. [Full Text]  

Frank Wappler

Is a Desflurane-Remifentanil Based Anesthetic Really the Best for the Wake-Up Test?
Anesth Analg 2005 101: 296. [Full Text]  

Puneet Sharma, Baljit Singh, and Amod Manocha

Stylet Stuck in the Back: An Unusual Complication of Spinal Needle
Anesth Analg 2005 101: 296-297. [Full Text]  

Paul F. White

Awake and Paralyzed: Was It Really Necessary?
Anesth Analg 2005 101: 297. [Full Text]  

M. Messner, U. Beese, J. Romstöck, M. Dinkel, and K. Tschaikowsky

Awake and Paralyzed: Was It Really Necessary?
Anesth Analg 2005 101: 297. [Full Text]  

B. Al-Shaikh and A.A.J. Van Zundert

The Soft Seal Laryngeal Mask Provides Good Ease of Insertion and Clinical Performance
Anesth Analg 2005 101: 297-298. [Full Text]  

J. Brimacombe and C. Keller

The Soft Seal Laryngeal Mask Provides Good Ease of Insertion and Clinical Performance
Anesth Analg 2005 101: 298. [Full Text]  

Mark A. Eggen and John G. Brock-Utne

Artifactual Increase in the Arterial Pressure Waveform: Remember the Stopcock
Anesth Analg 2005 101: 298-299. [Full Text]  

Carl-Henrik Nordström

Assessment of the Optimal Cerebral Perfusion Pressure in Head-Injured Patients
Anesth Analg 2005 101: 299-300. [Full Text]  

O. L. Cremer

Assessment of the Optimal Cerebral Perfusion Pressure in Head-Injured Patients
Anesth Analg 2005 101: 300. [Full Text]  

Joaquín García-Ferreira, Joaquín Hernández-Palazón, Antonio García-Candel, and Teresa Verdú-Martínez

Subarachnoid Block in a Patient with Essential Thrombocytemia
Anesth Analg 2005 101: 300. [Full Text]  

John C. Boncyk

Desflurane Versus Sevoflurane
Anesth Analg 2005 101: 300. [Full Text]  

Earl M. Strum and Janos Szenohradszki

Desflurane Versus Sevoflurane
Anesth Analg 2005 101: 300-301. [Full Text]  

Somi R. Desikan, Srinivas Pyati, and Ben Darveniza

Anesthesia for a Child with Reflex Anoxic Seizures
Anesth Analg 2005 101: 301. [Full Text]  

Payam Eghtesadi-Araghi and Seyed Mojtaba Marashi

Comparison of Propofol with Lidocaine Pretreatment Versus Propofol Formulated with Long- and Medium-Chain Triglycerides or Confounding Effect of Tourniquet
Anesth Analg 2005 101: 301. [Full Text]  

E. Schaub, C. Kern, and Ruth Landau

Comparison of Propofol with Lidocaine Pretreatment Versus Propofol Formulated with Long- and Medium-Chain Triglycerides or Confounding Effect of Tourniquet
Anesth Analg 2005 101: 301-302. [Full Text]  

Gaku Inagawa, Takaaki Miwa, and Koichi Hiroki

Unanticipated Dural Tap in Caudal Anesthesia: A Case of Intrasacral Meningocele
Anesth Analg 2005 101: 302. [Full Text]  

Sushil P. Ambesh and Chandra K. Pandey

Ambesh’s T-Dagger®: A New Device for Quick Bedside Percutaneous Dilational Tracheostomy
Anesth Analg 2005 101: 302-303. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

Charles W. Hogue, Jr

Cardiopulmonary Resuscitation.
Anesth Analg 2005 101: 304-305. [Full Text]  

Gregory A. Nuttall

Transfusion Therapy: Clinical Principles and Practice, 2nd ed.
Anesth Analg 2005 101: 305. [Full Text]  

Jane C. Ballantyne

Chronic Pain.
Anesth Analg 2005 101: 305-306. [Full Text]  

Books and Multimedia Received.
Anesth Analg 2005 101: 306. [Full Text]  

ERRATA:

Erratum
Anesth Analg 2005 101: 43. [Full Text]  

To see an article, click its [Full Text] link. To review many abstracts, check the boxes to the left of the titles you want, and click the 'Get All Checked Abstract(s)' button. To see one abstract at a time, click its [Abstract] link.