CARDIOVASCULAR ANESTHESIA:

William E. Johnston

PRO: Fluid Restriction in Cardiac Patients for Noncardiac Surgery is Beneficial (Editorial)
Anesth Analg 2006 102: 340-343. [Full Text] [PDF]  

Donat R. Spahn and Pierre-Guy Chassot

CON: Fluid Restriction for Cardiac Patients During Major Noncardiac Surgery Should be Replaced by Goal-Directed Intravascular Fluid Administration (Editorial)
Anesth Analg 2006 102: 344-346. [Full Text] [PDF]  

Dietmar Fries, Petra Innerhofer, Christian Reif, Werner Streif, Anton Klingler, Wolfgang Schobersberger, Corinna Velik-Salchner, and Barbara Friesenecker

The Effect of Fibrinogen Substitution on Reversal of Dilutional Coagulopathy: An In Vitro Model
Anesth Analg 2006 102: 347-351. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The administration of large amounts of colloids and crystalloids is associated with clinically relevant impairment of the coagulation system. The results of this in vitro study suggest that replacing the required fibrinogen might be useful to clot formation during continuing blood loss and volume requirement.

Steffen Rex, Stefan Brose, Sebastian Metzelder, Lothar de Rossi, Sylvia Schroth, Rüdiger Autschbach, Rolf Rossaint, and Wolfgang Buhre

Normothermic Beating Heart Surgery with Assistance of Miniaturized Bypass Systems: The Effects on Intraoperative Hemodynamics and Inflammatory Response
Anesth Analg 2006 102: 352-362. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Normothermic beating heart surgery with assistance of miniaturized bypass circuits was not effective in improving hemodynamic and myocardial performance after cardiopulmonary bypass. In addition, this less invasive technique was not able to attenuate the proinflammatory immune response after cardiopulmonary bypass.

Robina Matyal, Feroze Mahmood, Peter Panzica, John Mitchell, Sheila Barnett, Marybeth Hyde, David Campbell, and Kyung W. Park

Inadvertent Placement of a Flow-Directed Pulmonary Artery Catheter in the Coronary Sinus, Detected by Transesophageal Echocardiography (Case Report)
Anesth Analg 2006 102: 363-365. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Flow-directed placement of the pulmonary artery catheter can result in misplacement. Transesophageal echocardiography may be useful in the diagnosis of incorrect placement.

Thomas Theunissen, José Coddens, Luc Foubert, Guy Cammu, Ivan Degrieck, and Thierry Deloof

Intraoperative Severity Assessment of Coronary Artery Stenosis in Patients at Risk: The Role of Transesophageal Echocardiography (Case Report)
Anesth Analg 2006 102: 366-368. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Intraoperative color Doppler examination of the coronary arteries with transesophageal echocardiography in vascular surgical patients may detect significant lesions in the proximal coronary arteries. In the nonoperative setting the sensitivity and specificity of this technique have been demonstrated, but the predictive value under anesthesia is not yet established. Intraoperative Doppler recordings suggestive of significant coronary stenosis may indicate the need for subsequent diagnostic evaluation.

Chirag Patel and Peter L. Bailey

Sinus of Valsalva Aneurysm and Ventricular Tachycardia During Pulmonary Artery Catheterization (Case Report)
Anesth Analg 2006 102: 369-371. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We describe a patient in whom attempts to place a pulmonary artery catheter resulted in recurrent bouts of ventricular tachycardia. Transesophageal echocardiography revealed a right Sinus of Valsalva aneurysm protruding into the right ventricle, precluding placement of the pulmonary artery catheter.

Adam D. Lichtman and Charles Oribabor

Malignant Hyperthermia Following Systemic Rewarming After Hypothermic Cardiopulmonary Bypass (Case Report)
Anesth Analg 2006 102: 372-375. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We describe a previously unreported case of malignant hyperthermia after hypothermic cardiopulmonary bypass. In the absence of a known trigger we theorize that the cause was rewarming via a mechanism similar to heat stroke.

Angel O. K. Kwok, Brendan S. Silbert, Kara J. Allen, Peter J. Bray, and John Vidovich

Bilateral Vocal Cord Palsy During Carotid Endarterectomy Under Cervical Plexus Block (Case Report)
Anesth Analg 2006 102: 376-377. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Abrupt onset of vocal cord adduction during awake carotid endarterectomy may cause acute respiratory obstruction in the presence of prior contralateral vocal cord palsy.

Christopher B. Komanapalli, Uttam Tripathy, Mitchell Sokoloff, Siamak Daneshmand, Asish Das, and Matthew S. Slater

Intraoperative Renal Cell Carcinoma Tumor Embolization to the Right Atrium: Incidental Diagnosis by Transesophageal Echocardiography (Echo Rounds)
Anesth Analg 2006 102: 378-379. [Full Text] [PDF] [Data Supplement]   

PEDIATRIC ANESTHESIA:

Chantal Kerssens and Peter S. Sebel

To BIS or Not to BIS? That Is the Question (Editorial)
Anesth Analg 2006 102: 380-382. [Full Text] [PDF]  

Senthilkumar Sadhasivam, Arjunan Ganesh, Amy Robison, Robin Kaye, and Mehernoor F. Watcha

Validation of the Bispectral Index Monitor for Measuring the Depth of Sedation in Children
Anesth Analg 2006 102: 383-388. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The Bispectral Index monitor is a quantitative, easy to use method of assessing the depth of sedation in children that, unlike clinical sedation assessing methods, does not require patient stimulation and a consequent risk of disruption of the procedure from associated patient responses.

Shobha Malviya, Terri Voepel-Lewis, and Alan R. Tait

A Comparison of Observational and Objective Measures to Differentiate Depth of Sedation in Children from Birth to 18 Years of Age
Anesth Analg 2006 102: 389-394. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study demonstrates the correlation of objective and observational sedation measures across the sedation continuum in children <18 yr of age but suggests continuing limitations in their ability to differentiate moderate and deep sedation.

Samia Khalil, Hemanth Lingadevaru, Mariana Bolos, Mary Rabb, Maria Matuszczak, Douglas Maposa, and Alice Chuang

Caudal Regional Anesthesia, Ropivacaine Concentration, Postoperative Analgesia, and Infants
Anesth Analg 2006 102: 395-399. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Caudal blocks are commonly placed in infants for postoperative analgesia using ropivacaine 0.2%. This study demonstrates that ropivacaine 0.175% provides postoperative analgesia and duration similar to ropivacaine 0.2%; however, ropivacaine 0.15% and 0.1% did not. Ropivacaine 0.175% is associated with fewer motor effects than 0.2%.

Jochen Mayer, Joachim Boldt, Kerstin D. Röhm, Klaus Scheuermann, and Stefan W. Suttner

Desflurane Anesthesia After Sevoflurane Inhaled Induction Reduces Severity of Emergence Agitation in Children Undergoing Minor Ear-Nose-Throat Surgery Compared with Sevoflurane Induction and Maintenance
Anesth Analg 2006 102: 400-404. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Emergence agitation may occur after general anesthesia with volatile anesthetics in children. A more rapid emergence with less agitation, as measured by the Pediatric Anesthesia Emergence Delirium scale, occurred in children undergoing ear-nose-throat procedures when anesthesia was maintained with desflurane rather than sevoflurane.

Kai Goldmann, Christine Roettger, and Hinnerk Wulf

The Size 1 ProSeal^TM Laryngeal Mask Airway in Infants: A Randomized, Crossover Investigation with the Classic^TM Laryngeal Mask Airway
Anesth Analg 2006 102: 405-410. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The size 11/2 ProSealTM Laryngeal Mask Airway (LMA) seems to be a more suitable device for airway maintenance in infants than the same size ClassicTM LMA because it provides the ability to insert a gastric tube and has significantly higher airway leak pressure.

Nathalia Jimenez, Heidi Bradford, Kristy D. Seidel, Manuela Sousa, and Anne M. Lynn

A Comparison of a Needle-Free Injection System for Local Anesthesia Versus EMLA® for Intravenous Catheter Insertion in the Pediatric Patient
Anesth Analg 2006 102: 411-414. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Placement of IV catheters is a common and painful procedure for children. Topical local anesthetics applied before cannulation require time and produce vasoconstriction. J-Tip(R) is a needle-less injection system that can be used for painless delivery of local anesthetic before IV cannulation.

Renate C. Schoenfelder, Chandra M. Ponnamma, David Freyle, Shu-Ming Wang, and Zeev N. Kain

Residual Gastric Fluid Volume and Chewing Gum Before Surgery (Brief Report)
Anesth Analg 2006 102: 415-417. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Children who present for surgery while chewing gum have a two- to threefold increase in gastric fluid volume.

AMBULATORY ANESTHESIA:

Luis Romundstad, Harald Breivik, Helge Roald, Knut Skolleborg, Torleiv Haugen, Jon Narum, and Audun Stubhaug

Methylprednisolone Reduces Pain, Emesis, and Fatigue After Breast Augmentation Surgery: A Single-Dose, Randomized, Parallel-Group Study with Methylprednisolone 125 mg, Parecoxib 40 mg, and Placebo
Anesth Analg 2006 102: 418-425. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Methylprednisolone 125 mg IV and parecoxib 40 mg IV before surgery significantly reduced acute pain compared with placebo after breast augmentation surgery. Both active drugs reduced rescue analgesic consumption compared with placebo. After methylprednisolone, but not after parecoxib, postoperative emesis and fatigue were reduced.

Guy Cammu, Jan De Witte, Jan De Veylder, Geert Byttebier, Dirk Vandeput, Luc Foubert, Geert Vandenbroucke, and Thierry Deloof

Postoperative Residual Paralysis in Outpatients Versus Inpatients (Brief Report)
Anesth Analg 2006 102: 426-429. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: When administering neuromuscular blocking drugs, anesthesiologists in this study used clinical tests or pharmacological reversal, but seldom neuromuscular transmission monitoring, before endotracheal extubation. In more inpatients than outpatients, residual paralysis was detected postoperatively. Eight clinical tests were unreliable in predicting neuromuscular recovery status.

ANESTHETIC PHARMACOLOGY:

J. K. Götz Wietasch, Martin Scholz, Jörg Zinserling, Nicholas Kiefer, Christian Frenkel, Pascal Knüfermann, Ute Brauer, and Andreas Hoeft

The Performance of a Target-Controlled Infusion of Propofol in Combination with Remifentanil: A Clinical Investigation with Two Propofol Formulations
Anesth Analg 2006 102: 430-437. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: During routine surgery using the combination of remifentanil and propofol target-controlled infusion systems, the Marsh and Schnider parameter sets consistently underestimate propofol plasma concentrations. Prediction accuracy was improved using a new estimated pharmacokinetic parameter set. Propofol formulations and type of surgery were not important covariates, however, but ASA physical status and sex was.

Harry J. M. Lemmens and Jay B. Brodsky

The Dose of Succinylcholine in Morbid Obesity
Anesth Analg 2006 102: 438-442. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In morbidly obese patients, successful tracheal intubation can be achieved when 1.0 mg/kg succinylcholine is administered based on ideal body weight, lean body weight, or total body weight. None of these dosing regimens will provide both adequate intubating conditions and a safe (short) duration of apnea. Succinylcholine given in a dose of 1.0 mg/kg based on total body weight provides complete neuromuscular paralysis and predictable tracheal intubating conditions in morbidly obese patients. Smaller doses are not as effective.

Ahmet Ulugöl, Filiz Özyigit, Özgür Yesilyurt, and Ahmet Dogrul

The Additive Antinociceptive Interaction Between WIN 55,212-2, a Cannabinoid Agonist, and Ketorolac
Anesth Analg 2006 102: 443-447. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Cannabinoids are promising analgesic drugs. However, their beneficial effects for pain treatment are counterbalanced by serious adverse reactions. Our study indicated an additive antinociceptive interaction between cannabinoid and nonsteroidal antiinflammatory drugs (NSAIDs) in a mouse inflammatory visceral pain model. The combination of cannabinoids with NSAIDs may have utility in pain pharmacotherapy.

Robert A. Whittington and László Virág

Dexmedetomidine-Induced Decreases in Accumbal Dopamine in the Rat Are Partly Mediated via the Locus Coeruleus
Anesth Analg 2006 102: 448-455. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Dexmedetomidine, a highly specific {alpha}2-adrenergic agonist recently introduced into clinical practice, decreases extracellular dopamine concentrations in the rat nucleus accumbens, a major dopaminergic brain area linked to several of the effects of drugs of abuse. This decrease is partly mediated via the locus coeruleus, a major noradrenergic brain center.

Andrea Paris, Jean Mantz, Peter H. Tonner, Lutz Hein, Marc Brede, and Pierre Gressens

The Effects of Dexmedetomidine on Perinatal Excitotoxic Brain Injury are Mediated by the _2A-Adrenoceptor Subtype
Anesth Analg 2006 102: 456-461. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In a model of excitotoxic brain injury, with striking similarities to human perinatal hypoxic brain lesions, dexmedetomidine provides potent neuroprotection. This effect is completely abolished in mice lacking the {alpha}2A-adrenoceptor subtype, suggesting that the neuroprotective actions of dexmedetomidine against ibotenate-induced lesions are mediated via the {alpha}2A-adrenoceptor subtype.

Mayumi Takatori, Yoshihiro Kuroda, and Munetaka Hirose

Local Anesthetics Suppress Nerve Growth Factor-Mediated Neurite Outgrowth by Inhibition of Tyrosine Kinase Activity of TrkA
Anesth Analg 2006 102: 462-467. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The mechanism of suppression of neurite outgrowth by local anesthetics is unknown. We showed that TrkA activity, which induces neurite outgrowth, was inhibited by lidocaine, bupivacaine, or procaine. This inhibition might be involved in the mechanisms of suppression of neurite outgrowth by local anesthetics.

Frank Schuster, Hendrik Schöll, Martin Hager, Rainer Müller, Norbert Roewer, and Martin Anetseder

The Dose-Response Relationship and Regional Distribution of Lactate After Intramuscular Injection of Halothane and Caffeine in Malignant Hyperthermia-Susceptible Pigs
Anesth Analg 2006 102: 468-472. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Local injection of malignant hyperthermia trigger drug increases IM lactate and carbon dioxide dose-dependently, and this increase is limited to a small area around the stimulating probe. A metabolic test after local trigger application does not lead to a spreading malignant hyperthermia reaction, is dose-dependent, and might be a promising minimally invasive method to detect malignant hyperthermia susceptibility.

Peter Felleiter, Peter Lierz, and Jürg Graf

The Effects of Local Anesthetics on Bile Flow, Potassium Equilibrium and Oxygen Consumption in the Perfused Rat Liver
Anesth Analg 2006 102: 473-477. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Acute administration of lidocaine, bupivacaine, and ropivacaine results in significant changes in functional variables of the liver. These effects appear to result from mitochondrial uncoupling, uptake of the drugs, and biliary secretion of their metabolites and from inhibition of potassium channels.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Karl Øyri, Ilangko Balasingham, Eigil Samset, Jan Olav Høgetveit, and Erik Fosse

Wireless Continuous Arterial Blood Pressure Monitoring During Surgery: A Pilot Study
Anesth Analg 2006 102: 478-483. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Biomedical sensors can be used in a wireless environment for invasive measurements. Transport and ambulation of critically ill patients are needed, and wireless technology can be used to facilitate mobility.

Gregory M. Janelle and Nikolaus Gravenstein

An Accuracy Evaluation of the T-Line® Tensymeter (Continuous Noninvasive Blood Pressure Management Device) versus Conventional Invasive Radial Artery Monitoring in Surgical Patients
Anesth Analg 2006 102: 484-490. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Continuous arterial blood pressure measurements obtained using a noninvasive arterial blood pressure tensymeter agreed with simultaneous invasive arterial blood pressure measurements obtained using an arterial catheter for the population of surgical patients studied. These results indicated that the tensymeter shows promise as an option for noninvasive continuous arterial blood pressure measurement.

James W. Futrell, Jr and Jack L. Moore

The OxyArm^TM: A Supplemental Oxygen Delivery Device
Anesth Analg 2006 102: 491-494. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The use of the OxyArmTM as a supplemental oxygen delivery device will significantly reduce patient morbidity and will increase patient compliance in the administration of oxygen therapy. Regular use of the OxyArmTM will reduce overall anesthesia complication rates.

Steven L. Bell, David C. Smith, Robert Allen, and Mark E. Lutman

The Auditory Middle Latency Response, Evoked Using Maximum Length Sequences and Chirps, as an Indicator of Adequacy of Anesthesia (Technical Communication)
Anesth Analg 2006 102: 495-498. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The auditory evoked response may be a useful measure of adequacy of anesthesia, but signal acquisition is still a major obstacle. Signal processing techniques may speed acquisition time, but the morphology of the auditory evoked potential and its response to changes in anesthetic depth may be altered by these techniques.

PAIN MEDICINE:

Scott S. Reuben, Rene Pristas, Duane Dixon, Shameema Faruqi, Lakshmi Madabhushi, and Steven Wenner

The Incidence of Complex Regional Pain Syndrome After Fasciectomy for Dupuytren’s Contracture: A Prospective Observational Study of Four Anesthetic Techniques
Anesth Analg 2006 102: 499-503. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: For those patients undergoing Dupuytren's surgery, the use of axillary block or IV regional anesthesia with clonidine can significantly decrease the incidence of complex regional pain syndrome compared with either IV regional anesthesia with lidocaine alone or general anesthesia.

Gerri Casey, Sally-Ann Nortcliffe, Paul Sharpe, and D. J. Buggy

Perioperative Nimodipine and Postoperative Analgesia
Anesth Analg 2006 102: 504-508. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study has demonstrated increased morphine consumption after 12 h in postoperative patients receiving nimodipine, suggesting that, in patients undergoing knee replacement surgery, it has no adjunctive analgesic effect and may actually inhibit the analgesic effect of morphine.

Thomas Sycha, Doris Samal, Boris Chizh, Stephan Lehr, Burkhard Gustorff, Peter Schnider, and Eduard Auff

A Lack of Antinociceptive or Antiinflammatory Effect of Botulinum Toxin A in an Inflammatory Human Pain Model
Anesth Analg 2006 102: 509-516. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In a human inflammatory pain model, we studied whether botulinum toxin A (BoNT/A) has antiinflammatory and antinociceptive properties. Despite highly promising data from animal research, we have not observed such effects of BoNT/A in human inflammatory pain. This finding points to the important aspect of nontranslation of animal data into humans.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Kevin K. Tremper, Amy Shanks, and Michelle Morris

Trends in the Financial Status of United States Anesthesiology Training Programs: 2000 to 2004
Anesth Analg 2006 102: 517-523. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: United States anesthesiology training programs continue to have open faculty positions. The institutional support continues to grow, averaging $97,621/faculty in 2004, which is a 63% increase over the support in 2002.

Christopher Gonano, Ursula Leitgeb, Christian Sitzwohl, Gerald Ihra, Christian Weinstabl, and Stephan C. Kettner

Spinal Versus General Anesthesia for Orthopedic Surgery: Anesthesia Drug and Supply Costs
Anesth Analg 2006 102: 524-529. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We compared costs for spinal anesthesia with costs for general anesthesia in patients undergoing hip or knee replacement and found that spinal anesthesia is associated with explicit lower costs for intraoperative and postoperative anesthesia service. The two anesthetic techniques showed comparable times for anesthesia, surgery, and recovery.

Haim Berkenstadt, Yakov Yusim, Amitai Ziv, Tiberiu Ezri, and Azriel Perel

An Assessment of a Point-of-Care Information System for the Anesthesia Provider in Simulated Malignant Hyperthermia Crisis (Brief Report)
Anesth Analg 2006 102: 530-532. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A point-of-care information system improves performance during a malignant hyperthermia scenario.

CRITICAL CARE AND TRAUMA:

Michael Imhoff

Everybody on the Phone? (Editorial)
Anesth Analg 2006 102: 533-534. [Full Text] [PDF]  

Roy G. Soto, Larry F. Chu, Julian M. Goldman, Ira J. Rampil, and Keith J. Ruskin

Communication in Critical Care Environments: Mobile Telephones Improve Patient Care
Anesth Analg 2006 102: 535-541. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The relatively small risks of electromagnetic interference between mobile telephones and medical devices should be weighed against the potential benefits of improved communication.

Conán L. McCaul, Patrick J. McNamara, Doreen Engelberts, Gregory J. Wilson, Alex Romaschin, Andrew N. Redington, and Brian P. Kavanagh

Epinephrine Increases Mortality after Brief Asphyxial Cardiac Arrest in an In Vivo Rat Model
Anesth Analg 2006 102: 542-548. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In a laboratory-based animal experiment, epinephrine administered after brief asphyxial cardiac arrest caused dose-dependent diastolic dysfunction, left atrial hypertension, and increased mortality. These effects were attenuated by cotreatment with calcium channel blockade. If eventually applicable to humans, these data would suggest caution with the use of epinephrine for cardiac arrest due to asphyxia.

Anuj Bhatia, Brit Cadman, and Iain Mackenzie

Hypoglycemia and Cardiac Arrest in a Critically Ill Patient on Strict Glycemic Control (Case Report)
Anesth Analg 2006 102: 549-551. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: As strict glycemic control becomes the accepted standard of care for critically ill patients, the incidence of hypoglycemia is likely to increase. We describe a cardiac arrest in a patient receiving a concentrated glucose solution to treat hypoglycemia and highlight the potential dangers associated with the rapid administration of these solutions.

NEUROSURGICAL ANESTHESIA:

Yojiro Ogawa, Ken-ichi Iwasaki, Shigeki Shibata, Jitsu Kato, Setsuro Ogawa, and Yoshiyuki Oi

The Effect of Sevoflurane on Dynamic Cerebral Blood Flow Autoregulation Assessed by Spectral and Transfer Function Analysis
Anesth Analg 2006 102: 552-559. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study was conducted to evaluate the effects of sevoflurane on dynamic cerebral blood flow autoregulation by using spectral and transfer function analysis. Our results suggest that sevoflurane impairs dynamic cerebral autoregulation in the very low-frequency range, although dynamic cerebral autoregulation in the low- and high-frequency ranges are unaffected.

Irene Rozet, Monica S. Vavilala, Andrew M. Lindley, Elizabeth Visco, Miriam Treggiari, and Arthur M. Lam

Cerebral Autoregulation and CO₂ Reactivity in Anterior and Posterior Cerebral Circulation During Sevoflurane Anesthesia
Anesth Analg 2006 102: 560-564. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Cerebral vessels in the brainstem and cerebellum (posterior circulation) were shown to be different from vessels in the cerebrum (anterior circulation). The aim of this study was to investigate posterior circulation under general anesthesia and to compare it with anterior circulation.

Cécile Julien, Adrian Bradu, Raphaël Sablong, Emmanuelle Grillon, Chantal Remy, Jacques Derouard, and Jean-François Payen

Measuring Hemoglobin Oxygen Saturation During Graded Hypoxic Hypoxia in Rat Striatum
Anesth Analg 2006 102: 565-570. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study shows that reflectance spectroscopy of visible light permits continuous measure of relative changes in hemoglobin oxygen saturation induced by graded hypoxic hypoxia in rat striatum (SstrO2). Changes in SstrO2 reflect primarily those in brain venous oxygenation.

Katsutoshi Nakahata, Hiroyuki Kinoshita, Yasuyuki Tokinaga, Yuko Ishida, Yoshiki Kimoto, Mayuko Dojo, Kazuhiro Mizumoto, Koji Ogawa, and Yoshio Hatano

Vasodilation Mediated by Inward Rectifier K⁺ Channels in Cerebral Microvessels of Hypertensive and Normotensive Rats
Anesth Analg 2006 102: 571-576. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We demonstrated vasodilation via inward rectifier K+ channels in cerebral microvessels from hypertensive and normotensive rats. In cerebral parenchymal arterioles, inward rectifier K+ channels play an important role in vasodilation produced by extracellular K+, and the vasodilator responses via inward rectifier K+ channels are augmented in chronic hypertension.

OBSTETRIC ANESTHESIA:

Farida Ithnin, Yvonne Lim, Alex T. Sia, and Cecilia E. Ocampo

Combined Spinal Epidural Causes Higher Level of Block than Equivalent Single-Shot Spinal Anesthesia in Elective Cesarean Patients
Anesth Analg 2006 102: 577-580. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Spinal block from a combined spinal epidural technique results in a more extensive spread of local anesthetic in the subarachnoid space than spinal block from the single spinal shot technique when administered to parturients for cesarean delivery. A smaller dose is required to achieve a similar level of block when the combined spinal epidural technique is used.

Ashraf S. Habib, Nilda Itchon-Ramos, Barbara G. Phillips-Bute, Tong J. Gan, and the Duke Women’s Anesthesia (DWA) Research Group

Transcutaneous Acupoint Electrical Stimulation with the ReliefBand® for the Prevention of Nausea and Vomiting During and After Cesarean Delivery Under Spinal Anesthesia (Brief Report)
Anesth Analg 2006 102: 581-584. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Transcutaneous acupoint electrical stimulation at the P6 point using the ReliefBand(R) was not associated with a significant reduction in the incidence of nausea or vomiting during and after cesarean delivery performed with spinal anesthesia.

Andrea J. Fuller, Brendan Carvalho, Catherine Brummel, and Edward T. Riley

Epidural Anesthesia for Elective Cesarean Delivery with Intraoperative Arterial Occlusion Balloon Catheter Placement (Case Report)
Anesth Analg 2006 102: 585-587. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Abnormal placental growth is an increasingly common cause of bleeding during cesarean delivery. Intraarterial balloon catheters can be used for hemorrhage control in obstetrics. We describe the anesthetic management of elective cesarean deliveries where hemorrhage was expected and balloon catheters were used.

REGIONAL ANESTHESIA:

R. Kyle Hanks, Ricardo Pietrobon, Karen C. Nielsen, Susan M. Steele, Marcy Tucker, David S. Warner, Kathryn P. King, and Stephen M. Klein

The Effect of Age on Sciatic Nerve Block Duration
Anesth Analg 2006 102: 588-592. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study demonstrates that complete return of sensory and motor function after a 1% mepivacaine sciatic nerve block was prolonged in older patients compared with younger patients. The difference was small and would not be perceived clinically. More investigation is warranted to determine the factors behind these findings.

Manuel Taboada, Jaime Rodríguez, Cristina Valiño, Javier Carceller, Begoña Bascuas, Juan Oliveira, Julian Alvarez, Francisco Gude, and Peter G. Atanassoff

What Is the Minimum Effective Volume of Local Anesthetic Required for Sciatic Nerve Blockade? A Prospective, Randomized Comparison Between a Popliteal and a Subgluteal Approach
Anesth Analg 2006 102: 593-597. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A comparison of two approaches to block the sciatic nerve demonstrated that a larger volume of local anesthetic is necessary following the distal posterior popliteal approach as compared with the proximal subgluteal approach.

Eilish M. Galvin, Sjoerd Niehof, Hector J. Medina, Freek J. Zijlstra, Jasper van Bommel, Jan Klein, and Serge J. C. Verbrugge

Thermographic Temperature Measurement Compared with Pinprick and Cold Sensation in Predicting the Effectiveness of Regional Blocks
Anesth Analg 2006 102: 598-604. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Using an infrared camera, we investigated the usefulness of temperature measurement for assessing the success or failure of axillary blockades. Our results show that thermography is an objective and more reliable method of axillary block assessment than either cold or pinprick testing.

Zekiye Bigat, Neval Boztug, Necmiye Hadimioglu, Nihan Cete, Nesil Coskunfirat, and Ertugrul Ertok

Does Dexamethasone Improve the Quality of Intravenous Regional Anesthesia and Analgesia? A Randomized, Controlled Clinical Study
Anesth Analg 2006 102: 605-609. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The study was designed to evaluate the effect of dexamethasone when added to lidocaine for IV regional anesthesia. The addition of 8 mg dexamethasone to lidocaine for IV regional anesthesia improves the quality of anesthesia and both intraoperative and postoperative analgesia.

Régis Fuzier, Olivier Fourcade, Valérie Fuzier, Sylvie Arnold, Jane Torrie, and Michel Olivier

The Feasibility and Efficacy of Short Axillary Catheters for Emergency Upper Limb Surgery: A Descriptive Series of 120 Cases (Brief Report)
Anesth Analg 2006 102: 610-614. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We describe a simple technique of a short axillary brachial plexus catheter placed using a fascial technique for emergency surgery. The technique provided successful surgical anesthesia and postoperative analgesia.

GENERAL ARTICLES:

Adrian Regli, Britta S. von Ungern-Sternberg, Werner M. Strobel, Hans Pargger, Antje Welge-Luessen, and Adrian Reber

The Impact of Postoperative Nasal Packing on Sleep-Disordered Breathing and Nocturnal Oxygen Saturation in Patients with Obstructive Sleep Apnea Syndrome
Anesth Analg 2006 102: 615-620. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Compared with a control group receiving general anesthesia, postoperative nasal packing was associated with an increase of sleep-disordered breathing and oxygen desaturations, which was not further worsened by the preexistence of obstructive sleep apnea syndrome if oxygen was given to these patients on the first postoperative night.

Carin Hagberg, Yefim Bogomolny, Clarence Gilmore, Valentine Gibson, Mark Kaitner, and Somya Khurana

An Evaluation of the Insertion and Function of a New Supraglottic Airway Device, the King LT ^TM, During Spontaneous Ventilation
Anesth Analg 2006 102: 621-625. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study determined that the second generation of the reusable King LT TM is a simple and reliable device for airway management during spontaneous ventilation in anesthetized patients scheduled for elective surgery.

Rochelle W. W. Cheung, Michael G. Irwin, Bassanio C. W. Law, and C. K. Chan

A Clinical Comparison of the Flexiblade^TM and Macintosh Laryngoscopes for Laryngeal Exposure in Anesthetized Adults
Anesth Analg 2006 102: 626-630. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The FlexibladeTM laryngoscope, after lever activation, is better than the Macintosh for laryngeal visualization in paralyzed adults.

Luis Gaitini, Boris Yanovski, Mustafa Somri, Sonia Vaida, Tome Riad, and David Alfery

A Comparison Between the PLA Cobra^TM and the Laryngeal Mask Airway Unique^TM During Spontaneous Ventilation: A Randomized Prospective Study
Anesth Analg 2006 102: 631-636. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The Laryngeal Mask Airway "Unique" and the Cobra Perilaryngeal Airway (CobraPLA) are supraglottic devices. We compared the performances of these devices during spontaneous ventilation in adult patients under general anesthesia. We found that they appear to be equally effective.

Jayashree Sood, Lakshmi Jayaraman, Ved P. Kumra, and Pradeep K. Chowbey

Laparoscopic Approach to Pheochromocytoma: Is a Lower Intraabdominal Pressure Helpful?
Anesth Analg 2006 102: 637-641. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Pheochromocytoma is an adrenal tumor that secretes certain hormones. Surgical manipulation of this tumor will result in excessive secretion of hormones leading to an increase in arterial blood pressure and heart rate. We conclude that a lower intraabdominal pressure of 8-10 mm Hg causes less catecholamine release and fewer hemodynamic fluctuations.

Nicki S. Tarant, Rhodel G. Dacanay, Brian W. Mecklenburg, Sean D. Birmingham, Eugenio Lujan, and Richard Green

Acute Appendicitis in a Patient with Undiagnosed Pheochromocytoma (Case Report)
Anesth Analg 2006 102: 642-643. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A patient presenting with acute appendicitis had surgery cancelled because of suspected pheochromocytoma. The possibility of mortality associated with surgery in a patient with pheochromocytoma outweighed the risk of nonoperative management for appendicitis. This case resulted in a nonoperative resolution of appendicitis and an unremarkable recovery.

LETTER TO THE EDITOR:

Kevin K. Tremper, Amy Shanks, Michelle Morris, and Dave A. Burnett

Validation of Institutional Support Survey for Anesthesiology Training Programs in the United States
Anesth Analg 2006 102: 644. [Full Text] [PDF]  

John G. Brock-Utne, Patrick Bolton, and Gina Marie Zisook

Hasty C-arm Positioning: A Recipe for Disaster
Anesth Analg 2006 102: 644. [Full Text] [PDF]  

Peter Paal, Guenther Putz, Elisabeth Gruber, Giao T. Q. Le, and Peter Lemberger

Subarachnoid Hemorrhage After Lumbar Puncture in a Patient Receiving Aspirin and Clopidrogel
Anesth Analg 2006 102: 644-645. [Full Text] [PDF]  

Najib Babul, Paul Sloan, and Arthur G. Lipman

Safety of Cox-2 Selective Nonsteroidal Antiinflammatory Drugs for Postsurgical Pain
Anesth Analg 2006 102: 645-646. [Full Text] [PDF]  

Paul F. White

Safety of Cox-2 Selective Nonsteroidal Antiinflammatory Drugs for Postsurgical Pain
Anesth Analg 2006 102: 646. [Full Text] [PDF]  

Timothy E. Smith and Wm. Gavin Elliott

Routine Inhaled Induction in Adults: A Safe Practice?
Anesth Analg 2006 102: 646-647. [Full Text] [PDF]  

Anton A. van den Berg and Abdelaly Abeidi

Routine Inhaled Induction in Adults: A Safe Practice?
Anesth Analg 2006 102: 647. [Full Text] [PDF]  

Payam Eghtesadi-Araghi and Seyed Mojtaba Marashi

Reliability Measurement with Unreliable Method
Anesth Analg 2006 102: 647-648. [Full Text] [PDF]  

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

Reliability Measurement with Unreliable Method
Anesth Analg 2006 102: 648. [Full Text] [PDF]  

Rajesh Mahajan, Rahul Gupta, and Anju Sharma

Extravasation Injury Caused by Propofol
Anesth Analg 2006 102: 648. [Full Text] [PDF]  

Matthias Hübler and Sebastian N. Stehr

Not All Reasons for Difficult Peripheral Nerve Blocks Are at the Proximal End of the Needle
Anesth Analg 2006 102: 649. [Full Text] [PDF]  

Roser Garcia-Guasch

Double Arndt Bronchial Blocker Technique: Was It Necessary?
Anesth Analg 2006 102: 649. [Full Text] [PDF]  

W. C. Culp, Jr and Michael P. Kinsky

Double Arndt Bronchial Blocker Technique: Was It Necessary?
Anesth Analg 2006 102: 649-650. [Full Text] [PDF]  

Evan G. Pivalizza, Robert D. Warters, and Peter Szmuk

Appropriate Response to Hypotension
Anesth Analg 2006 102: 650. [Full Text] [PDF]  

Günter Luckner

Appropriate Response to Hypotension
Anesth Analg 2006 102: 650. [Full Text] [PDF]  

Robert R. Gaiser

Small Group Teaching and the Outcomes Project
Anesth Analg 2006 102: 650. [Full Text] [PDF]  

Jacques E. Chelly and Nader F.H. Adelmassieh

Was the Postoperative Nerve Injury Really Related to the Performance of the Block?
Anesth Analg 2006 102: 650-651. [Full Text] [PDF]  

Admir Hadzic

Was the Postoperative Nerve Injury Really Related to the Performance of the Block?
Anesth Analg 2006 102: 651. [Full Text] [PDF]  

Daniel A. Reuter and Alwin E. Goetz

Differentiating "Volumetric Preload Monitoring" and Assessing "Fluid Responsiveness"
Anesth Analg 2006 102: 651-652. [Full Text] [PDF]  

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

Differentiating "Volumetric Preload Monitoring" and Assessing "Fluid Responsiveness"
Anesth Analg 2006 102: 652. [Full Text] [PDF]  

Stephan Blumenthal, Hans Jutzi, and Alain Borgeat

Is the Interscalene Brachial Plexus Block the Best Approach?
Anesth Analg 2006 102: 652-653. [Full Text] [PDF]  

Fatis Altintas

Is the Interscalene Brachial Plexus Block the Best Approach?
Anesth Analg 2006 102: 653. [Full Text] [PDF]  

Luiz F. Souza

Ghost-Boostering Phantom Gradients
Anesth Analg 2006 102: 653-654. [Full Text] [PDF]  

Wanda M. Popescu

Ghost-Boostering Phantom Gradients
Anesth Analg 2006 102: 654. [Full Text] [PDF]  

Donald H. Lambert

Is TNS Really No Big Deal?
Anesth Analg 2006 102: 654. [Full Text] [PDF]  

D. Zaric, C. Christiansen, N. L. Pace, and Yodying Punjasawadwong

Is TNS Really No Big Deal?
Anesth Analg 2006 102: 654-655. [Full Text] [PDF]  

George A. Mashour, Wilton Levine, and Vilma E. Ortiz

Intraoperative Harlequin Syndrome
Anesth Analg 2006 102: 655. [Full Text] [PDF]  

Karl Wagner and Joy Loy

A Strange Place to Find a Cable Tie
Anesth Analg 2006 102: 655-656. [Full Text] [PDF]  

BOOK AND MULTIMEDIA REVIEWS:

Pablo Motta

Core Topics in Cardiac Anaesthesia
Anesth Analg 2006 102: 657. [Full Text] [PDF]  

Paul S. Molinari

Recent Advances in Anaesthesia and Intensive Care, Vol. 23
Anesth Analg 2006 102: 657-658. [Full Text] [PDF]  

Patrick Neligan

Morbid Obesity: Perioperative Management
Anesth Analg 2006 102: 658. [Full Text] [PDF]  

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