CARDIOVASCULAR ANESTHESIA:

Hilde Pleym, Alexander Wahba, Vibeke Videm, Arne Åsberg, Stian Lydersen, Lise Bjella, Ola Dale, and Roar Stenseth

Increased Fibrinolysis and Platelet Activation in Elderly Patients Undergoing Coronary Bypass Surgery
Anesth Analg 2006 102: 660-667. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Elderly patients have an increased risk of excessive bleeding and reexploration after cardiac surgery. This may be caused by increased activation of the hemostatic system, in particular the increase in postoperative fibrinolysis.

Craig A. McCutcheon, Ruari M. Orme, David A. Scott, Michael J. Davies, and Desmond P. McGlade

A Comparison of Dexmedetomidine Versus Conventional Therapy for Sedation and Hemodynamic Control During Carotid Endarterectomy Performed Under Regional Anesthesia
Anesth Analg 2006 102: 668-675. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dexmedetomidine is a sedative drug with hemodynamic effects that is being used more frequently in anesthesia. This study addresses the suitability of dexmedetomidine supplementing regional anesthesia during awake carotid endarterectomy.

María Jesús Juan-Fita, María Luisa Vargas, and Jesús Hernández

Diazepam Enhances Inotropic Responses to Dopamine in Rat Ventricular Myocardium
Anesth Analg 2006 102: 676-681. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using electrically stimulated right ventricular rat myocardium it was shown that diazepam enhances the effects of dopamine on contractility and cAMP tissue levels, producing a synergistic interaction.

Soon-Eun Park, Ju-Tae Sohn, Cheol Kim, Ki Churl Chang, Il-Woo Shin, Kyeong-Eon Park, Heon-Keun Lee, and Young-Kyun Chung

Diazepam Attenuates Phenylephrine-Induced Contractions in Rat Aorta
Anesth Analg 2006 102: 682-689. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Diazepam at a clinical concentration attenuates phenylephrine-induced contractions via an endothelium-dependent mechanism involving increased endothelial nitric oxide activity. This diazepam-induced attenuation does not occur via peripheral benzodiazepine receptor activation.

James Y. Findlay, Bhargavi Gali, Mark T. Keegan, Christopher M. Burkle, and David J. Plevak

Vasotrac® Arterial Blood Pressure and Direct Arterial Blood Pressure Monitoring During Liver Transplantation (Brief Report)
Anesth Analg 2006 102: 690-693. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared Vasotrac(R) noninvasive arterial blood pressures to direct radial arterial blood pressures during liver transplantation. The Vasotrac(R) was not sufficiently accurate to substitute for direct arterial blood pressure monitoring.

Isobel A. Russell, Kathryn Rouine-Rapp, Greg Stratmann, and Wanda C. Miller-Hance

Congenital Heart Disease in the Adult: A Review with Internet-Accessible Transesophageal Echocardiographic Images (Review Article)
Anesth Analg 2006 102: 694-723. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

Douglas Jackson, Andrei Botea, Yuriy Gubenko, Ellise Delphin, and Henry Bennett

Successful Intraoperative Use of Recombinant Tissue Plasminogen Activator During Liver Transplantation Complicated by Massive Intracardiac/Pulmonary Thrombosis (Case Report)
Anesth Analg 2006 102: 724-728. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Antifibrinolytic drugs have been associated with fatal intraoperative intracardiac/pulmonary thromboembolism during liver transplantation. We report the successful intraoperative resuscitation of a patient in cardiogenic shock with thrombolytic therapy.

J. W. Allyn, P. F. Lennon, J. H. Siegle, R. D. Quinn, and M. N. D’Ambra

The Use of Epicardial Echocardiography as an Adjunct to Transesophageal Echocardiography for the Detection of Pulmonary Embolism (Echo Rounds)
Anesth Analg 2006 102: 729-730. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

PEDIATRIC ANESTHESIA:

Donald M. Arnold, Dean A. Fergusson, Anthony K.C. Chan, Richard J. Cook, Graeme A. Fraser, Wendy Lim, Morris A. Blajchman, and Deborah J. Cook

Avoiding Transfusions in Children Undergoing Cardiac Surgery: A Meta-Analysis of Randomized Trials of Aprotinin
Anesth Analg 2006 102: 731-737. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this meta-analysis of randomized controlled trials, aprotinin reduced the proportion of children who received blood transfusions during cardiac surgery. However, the sustained effect of aprotinin on reducing blood loss remains uncertain. Further rigorous clinical trials with clinically important outcomes are needed before aprotinin can be routinely recommended.

Karynn Imbeault, Davina E. Withington, and France Varin

Pharmacokinetics and Pharmacodynamics of a 0.1 mg/kg Dose of Cisatracurium Besylate in Children During N₂O/O₂/Propofol Anesthesia
Anesth Analg 2006 102: 738-743. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cisatracurium was shown to provide safe muscle relaxation in children 1-6 yr old during propofol anesthesia by studying cisatracurium blood levels and depth of paralysis. Differences in pharmacokinetics/pharmacodynamics from adults highlight the need for pediatric studies to guide dosing and predict duration of action in children.

Christophe Dadure, Sophie Bringuier, Florence Nicolas, Luke Bromilow, Olivier Raux, Alain Rochette, and Xavier Capdevila

Continuous Epidural Block Versus Continuous Popliteal Nerve Block for Postoperative Pain Relief After Major Podiatric Surgery in Children: A Prospective, Comparative Randomized Study
Anesth Analg 2006 102: 744-749. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Continuous popliteal nerve block is an effective technique for analgesia after orthopedic podiatric surgery in children. The advantages of continuous popliteal block compared with continuous epidural block relate primarily to adverse events.

Ronald S. Litman, Joseph M. McDonough, Carole L. Marcus, Alan R. Schwartz, and Denham S. Ward

Upper Airway Collapsibility in Anesthetized Children
Anesth Analg 2006 102: 750-754. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using dynamic application of negative airway pressure, we determined the upper airway closing characteristics of anesthetized healthy children. During 1 MAC levels of inhaled anesthesia, halothane appears to cause less upper airway obstruction than sevoflurane at equipotent concentrations.

AMBULATORY ANESTHESIA:

Hans-F Gramke, Jurgen J. J. Petry, Marcel E. Durieux, Jean-P Mustaki, Marcel Vercauteren, Georges Verheecke, and Marco A. E. Marcus

Sublingual Piroxicam for Postoperative Analgesia: Preoperative Versus Postoperative Administration: A Randomized, Double-Blind Study
Anesth Analg 2006 102: 755-758. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Preoperative piroxicam may provide improvements of postoperative analgesia with laparoscopic hernia repair procedures compared with postoperatively administered piroxicam.

Girish P. Joshi

The Society for Ambulatory Anesthesia: 20th Annual Meeting Report (Meeting Report)
Anesth Analg 2006 102: 759-763. [Full Text] [PDF] [Request Permissions]  

ANESTHETIC PHARMACOLOGY:

Jason C. Sewell and John W. Sear

Determinants of Volatile General Anesthetic Potency: A Preliminary Three-Dimensional Pharmacophore for Halogenated Anesthetics
Anesth Analg 2006 102: 764-771. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe the derivation of an activity model for halogenated volatile anesthetics using molecular modeling. Pharmacophoric maps are derived that describe the molecular basis for the immobilizing activity of the anesthetics in terms of the spatial distribution of key electrostatic and steric regions.

Takehisa Asahi, Koki Hirota, Rika Sasaki, Yamazaki Mitsuaki, and Sheldon H. Roth

Intravenous Anesthetics Are More Effective than Volatile Anesthetics on Inhibitory Pathways in Rat Hippocampal CA1
Anesth Analg 2006 102: 772-778. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined whether excitatory or inhibitory synapses are the major targets of anesthetic action. Sevoflurane and isoflurane inhibit mainly glutamate-mediated orthodromic pathways, whereas thiopental and propofol enhance {gamma}-aminobutyric acid-A-mediated recurrent inhibitory pathways in CA1 neurons, thus providing further evidence that mechanisms of general anesthetics are drug- and pathway-specific.

Joseph F. Cotten, Bharat Keshavaprasad, Michael J. Laster, Edmond I. Eger, II, and C. Spencer Yost

The Ventilatory Stimulant Doxapram Inhibits TASK Tandem Pore (K_2P) Potassium Channel Function but Does Not Affect Minimum Alveolar Anesthetic Concentration
Anesth Analg 2006 102: 779-785. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study demonstrates that TASK potassium channels are plausible molecular targets for doxapram yet do not contribute to halothane-induced immobility (minimum alveolar anesthetic concentration).

Hiroyuki Kinoshita, Mayuko Dojo, Katsutoshi Nakahata, Yoshiki Kimoto, Tetsuya Kakutani, Kazuhiro Mizumoto, and Yoshio Hatano

Augmented Activity of Adenosine Triphosphate-Sensitive K⁺ Channels Induced by Droperidol in the Rat Aorta
Anesth Analg 2006 102: 786-791. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Droperidol augments activity of adenosine triphosphate-sensitive K+ channels of vascular smooth muscle cells. It is unlikely that this augmentation of vasodilation is mediated by the inhibition of {alpha}-adrenergic receptors in the vascular smooth muscle.

Núbia G. B. Chedid, Roberto T. Sudo, Marli I. S. Aguiar, Margarete M. Trachez, Masako O. Masuda, and Gisele Zapata-Sudo

Regulation of Intracellular Calcium by Bupivacaine Isomers in Cardiac Myocytes from Wistar Rats
Anesth Analg 2006 102: 792-798. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the effects of racemic bupivacaine and its isomers on Ca2+ handling by ventricular myocytes of Wistar rats. Racemic bupivacaine and the isomers increased the sensitivity of the contractile system to Ca2+. The increase of intracellular Ca2+ concentration in cardiac myocytes was consequent to an increase of Ca2+ release from sarcoplasmic reticulum that was stereoselective for S(-) bupivacaine.

Thomas A. Stekiel, Stephen J. Contney, Zeljko J. Bosnjak, John P. Kampine, Richard J. Roman, and William J. Stekiel

Chromosomal Substitution-Dependent Differences in Cardiovascular Responses to Sodium Pentobarbital
Anesth Analg 2006 102: 799-805. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Substitution of Brown Norway chromosome 13 (but not 16) into an otherwise unchanged Dahl Salt Sensitive genetic background significantly reduced the vascular smooth muscle hyperpolarization produced by sodium pentobarbital. This reduction correlated with an increase in the maximum cumulative dose tolerated before the onset of cardiovascular collapse.

Chiu-Ming Ho and Chun-Kuei Su

Ketamine Attenuates Sympathetic Activity Through Mechanisms not Mediated by N-Methyl-d-Aspartate Receptors in the Isolated Spinal Cord of Neonatal Rats
Anesth Analg 2006 102: 806-810. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ketamine has sympathomimetic actions, although the underlying mechanism remains unclear. We used an in vitro neonatal rat splanchnic nerve-spinal cord preparation to demonstrate that ketamine reduces tonic sympathetic activity by mechanisms independent of N-methyl-d-aspartate receptor activity.

Taeko Fukuda, Kazuhiro Watanabe, Setsuji Hisano, and Hidenori Toyooka

Licking and C-Fos Expression in the Dorsal Horn of the Spinal Cord After the Formalin Test (Brief Report)
Anesth Analg 2006 102: 811-814. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The purpose of this study was to investigate whether c-fos expression of the dorsal horn is affected by licking in the formalin test. Restriction of licking decreased c-fos expression to 59% of that in the unrestricted rats. Thus, licking plays an important role in c-fos expression after formalin injection.

Igor Kwetny and Brendan T. Finucane

Negative Arterial to End-Tidal Carbon Dioxide Gradient: An Additional Sign of Malignant Hyperthermia During Desflurane Anesthesia (Case Report)
Anesth Analg 2006 102: 815-817. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Desflurane anesthesia often results in delayed onset of malignant hypothermia (MH) symptoms. We describe an unusual case of MH in which a negative value of (a-ET) Pco 2 gradient has been used as a diagnostic and monitoring tool.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Mohamed Naguib, Franklin L. Scamman, Cormac O'Sullivan, John Aker, Alan F. Ross, Steven Kosmach, and Joe E. Ensor

Predictive Performance of Three Multivariate Difficult Tracheal Intubation Models: A Double-Blind, Case-Controlled Study
Anesth Analg 2006 102: 818-824. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study is the first to provide an evidence-based foundation for selection of the most sensitive model for prediction of unanticipated difficult tracheal intubation.

Wolfgang J. Kox, Christian von Heymann, Judith Heinze, Leslie S. Prichep, E. Roy John, and Ingrid Rundshagen

Electroencephalographic Mapping During Routine Clinical Practice: Cortical Arousal During Tracheal Intubation?
Anesth Analg 2006 102: 825-831. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Achieving an adequate depth of anesthesia is of major importance for anesthesiologists. Multichannel electroencephalography recorded during administration of routine clinical anesthesia demonstrated a wake-up (arousal) phenomenon during tracheal intubation. Quantitative electroencephalography is discussed as a sensitive method to measure anesthetic depth.

PAIN MEDICINE:

Alexandre R. Oliveira and Helena M. T. Barros

Ultrasonic Rat Vocalizations During the Formalin Test: A Measure of the Affective Dimension of Pain?
Anesth Analg 2006 102: 832-839. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: An affective component must be studied to improve behavioral measures during animal models of pain. The present study tested formalin concentrations to induce ultrasonic vocalization (USV) in the formalin test and the effects of opioids on USV during the interphase of the formalin test. This is a demonstration of USV emission during the formalin test and the influence of opioids on this behavior.

Dieter Kleinböhl, Roman Görtelmeyer, Hans-Joachim Bender, and Rupert Hölzl

Amantadine Sulfate Reduces Experimental Sensitization and Pain in Chronic Back Pain Patients
Anesth Analg 2006 102: 840-847. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study introduces psychophysical markers of enhanced short-term sensitization in chronic musculoskeletal pain to differentially indicate and control the adjuvant treatment with the N-methyl-d-aspartate receptor antagonist amantadine sulfate, showing that pharmacological blockade of this type alters sensitization and might be related to clinical pain improvement.

Paul M. Murphy, Danielle E. Skouvaklis, Ryan J.J. Amadeo, Craig Haberman, David H. Brazier, and Michael J. Cousins

Intrathecal Catheter Granuloma Associated with Isolated Baclofen Infusion
Anesth Analg 2006 102: 848-852. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Catheter-associated granuloma is a recognized complication of intrathecal drug delivery that has not previously been associated with isolated baclofen infusion. This report suggests that the possibility of catheter-associated granuloma must be considered in all patients receiving intrathecal baclofen presenting with altered neurological function or significant increase in drug requirement.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Haim Berkenstadt, Amitai Ziv, Naomi Gafni, and Avner Sidi

Incorporating Simulation-Based Objective Structured Clinical Examination into the Israeli National Board Examination in Anesthesiology
Anesth Analg 2006 102: 853-858. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Simulation-based objective structured clinical evaluation can be incorporated into the National Board Examination in Anesthesiology.

Lisa C. Silcox, Ted L. Ashbury, Elizabeth G. VanDenKerkhof, and Brian Milne

Residents' and Program Directors' Attitudes Toward Research During Anesthesiology Training: A Canadian Perspective
Anesth Analg 2006 102: 859-864. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: Residents and program directors generally agree about the barriers to resident research. Seventy-five percent of residents would prefer to spend time in alternate academic activities rather than undertaking a research project during residency training.

Peta G. Lorraway, Georges L. Savoldelli, Hwan S. Joo, Deven B. Chandra, Roger Chow, and Viren N. Naik

Management of Simulated Oxygen Supply Failure: Is There a Gap in the Curriculum? (Brief Report)
Anesth Analg 2006 102: 865-867. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Residents showed deficiency in managing simulated oxygen failure. The majority of the participants did not recognize the problem and did not know how to change the oxygen cylinder. The delegation of gas machine maintenance to perioperative personnel may have created this new gap in equipment knowledge.

CRITICAL CARE AND TRAUMA:

E. Andrew Ochroch, Michael W. Russell, William C. Hanson, III, Gayle A. Devine, Andrew J. Cucchiara, Mark G. Weiner, and Sanford J. Schwartz

The Impact of Continuous Pulse Oximetry Monitoring on Intensive Care Unit Admissions from a Postsurgical Care Floor
Anesth Analg 2006 102: 868-875. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In a randomized and nonblinded study, centrally monitored continuous pulse oximetry did not alter the rate of admission to the intensive care unit from a postsurgical care floor, mortality, or total hospital estimated cost. Use of continuous pulse oximetry did result in reduced estimated cost and length of intensive care unit stay, possibly by allowing for earlier intervention in pulmonary complications.

Ismet Topcu, N. Zeynep Ekici, Rusen Isik, and Melek Sakarya

The Effects of Tramadol and Fentanyl on Gastrointestinal Motility in Septic Rats
Anesth Analg 2006 102: 876-881. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The antitransit effect of fentanyl is increased during acute systemic inflammation in experimental sepsis, but no decrease in gastrointestinal transit is obtained with tramadol. This is a consideration in the choice of an appropriate analgesic regimen for patients with sepsis in the intensive care unit.

NEUROSURGICAL ANESTHESIA:

Andrius P. Skucas and Alan A. Artru

Anesthetic Complications of Awake Craniotomies for Epilepsy Surgery
Anesth Analg 2006 102: 882-887. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We performed a retrospective chart review of awake craniotomies for epilepsy at a single, large-volume center and examined the incidence of complications when using a uniform anesthetic protocol with unprotected airways. Clinically significant respiratory, hemodynamic, or other complications were uncommon.

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

The Effects of Stimulation Pattern and Sevoflurane Concentration on Intraoperative Motor-Evoked Potentials
Anesth Analg 2006 102: 888-895. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effects of different stimulation patterns and different concentrations of sevoflurane on intraoperative motor-evoked potentials were investigated in a prospective, randomized study. High frequency repetitive stimulation overcame the suppressive effects of sevoflurane and, thus, allowed intraoperative monitoring of motor-evoked potentials during inhaled anesthesia with sevoflurane and remifentanil.

John C. Drummond, Raymond N. Englander, and Catherine J. Gallo

Cerebral Ischemia as an Apparent Complication of Anterior Cervical Discectomy in a Patient with an Incomplete Circle of Willis (Case Report)
Anesth Analg 2006 102: 896-899. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anterior cervical discectomy entails a small but finite risk of cerebral ischemia related to carotid compression. This risk may be increased in sporadic patients with an incomplete circle of Willis, a normal anatomic variant. This report reaffirms the importance of intraoperative measures to confirm the patency of the carotid artery and suggests that hypotension that is not essential to the conduct of the procedure should be avoided.

OBSTETRIC ANESTHESIA:

Chiu-Ming Ho, Hsin-Jung Tsai, Kwok-Hon Chan, and Shen-Kou Tsai

P6 Acupressure Does Not Prevent Emesis During Spinal Anesthesia for Cesarean Delivery
Anesth Analg 2006 102: 900-903. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Emesis is a major adverse effect during cesarean delivery under spinal anesthesia. We showed that prophylactic use of bilateral acupressure bands on the P6 acupoint was ineffective in preventing nausea and vomiting during elective cesarean delivery under spinal anesthesia.

Cynthia A. Wong, John T. Ratliff, John T. Sullivan, Barbara M. Scavone, Paloma Toledo, and Robert J. McCarthy

A Randomized Comparison of Programmed Intermittent Epidural Bolus with Continuous Epidural Infusion for Labor Analgesia
Anesth Analg 2006 102: 904-909. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Programmed intermittent epidural bolus provided similar analgesia with a smaller bupivacaine dose and better patient satisfaction compared with a continuous epidural infusion for maintenance of labor analgesia.

James Warren and Shiv K. Sharma

Ventilatory Support Using Bilevel Positive Airway Pressure During Neuraxial Blockade in a Patient with Severe Respiratory Compromise (Case Report)
Anesth Analg 2006 102: 910-911. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report indicates that a successful neuraxial anesthesia in parturients with myasthenia gravis and severe respiratory compromise is possible with a noninvasive ventilatory support.

REGIONAL ANESTHESIA:

Vincent Minville, Olivier Fourcade, Lamia Idabouk, Jonathan Claassen, Clément Chassery, Luc Nguyen, Jean-Claude Pourrut, and Dan Benhamou

Infraclavicular Brachial Plexus Block Versus Humeral Block in Trauma Patients: A Comparison of Patient Comfort
Anesth Analg 2006 102: 912-915. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study showed that infraclavicular brachial plexus block resulted in less discomfort during block placement than humeral block in trauma patients.

Selda Sen, Bakiye Ugur, Osman N. Aydin, Mustafa Ogurlu, Feray Gursoy, and Oner Savk

The Analgesic Effect of Nitroglycerin Added to Lidocaine on Intravenous Regional Anesthesia
Anesth Analg 2006 102: 916-920. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that the addition of IV nitroglycerin to a local anesthetic (lidocaine) may influence the extent of sensorial and motor blockade and tourniquet pain during IV regional anesthesia and maintains better postoperative analgesia without side effects.

Joanne Guay

The Epidural Test Dose: A Review
Anesth Analg 2006 102: 921-929. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The epinephrine test dose for intravascular epidural needle/catheter misplacement can only be recommended for nonpregnant adult patients and children. More studies are required to determine the best strategies to detect intrathecal and subdural needle/catheter misplacement for adult nonpregnant patients, pregnant women, and children.

Yumika Koizumi, Mishiya Matsumoto, Atsuo Yamashita, Shunsuke Tsuruta, Takanao Ohtake, and Takefumi Sakabe

The Effects of an AMPA Receptor Antagonist on the Neurotoxicity of Tetracaine Intrathecally Administered in Rabbits
Anesth Analg 2006 102: 930-936. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Large concentrations of intrathecal local anesthetics increase glutamate concentrations in the cerebrospinal fluid and cause neuronal injury. The current study suggests that {alpha}-amino-3-hydroxy-5-methylisoxazole-4-propionic acid (AMPA) receptor activation is involved, at least in part, in the tetracaine-induced neurotoxicity in the spinal cord.

GENERAL ARTICLES:

Matthias Eikermann, Manfred Blobner, Harald Groeben, Christopher Rex, Thomas Grote, Markus Neuhäuser, Martin Beiderlinden, and Jürgen Peters

Postoperative Upper Airway Obstruction After Recovery of the Train of Four Ratio of the Adductor Pollicis Muscle from Neuromuscular Blockade
Anesth Analg 2006 102: 937-942. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A combination of train-of-four (TOF) monitoring with other monitoring methods, e.g., forced vital capacity fade or testing the ability to swallow normally, may increase the ability to detect "outliers," i.e., patients with persistent effects of neuromuscular blockade on upper airway integrity despite recovery of the TOF ratio.

Thomas Mencke, Heike Knoll, Jan-Uwe Schreiber, Matthias Echternach, Sarah Klein, Gabriele Noeldge-Schomburg, and Malte Silomon

Rocuronium Is Not Associated with More Vocal Cord Injuries than Succinylcholine After Rapid-Sequence Induction: A Randomized, Prospective, Controlled Trial
Anesth Analg 2006 102: 943-949. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We tested the hypothesis that a rapid-sequence induction with succinylcholine would lead to less vocal cord injuries than with rocuronium. Intubating conditions were significantly better in the succinylcholine group compared with the rocuronium group. However, the rate of adverse airway effects was not different between groups. Succinylcholine should be used if excellent intubating conditions are mandatory.

Terese T. Horlocker, James R. Hebl, Bhargavi Gali, Christopher J. Jankowski, Christopher M. Burkle, Daniel J. Berry, Fernando A. Zepeda, Susanna R. Stevens, and Darrell R. Schroeder

Anesthetic, Patient, and Surgical Risk Factors for Neurologic Complications After Prolonged Total Tourniquet Time During Total Knee Arthroplasty
Anesth Analg 2006 102: 950-955. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Neurologic complications after total knee arthroplasty were associated with younger age, the presence of a flexion contracture preoperatively, and longer total tourniquet time. Identification of risk factors may theoretically improve patient care by allowing optimization of surgical and anesthetic techniques to avoid nerve injury, as well as early diagnosis and intervention to improve neurologic recovery.

Deborah J. Culley, Alexander Loguinov, Rustam Yukhananov, and Gregory Crosby

General Anesthesia Does Not Reduce Life Expectancy in Aged Rats
Anesth Analg 2006 102: 956-959. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the effect of general anesthesia with 1.2% isoflurane-70% nitrous oxide-30% on life expectancy in aged Fischer 344 rats. We found no differences in long-term survival between the anesthetized and control groups, indicating that general anesthesia does not reduce life expectancy in rodents.

Kai O. Schoenhage and Heidi M. Koenig

Unanticipated Difficult Endotracheal Intubations in Patients with Cervical Spine Instrumentation (Case Report)
Anesth Analg 2006 102: 960-963. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This report highlights the importance of reviewing the most recent radiographs for potential airway compromise before anesthetizing patients presenting for revision of cervical instrumentation.

COCHRANE CORNER:

D. Gillies, L. O’Riordan, M. Wallen, A. Morrison, K. Rankin, and S. Nagy

Optimal Timing for Intravenous Administration Set Replacement
Anesth Analg 2006 102: 964. [Full Text] [PDF] [Request Permissions]  

M. Buzzarro and I. Gross

Inhaled Nitric Oxide for the Postoperative Management of Pulmonary Hypertension in Infants and Children with Congenital Heart Disease
Anesth Analg 2006 102: 964. [Full Text] [PDF] [Request Permissions]  

LETTER TO THE EDITOR:

Indu Bala, Babita Ghai, Arun Kumar, and Monica Pratap

Bilateral Pupillary Dilatation After Intracisternal Papaverine Application
Anesth Analg 2006 102: 965. [Full Text] [PDF] [Request Permissions]  

Avery Tung, Jennifer Anderson, Suanne Daves, Darrel Waggoner, and Madelyn Kahana

Hypernatremia After Cleft Lip Repair in a Patient with Holoprosencephaly
Anesth Analg 2006 102: 965-966. [Full Text] [PDF] [Request Permissions]  

Satoshi Hagihira, Masaki Takashina, Takahiko Mori, and Takashi Mashimo

EEG During Anesthesia Is Not a Linear Random Process
Anesth Analg 2006 102: 966. [Full Text] [PDF] [Request Permissions]  

Christian Jeleazcov, Jörg Fechner, and Helmut Schwilden

EEG During Anesthesia Is Not a Linear Random Process
Anesth Analg 2006 102: 966-967. [Full Text] [PDF] [Request Permissions]  

Mats Enlund

TIVA, Awareness, and the Brice Interview
Anesth Analg 2006 102: 967. [Full Text] [PDF] [Request Permissions]  

Edmond I. Eger, II and James M. Sonner

TIVA, Awareness, and the Brice Interview
Anesth Analg 2006 102: 967. [Full Text] [PDF] [Request Permissions]  

Adhikary Sanjib Das and K. Srinivasa Babu

Informed Awareness: Is It Ethical?
Anesth Analg 2006 102: 967-968. [Full Text] [PDF] [Request Permissions]  

Paul F. White

Informed Awareness: Is It Ethical?
Anesth Analg 2006 102: 968. [Full Text] [PDF] [Request Permissions]  

Aryeh Shander and David Moskowitz

Hydroxyethyl Starch and Risk of Bleeding: The Missing Links
Anesth Analg 2006 102: 968. [Full Text] [PDF] [Request Permissions]  

Ramiro Arellano

Hydroxyethyl Starch and Risk of Bleeding: The Missing Links
Anesth Analg 2006 102: 968. [Full Text] [PDF] [Request Permissions]  

Berend Mets and Kent Eckerd

Faculty Incentive Plans: Clinical or Academic Productivity or Both?
Anesth Analg 2006 102: 968-969. [Full Text] [PDF] [Request Permissions]  

Ronald D. Miller and Neal H. Cohen

Faculty Incentive Plans: Clinical or Academic Productivity or Both?
Anesth Analg 2006 102: 969-970. [Full Text] [PDF] [Request Permissions]  

Stephan K. W. Schwarz

Can Items on an Aviation-Style Checklist for Preparation of Cesarean Delivery Under General Anesthesia Present a Threat for Patient Safety?
Anesth Analg 2006 102: 970. [Full Text] [PDF] [Request Permissions]  

Harry Owen and Elaine Hart

Can Items on an Aviation-Style Checklist for Preparation of Cesarean Delivery Under General Anesthesia Present a Threat for Patient Safety?
Anesth Analg 2006 102: 970. [Full Text] [PDF] [Request Permissions]  

M. A. Hamilton, M. G. Mythen, and G. L. Ackland

Less Is Not More: A Lack of Evidence for Intraoperative Fluid Restriction Improving Outcome After Major Elective Gastrointestinal Surgery
Anesth Analg 2006 102: 970-971. [Full Text] [PDF] [Request Permissions]  

Girish P. Joshi

Less Is Not More: A Lack of Evidence for Intraoperative Fluid Restriction Improving Outcome After Major Elective Gastrointestinal Surgery
Anesth Analg 2006 102: 971. [Full Text] [PDF] [Request Permissions]  

Ata Mahmoodpoor

Role for the Second Anesthesiologist in Failed Intubations
Anesth Analg 2006 102: 971. [Full Text] [PDF] [Request Permissions]  

Naveen Eipe, A. Dildeep Pillai, Ashish Choudhrie, and Rajiv Choudhrie

The Tongue Flap: An Iatrogenic Difficult Airway?
Anesth Analg 2006 102: 971-973. [Full Text] [PDF] [Request Permissions]  

Shigeki Yamaguchi, Kazumasa Urabe, Tomohito Ikeda, and Toshimitsu Kitajima

Airway Obstruction Due to Incarceration of the Epiglottis into the Epiglottic Bars During General Anesthesia with a New Perilaryngeal Airway (CobraPLA)
Anesth Analg 2006 102: 973. [Full Text] [PDF] [Request Permissions]  

Manuel C. Vallejo, Shawn T. Beaman, and Sivam Ramanathan

Blurred Vision as the only Symptom of a Positive Epidural Test Dose
Anesth Analg 2006 102: 973-974. [Full Text] [PDF] [Request Permissions]  

Sanford L. Klein and Dennis B. Hall

Concerns with Nerve Blocks at Home
Anesth Analg 2006 102: 974. [Full Text] [PDF] [Request Permissions]  

Brian M. Ilfeld and F. Kayser Enneking

Concerns with Nerve Blocks at Home
Anesth Analg 2006 102: 974. [Full Text] [PDF] [Request Permissions]  

Jaydev Sarma

Intubation Using an LMA and Gum Elastic Bougie
Anesth Analg 2006 102: 975. [Full Text] [PDF] [Request Permissions]  

Stephen O. Bader, Kirti K. Doshi, and Zvi Grunwald

A Novel Leak from an Unfamiliar Component
Anesth Analg 2006 102: 975-976. [Full Text] [PDF] [Request Permissions]  

Narasimhan Jagannathan

Vegan? Sorry, We Have Porcine Heparin on the Menu!
Anesth Analg 2006 102: 976. [Full Text] [PDF] [Request Permissions]  

Makiko Uji, Satoki Inoue, and Hitoshi Furuya

Sustained Hypertension at Reperfusion of the Transplanted Kidneys from the Non-Heart Beating Donor
Anesth Analg 2006 102: 976. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Donald R. Stanski

Gerry’s Real World Guide to Pharmacokinetics and Other Things.
Anesth Analg 2006 102: 977. [Full Text] [PDF] [Request Permissions]  

Julien F. Biebuyck

Pioneer British Anaesthetists, Vol. IX in the Careers in Anesthesiology series.
Anesth Analg 2006 102: 977-978. [Full Text] [PDF] [Request Permissions]  

Carin A. Hagberg

Core Topics in Airway Management.
Anesth Analg 2006 102: 978-979. [Full Text] [PDF] [Request Permissions]  

ERRATA:

Erratum
Anesth Analg 2006 102: 875. [Full Text] [PDF] [Request Permissions]  

Erratum
Anesth Analg 2006 102: 881. [Full Text] [PDF] [Request Permissions]  

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