EDITORIALS:

Steven L. Shafer

Thank You, Ron Miller (Editorial)
Anesth Analg 2006 102: 982-983. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Marc Lutz and Hong Liu

Inhaled Sevoflurane Produces Better Delayed Myocardial Protection at 48 Versus 24 Hours After Exposure
Anesth Analg 2006 102: 984-990. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A delayed window of volatile anesthetic preconditioning limits intracellular Na+ and Ca+2, prevents the depletion of adenosine triphosphate, and improves function after ischemia in isolated rat hearts. A 48-h delay provided better protection than a 24-h delay.

Paul G. Loubser and Anthony Chan

Prediction of the Effect of Acute Normovolemic Hemodilution on the Hematological Constituents of Sequestered Autologous Whole Blood
Anesth Analg 2006 102: 991-997. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A unique mathematical model was developed to predict the effect of acute normovolemic hemodilution on selected constituents of sequestered whole blood. This model provides an objective method of comparing blood sequestration techniques and clinical outcome in studies using hemodilution as a blood conservation method.

Tomi T. Niemi, Raili T. Suojaranta-Ylinen, Sinikka I. Kukkonen, and Anne H. Kuitunen

Gelatin and Hydroxyethyl Starch, but Not Albumin, Impair Hemostasis After Cardiac Surgery
Anesth Analg 2006 102: 998-1006. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Gelatin and hydroxyethyl starch, 15 mL kg-1 after on-pump cardiac surgery, significantly impair blood coagulation as assessed by thromboelastometry.

Tomoki Nishiyama

Antithrombin Can Modulate Coagulation, Cytokine Production, and Expression of Adhesion Molecules in Abdominal Aortic Aneurysm Repair Surgery
Anesth Analg 2006 102: 1007-1011. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In graft replacement of an abdominal aortic aneurysm, hypercoagulability and inflammatory reaction were observed. Antithrombin could inhibit these hypercoagulability and inflammatory reactions, which may decrease perioperative adverse events.

Gregory A. Nuttall, Nicole Henderson, Michael Quinn, Clay Blair, Layne Summers, Brent A. Williams, William C. Oliver, and Paula J. Santrach

Excessive Bleeding and Transfusion in a Prior Cardiac Surgery is Associated with Excessive Bleeding and Transfusion in the Next Surgery
Anesth Analg 2006 102: 1012-1017. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A history of excessive bleeding and blood transfusion in the first cardiac surgery is significantly associated with excessive bleeding and blood transfusion in a subsequent cardiac surgery.

Ting-Jie Zhang, Jian Hang, Da-Xiang Wen, Yan-Nan Hang, and Frederick E. Sieber

Hippocampus bcl-2 and bax Expression and Neuronal Apoptosis After Moderate Hypothermic Cardiopulmonary Bypass in Rats
Anesth Analg 2006 102: 1018-1025. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In rats, moderate hypothermic cardiopulmonary bypass with a hemodilution is associated with CA1 hippocampus bax and bcl-2 gene expression and neuronal apoptosis during the early postcardiopulmonary bypass recovery period.

Timo T. Laitio, Heikki V. Huikuri, Juha Koskenvuo, Jouko Jalonen, Timo H. Mäkikallio, Hans Helenius, Erkki S.H. Kentala, Jaakko Hartiala, and Harry Scheinin

Long-Term Alterations of Heart Rate Dynamics After Coronary Artery Bypass Graft Surgery
Anesth Analg 2006 102: 1026-1031. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Frequency domain measures of heart rate variability do not recover to the preoperative level 1 yr after coronary artery bypass graft surgery. Approximate entropy decreases significantly a year after surgery, indicating more predictable heart rate dynamics. The possible impact of these findings remains to be studied.

Ju Mizuno, Satoshi Mohri, Juichiro Shimizu, Shunsuke Suzuki, Takeshi Mikane, Junichi Araki, Hiromi Matsubara, Terumasa Morita, Kazuo Hanaoka, and Hiroyuki Suga

Starling-Effect-Independent Lusitropism Index in Canine Left Ventricle: Logistic Time Constant
Anesth Analg 2006 102: 1032-1039. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined whether and how the Frank-Starling effect influences the logistic time constant {tau}L proposed as an index of the rate of relaxation or lusitropism. We showed that left ventricular volume loading did not affect {tau}L but did slightly affect the conventional monoexponential time constant {tau}E.

Ayda Türköz, Öner Gülcan, Fahri Tercan, Tolga Koçum, and Riza Türköz

Hemodynamic Collapse Caused by a Large Unruptured Aneurysm of the Ascending Aorta in an 18 Year Old (Case Report)
Anesth Analg 2006 102: 1040-1042. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case in which hemodynamic collapse occurred because of severe compression of the right pulmonary artery and left mainstem bronchus by an aneurysm of the ascending aorta.

Nikolaos Skubas, Natalia Ivascu Brown, and Rakesh Mishra

Diagnostic Dilemma: A Pacemaker Lead Inside the Left Atrium or an Echocardiographic Beam Width Artifact? (Echo Rounds)
Anesth Analg 2006 102: 1043-1044. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

PEDIATRIC ANESTHESIA:

Richard J. Berens, Michael T. Meyer, Theresa A. Mikhailov, Krista D. Colpaert, Michelle L. Czarnecki, Nancy S. Ghanayem, George M. Hoffman, Deborah J. Soetenga, Thomas J. Nelson, and Steven J. Weisman

A Prospective Evaluation of Opioid Weaning in Opioid-Dependent Pediatric Critical Care Patients
Anesth Analg 2006 102: 1045-1050. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study evaluated the effectiveness of 2 methadone-weaning strategies, 5 versus 10 days, in pediatric critical care patients with physical dependence on opioid medications.

Gordon T. Wong, Igor Luginbuehl, Cengiz Karsli, and Bruno Bissonnette

The Effect of Sevoflurane on Cerebral Autoregulation in Young Children as Assessed by the Transient Hyperemic Response
Anesth Analg 2006 102: 1051-1055. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The transient hyperemic response test can be used in young children. The transient hyperemic response is preserved in children undergoing sevoflurane anesthesia at clinically relevant concentrations, suggesting preservation of cerebral autoregulation under these conditions.

Bernard J. Dalens, Anne Marie Pinard, Dany-Roch Létourneau, Natalie T. Albert, and René J. Y. Truchon

Prevention of Emergence Agitation After Sevoflurane Anesthesia for Pediatric Cerebral Magnetic Resonance Imaging by Small Doses of Ketamine or Nalbuphine Administered Just Before Discontinuing Anesthesia
Anesth Analg 2006 102: 1056-1061. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Small doses of ketamine or nalbuphine, administered at the end of a magnetic resonance imaging scan to patients anesthetized with sevoflurane anesthesia, reduce emergence agitation without delaying discharge. Nalbuphine offers the highest benefit/risk ratio.

Athena F. Zuppa, Susan C. Nicolson, Peter C. Adamson, Gil Wernovsky, John T. Mondick, Nancy Burnham, Timothy M. Hoffman, J. William Gaynor, Lauren A. Davis, William J. Greeley, Thomas L. Spray, and Jeffrey S. Barrett

Population Pharmacokinetics of Milrinone in Neonates with Hypoplastic Left Heart Syndrome Undergoing Stage I Reconstruction
Anesth Analg 2006 102: 1062-1069. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This clinical trial describes neonates with hypoplastic left heart syndrome undergoing stage I reconstruction pharmacokinetics of milrinone in this population and characterizes drug disposition during cardiopulmonary bypass, modified ultrafiltration, and in the postoperative period. Future clinical investigation will be required to explore whether the achievable milrinone concentrations are optimal with respect to individual patient outcomes.

Leonard Golden, Murali Pagala, Sujatha Sukhavasi, Dheeraj Nagpal, Ayeesha Ahmad, and Aruna Mahanta

Giving Toys to Children Reduces Their Anxiety About Receiving Premedication for Surgery (Brief Report)
Anesth Analg 2006 102: 1070-1072. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study assessed whether giving toys to children decreases anxiety about taking premedication before anesthesia. One-hundred children were randomized into toy and no-toy groups. Anxiety to receive midazolam was assessed using the Modified Yale Preoperative Anxiety Scale, and it was significantly reduced in the toy group.

AMBULATORY ANESTHESIA:

Paul F. White

Choice of Peripheral Nerve Block for Inguinal Herniorrhaphy: Is Better the Enemy of Good? (Editorial)
Anesth Analg 2006 102: 1073-1075. [Full Text] [PDF] [Request Permissions]  

Admir Hadzic, Beklen Kerimoglu, Dan Loreio, Pelin Emine Karaca, Richard E. Claudio, Marina Yufa, Ray Wedderburn, Alan C. Santos, and Daniel M. Thys

Paravertebral Blocks Provide Superior Same-Day Recovery over General Anesthesia for Patients Undergoing Inguinal Hernia Repair
Anesth Analg 2006 102: 1076-1081. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In outpatients undergoing inguinal herniorrhaphy, regional anesthesia (paravertebral blocks) provided faster recovery than general anesthesia.

Jérôme Morel, Jean Pascal, David Charier, Véronique De Pasquale, Philippe Gain, Christian Auboyer, and Serge Molliex

Preoperative Peribulbar Block in Patients Undergoing Retinal Detachment Surgery Under General Anesthesia: A Randomized Double-Blind Study
Anesth Analg 2006 102: 1082-1087. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Peribulbar block combined with general anesthesia for retinal detachment surgery reduced perioperative bleeding and the incidence of oculocardiac reflex and improved postoperative analgesia compared with general anesthesia alone.

ANESTHETIC PHARMACOLOGY:

Dharshi Karalapillai, Kate Leslie, Abhay Umranikar, and Andrew R. Bjorksten

Nitrous Oxide and Anesthetic Requirement for Loss of Response to Command During Propofol Anesthesia
Anesth Analg 2006 102: 1088-1093. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The blood concentration associated with loss of response to command in 50% of subjects is an important measure of anesthetic potency. In this study, nitrous oxide decreased propofol requirement for loss of response to command in healthy surgical patients. The bispectral index predicted response to command.

Yutaka Oda, Katsuaki Tanaka, Tadashi Matsuura, Ichiro Hase, Kiyonobu Nishikawa, and Akira Asada

Nitrous Oxide Induces Paradoxical Electroencephalographic Changes After Tracheal Intubation During Isoflurane and Sevoflurane Anesthesia
Anesth Analg 2006 102: 1094-1102. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During isoflurane and sevoflurane anesthesia, addition of nitrous oxide decreased the frequency of electroencephalogram and bispectral index (BIS) but did not suppress hemodynamic changes in response to tracheal intubation. These electroencephalographic changes with a decrease of BIS are caused by paradoxical arousal.

Masahiro Sakaguchi, Yoshihiro Kuroda, and Munetaka Hirose

The Antiproliferative Effect of Lidocaine on Human Tongue Cancer Cells with Inhibition of the Activity of Epidermal Growth Factor Receptor
Anesth Analg 2006 102: 1103-1107. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Topical local anesthetics are used for cancer pain relief and may suppress the proliferation of cancer cells. We investigated the effects of lidocaine on proliferation of the human tongue cancer cell line CAL27. A clinical concentration of lidocaine suppressed the proliferation of CAL27 with inhibition of the activity of the epidermal growth factor receptor.

Manuela J. M. de Klaver, Gregory S. Weingart, Tom G. Obrig, and George F. Rich

Local Anesthetic-Induced Protection Against Lipopolysaccharide-Induced Injury in Endothelial Cells: The Role of Mitochondrial Adenosine Triphosphate-Sensitive Potassium Channels
Anesth Analg 2006 102: 1108-1113. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Injury to the vascular system is an important cause of morbidity and mortality. This study indicates that certain local anesthetics may protect vascular cells from injury.

Chuan-Xiu Yang, Han Xu, Ke-Qing Zhou, Meng-Ya Wang, and Tian-Le Xu

Modulation of Gamma-Aminobutyric Acid_A Receptor Function by Thiopental in the Rat Spinal Dorsal Horn Neurons
Anesth Analg 2006 102: 1114-1120. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The modulatory effects of thiopental on {gamma}-aminobutyric acid (GABA)A receptor function were examined in acutely dissociated rat spinal dorsal horn neurons using whole cell patch-clamp recording. Thiopental enhanced GABAA receptor function and GABAergic inhibitory transmission, suggesting that the spinal cord is a potential site for thiopental to exert its anesthetic action.

Osamu Shibata, Masataka Saito, Maki Yoshimura, Masakazu Yamaguchi, Kenji Nishioka, Tetsuji Makita, and Koji Sumikawa

Anticholinesterase Drugs Stimulate Smooth Muscle Contraction of the Rat Trachea Through the Rho-Kinase Pathway
Anesth Analg 2006 102: 1121-1126. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined the effects of Rho-kinase inhibitors on anticholinesterase-induced contractile and phosphatidylinositol responses of rat trachea. Neostigmine- and pyridostigmine-induced contractions were almost completely inhibited by the Rho-kinase inhibitors, Y-27632 and fasudil. The results suggest that anticholinesterases cause airway smooth muscle contraction, in part, through activation of the Rho-kinase pathway.

Piotr K. Janicki, H. Gregg Schuler, Tomasz M. Jarzembowski, and Malina Rossi, II

Prevention of Postoperative Nausea and Vomiting with Granisetron and Dolasetron in Relation to CYP2D6 Genotype
Anesth Analg 2006 102: 1127-1133. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Administration of granisetron, 1 mg IV, and dolasetron, 12.5 mg IV, was equally effective in preventing postoperative nausea and vomiting in the postanesthesia care unit. Administration of granisetron achieved a more frequent complete response rate in the 24-h postdischarge period than administration of dolasetron. In subjects receiving dolasetron, carriers of the duplication of the CYP2D6 allele predicting ultrarapid metabolizer status had more vomiting episodes than patients in the granisetron group.

Alex Bekker, Romin Shah, David Quartermain, Yong-Sheng Li, and Thomas Blanck

Isoflurane Preserves Spatial Working Memory in Adult Mice After Moderate Hypoxia
Anesth Analg 2006 102: 1134-1138. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Moderate hypoxia (oxygen 8% for 1 hour) transiently impairs performance of adult mice in a spatial memory task. Isoflurane 1.2% prevented the deterioration of working memory.

Sofianou Anta, Chatzieleftheriou Athanasios, Mavrommati Panorea, and Velmachou Kyriaki

Accidental Epidural Administration of Succinylcholine (Case Report)
Anesth Analg 2006 102: 1139-1140. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Accidental epidural administration of succinylcholine has not been previously reported. This case report describes accidental injection of succinylcholine in the epidural space, the side effects, and how to deal with this situation.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Sascha Kreuer, Jörgen Bruhn, Reinhard Larsen, Heiko Buchinger, and Wolfram Wilhelm

A-Line, Bispectral Index, and Estimated Effect-Site Concentrations: A Prediction of Clinical End-Points of Anesthesia
Anesth Analg 2006 102: 1141-1146. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Autoregressive modeling with exogenous input of middle-latency auditory evoked potentials has recently been developed for monitoring anesthesia depth. We investigated the prediction of recovery and dose-response relationship of desflurane concentrations and the A-Line AEP index or bispectral index values. The correlation between bispectral index monitoring and clinical end-points of anesthesia or the desflurane effect compartment concentration is better than for the A-Line AEP index. The opening of eyes was best predicted by the calculated desflurane effect-site concentration.

Mark A. Lovich, M. Ellen Kinnealley, Nathanial M. Sims, and Robert A. Peterfreund

The Delivery of Drugs to Patients by Continuous Intravenous Infusion: Modeling Predicts Potential Dose Fluctuations Depending on Flow Rates and Infusion System Dead Volume
Anesth Analg 2006 102: 1147-1153. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: IV drug infusion has the potential for dosing errors, arising from interactions between carrier flows and the infusion set dead volume. Computational models showed the mass of drug stored in the dead volume, which is available for accidental bolus, and the impact of abruptly stopping or altering carrier flows on drug delivery.

Christian Koch, Christine Hollister, and Peter H. Breen

Infusion Pump Delivers Over-Dosage of Propofol as a Result of Missing Syringe Support (Case Report)
Anesth Analg 2006 102: 1154-1156. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe the malfunction of a common drug infusion pump in which the pump falsely detected a smaller syringe size and consequently delivered an increased infusion rate and overdose of propofol to the patient.

PAIN MEDICINE:

Lesley De Pietri, Antonio Siniscalchi, Alexia Reggiani, Michele Masetti, Bruno Begliomini, Matteo Gazzi, Giorgio E. Gerunda, and Alberto Pasetto

The Use of Intrathecal Morphine for Postoperative Pain Relief After Liver Resection: A Comparison with Epidural Analgesia
Anesth Analg 2006 102: 1157-1163. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Postoperative analgesia and side effects of intrathecal morphine versus epidural naropine were compared after liver resection. Pain relief in the intrathecal group was not inferior to the epidural group, but pruritus and nausea were more frequent. A single dose of intrathecal morphine provides satisfactory postoperative analgesia after liver surgery.

Philip J. Siddall, Peter Stanwell, Annie Woodhouse, Ray L. Somorjai, Brion Dolenko, Alexander Nikulin, Roger Bourne, Uwe Himmelreich, Cynthia Lean, Michael J. Cousins, and Carolyn E. Mountford

Magnetic Resonance Spectroscopy Detects Biochemical Changes in the Brain Associated with Chronic Low Back Pain: A Preliminary Report
Anesth Analg 2006 102: 1164-1168. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Magnetic resonance spectroscopy can detect brain biochemical changes associated with pain. Combined with a pattern recognition strategy for analysis, it was possible to discriminate between subjects with chronic pain and control subjects with accuracies approaching 100%. This technique may be useful as an objective method of detecting changes associated with pain.

Toshihiko Mitsuyo, Joseph F. Antognini, and Earl Carstens

Etomidate Depresses Lumbar Dorsal Horn Neuronal Responses to Noxious Thermal Stimulation in Rats
Anesth Analg 2006 102: 1169-1173. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Etomidate depressed lumbar neuronal responses to noxious thermal stimulation applied to the hindpaw of isoflurane-anesthetized rats. These data suggest that etomidate might exert an analgesic action in the spinal cord.

Zeynep Eti, Pinar Irmak, Bahadir M. Gulluoglu, Manuk N. Manukyan, and F. Yilmaz Gogus

Does Bilateral Superficial Cervical Plexus Block Decrease Analgesic Requirement After Thyroid Surgery? (Brief Report)
Anesth Analg 2006 102: 1174-1176. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated and compared the analgesic efficacy of bilateral superficial cervical plexus block and local anesthetic wound infiltration after thyroid surgery in this randomized, double-blind and controlled study and concluded that neither of the regional techniques decreased postoperative opioid requirement.

ECONOMICS, EDUCATION, AND POLICY:

R. David Warters, Peter Szmuk, Evan G. Pivalizza, Ralf E. Gebhard, Jeffrey Katz, and Tiberiu Ezri

The Role of Anesthesiologists in the Selection and Administration of Perioperative Antibiotics: A Survey of the American Association of Clinical Directors
Anesth Analg 2006 102: 1177-1182. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This survey of the American Society of Clinical Directors evaluates the role of anesthesiologists in the selection and administration of perioperative antibiotics. The data indicate limited involvement in selection but an intense level of involvement in administration. In addition, the results indicate that antibiotic administration in general is poorly monitored and that roles are poorly defined.

Riitta A. Marjamaa, Paulus M. Torkki, Markus I. Torkki, and Olli A. Kirvelä

Time Accuracy of a Radio Frequency Identification Patient Tracking System for Recording Operating Room Timestamps
Anesth Analg 2006 102: 1183-1186. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A patient tracking system, based on radio frequency/infrared indoor positioning, enables automatic documentation of timestamps. Automatic documentation is more accurate and precise than manual documentation. An indoor positioning system is technically suitable for automatic documentation of timestamps in the operating room environment.

CRITICAL CARE AND TRAUMA:

Hans Knotzer, Werner Pajk, Martin W. Dünser, Stephan Maier, Andreas J. Mayr, Nicole Ritsch, Barbara Friesenecker, and Walter R. Hasibeder

Regional Microvascular Function and Vascular Reactivity in Patients with Different Degrees of Multiple Organ Dysfunction Syndrome
Anesth Analg 2006 102: 1187-1193. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that regional variables of microvascular function and vascular reactivity assessed by different measurement techniques do not reflect the severity of multiple organ dysfunction syndrome in hemodynamically stable, resuscitated, surgical intensive care patients with different mortality rates.

Claudia De Lorenzo, Andreas Calatzis, Ulrich Welsch, and Bernhard Heindl

Fibrinogen Concentrate Reverses Dilutional Coagulopathy Induced In Vitro by Saline but Not by Hydroxyethyl Starch 6%
Anesth Analg 2006 102: 1194-1200. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dilutional coagulopathy, which is often seen after severe bleeding, can be successfully reversed in vitro by administration of fibrinogen concentrate. In comparison with crystalloid solutions, hydroxyethyl starch molecules inhibit fibrin polymerization and thereby significantly reduce the benefit of fibrinogen replacement.

Akinori Uchiyama, Yuji Fujino, Kikumi Hosotsubo, Eriko Miyoshi, Takashi Mashimo, and Masaji Nishimura

Regional Blood Flow in Respiratory Muscles During Partial Ventilatory Assistance in Rabbits
Anesth Analg 2006 102: 1201-1206. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that mode and settings of mechanical ventilation affect regional diaphragmatic blood flow in rabbits. At higher levels of pressure-supported ventilation, increases in diaphragmatic blood flow may be associated with animal-ventilator asynchrony.

Joshua H. Atkins and Jonas S. Johansson

Technologies to Shape the Future: Proteomics Applications in Anesthesiology and Critical Care Medicine (Review Article)
Anesth Analg 2006 102: 1207-1216. [Abstract] [Full Text] [PDF] [Request Permissions]  

NEUROSURGICAL ANESTHESIA:

Tatsuya Fuchigami, Manabu Kakinohana, Seiya Nakamura, Kenji Murata, and Kazuhiro Sugahara

Intrathecal Nicorandil and Small-Dose Morphine Can Induce Spastic Paraparesis After a Noninjurious Interval of Spinal Cord Ischemia in the Rat
Anesth Analg 2006 102: 1217-1222. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: These experimental data indicate that neuraxial morphine, even at a small dose, can induce spastic paraparesis in the presence of a K+ channel opener when rats are exposed to mild spinal cord ischemia.

KyungYeon Yoo, JaeHa Hwang, SungTae Jeong, SeokJai Kim, HongBeom Bae, JeongIl Choi, SungSu Chung, and JongUn Lee

Anesthetic Requirements and Stress Hormone Responses in Spinal Cord-Injured Patients Undergoing Surgery Below the Level of Injury
Anesth Analg 2006 102: 1223-1228. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Sevoflurane requirement is reduced by 20%-39% to maintain the Bispectral index at 40-50 in spinal cord-injured patients during surgery below the level of injury, in association with blunted stress hormone responses.

OBSTETRIC ANESTHESIA:

James P. McMichael

Will a "G" PS Clarify the Landscape? (Editorial)
Anesth Analg 2006 102: 1229-1230. [Full Text] [PDF] [Request Permissions]  

Atilio Barbeito, Holly A. Muir, Tong J. Gan, James D. Reynolds, Tede Spahn, William D. White, Moeen K. Panni, and John R. Schultz

Use of a Modifier Reduces Inconsistency in the American Society of Anesthesiologists Physical Status Classification in Parturients (Brief Report)
Anesth Analg 2006 102: 1231-1233. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The current ASA Physical Status Classification does not consistently address the physiological changes of pregnancy. The use of a modifier, G (for gravid), reduces inconsistency in assigning the ASA Physical Status Classification.

REGIONAL ANESTHESIA:

Francis V. Salinas, Spencer S. Liu, and Michael F. Mulroy

The Effect of Single-Injection Femoral Nerve Block Versus Continuous Femoral Nerve Block After Total Knee Arthroplasty on Hospital Length of Stay and Long-Term Functional Recovery Within an Established Clinical Pathway
Anesth Analg 2006 102: 1234-1239. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Within a standardized clinical pathway, continuous femoral nerves blocks significantly improve postoperative analgesia after total knee arthroplasty compared with single-injection femoral nerve blocks but do not decrease hospital length of stay or improve long-term functional recovery.

Dusanka Zaric, Klavs Boysen, Christian Christiansen, Jadwiga Christiansen, Snorre Stephensen, and Bodil Christensen

A Comparison of Epidural Analgesia With Combined Continuous Femoral-Sciatic Nerve Blocks After Total Knee Replacement
Anesth Analg 2006 102: 1240-1246. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Combined continuous femoral and sciatic nerve blocks were accompanied by fewer side effects than continuous epidural analgesia on the first postoperative day after total knee replacement. Analgesic efficacy, rehabilitation indices, and the duration of hospital stay were similar.

Markus F. Stevens, Robert Werdehausen, Henning Hermanns, and Peter Lipfert

Skin Temperature During Regional Anesthesia of the Lower Extremity
Anesth Analg 2006 102: 1247-1251. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: An increase of skin temperature (Ts) is a reliable, but late, sign of successful sciatic nerve block. Therefore it is of limited clinical value. The increase in Ts after femoral block is negligible and late.

Carlo D. Franco, Feodor J. Gloss, Gennadiy Voronov, Serge G. Tyler, and Ljuba S. Stojiljkovic

Supraclavicular Block in the Obese Population: An Analysis of 2020 Blocks (Brief Report)
Anesth Analg 2006 102: 1252-1254. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Supraclavicular block is highly successful in the obese and non-obese populations without any apparent difference in acute complications.

GENERAL ARTICLES:

Harold K. Fong, Laura P. Sands, and Jacqueline M. Leung

The Role of Postoperative Analgesia in Delirium and Cognitive Decline in Elderly Patients: A Systematic Review
Anesth Analg 2006 102: 1255-1266. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The current systematic review demonstrates that there are only a few clinical trials that compare opioid analgesics or analgesic modalities. Meperidine appears to be the only drug that should clearly be avoided. Whether an IV or epidural method of postoperative analgesia is more desirable cannot be convincingly answered at this point.

Linnea E. Vaurio, Laura P. Sands, Yun Wang, E. Ann Mullen, and Jacqueline M. Leung

Postoperative Delirium: The Importance of Pain and Pain Management
Anesth Analg 2006 102: 1267-1273. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our study demonstrates that pain and pain management strategies are important factors related to the development of postoperative delirium in elderly patients. These results suggest that elderly surgical patients with substantial preoperative baseline pain should be targeted for more intensive pain control or addition of adjuvant analgesia postoperatively.

Anthony M. Roche, Michael F. M. James, Elliott Bennett-Guerrero, and Michael G. Mythen

A Head-to-Head Comparison of the In Vitro Coagulation Effects of Saline-Based and Balanced Electrolyte Crystalloid and Colloid Intravenous Fluids
Anesth Analg 2006 102: 1274-1279. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Crystalloids, smaller molecular weight hydroxyethyl starch, and balanced electrolyte IV fluid preparations lead to less thrombelastograph(R) coagulation derangement than larger molecular weight and saline-based solutions.

Gisela Scharbert, Madeleine Kalb, Corinna Marschalek, and Sibylle A. Kozek-Langenecker

The Effects of Test Temperature and Storage Temperature on Platelet Aggregation: A Whole Blood In Vitro Study
Anesth Analg 2006 102: 1280-1284. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effect of the test temperature on platelet aggregation depends on the platelet agonist used and the blood storage condition until platelet analysis. Although the response to the routine platelet agonists, adenosine diphosphate and collagen, varies considerably with storage temperature, arachidonic acid and ristocetin can be considered as robust agonists.

Motohiro Nakamura, Masanori Ogata, Yumiko Matsuo, and Takeyoshi Sata

Anesthetic Management of a Patient with Gerstmann-Sträussler-Scheinker Syndrome (Mutation of Prion Protein) (Case Report)
Anesth Analg 2006 102: 1285-1286. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This is the first report regarding an anesthetic experience with the patients of Gerstmann-Straussler-Scheinker syndrome, which is related to a mutated prion protein.

LETTER TO THE EDITOR:

John D. Wasnick

Anesthesiologists Caring for Conjoined Twins Are by Necessity Utilitarians
Anesth Analg 2006 102: 1287. [Full Text] [PDF] [Request Permissions]  

David B. Waisel

Anesthesiologists Caring for Conjoined Twins Are by Necessity Utilitarians
Anesth Analg 2006 102: 1287. [Full Text] [PDF] [Request Permissions]  

Luiz F. Souza

Anesthesia Research Needs Definitions
Anesth Analg 2006 102: 1287. [Full Text] [PDF] [Request Permissions]  

Gyu-Sam Hwang, Young-Kug Kim, In-Young Huh, and Su-Jin Kang

Assessing Arterial Baroreflex Control of Heart Rate During General Anesthesia
Anesth Analg 2006 102: 1288. [Full Text] [PDF] [Request Permissions]  

G. Allen Finley

Evaluation of Adverse Outcomes Requires the Correct Denominator
Anesth Analg 2006 102: 1288. [Full Text] [PDF] [Request Permissions]  

Hector Vila, Jr, R. A. Smith, and R. V. Miguel

Evaluation of Adverse Outcomes Requires the Correct Denominator
Anesth Analg 2006 102: 1288-1289. [Full Text] [PDF] [Request Permissions]  

Ibrahim Basagaoglu, S. Karaca, and Ziya Salihoglu

Anesthesia Techniques in the Fifteenth Century by Serafeddin Sabuncuoglu
Anesth Analg 2006 102: 1289. [Full Text] [PDF] [Request Permissions]  

Axel R. Heller, Sebastian N. Stehr, and Rainer J. Litz

Omega-3 Alpha Linolenic Acid Does Not Reflect the Entire Omega-3 Fatty Acid Family
Anesth Analg 2006 102: 1289. [Full Text] [PDF] [Request Permissions]  

Stéphanie Chevalier, Jordi Pérez, and Yoram Shir

Omega-3 Alpha Linolenic Acid Does Not Reflect the Entire Omega-3 Fatty Acid Family
Anesth Analg 2006 102: 1289-1290. [Full Text] [PDF] [Request Permissions]  

Mustafa Suren, Gökcen Basaranoglu, Basol Bay, Unal Egeli, Ismail Afacan, Kahraman Ozturk, and Ozgur Ortak

Patchy Spinal Anesthesia
Anesth Analg 2006 102: 1290. [Full Text] [PDF] [Request Permissions]  

Lewis S. Coleman

Should Soda Lime Be Abolished?
Anesth Analg 2006 102: 1290-1291. [Full Text] [PDF] [Request Permissions]  

Prabhat Kumar Sinha, P. R. Suneel, K. P. Unnikrishnan, V. Smita, and Ramesh Chandra Rathod

An Alternative Site for Entropy Sensor Placement
Anesth Analg 2006 102: 1291. [Full Text] [PDF] [Request Permissions]  

Kunal Karamchandani, V. Darlong, Prashant Rampal, and Virender Mohan

Intraoperative Bronchospasm After Organophosphate Inhalation
Anesth Analg 2006 102: 1291-1292. [Full Text] [PDF] [Request Permissions]  

Helen Vlachtsis

Brown-Séquard Syndrome Following Removal of a Cerebrospinal Fluid Drainage Catheter After Thoracic Aortic Surgery
Anesth Analg 2006 102: 1292. [Full Text] [PDF] [Request Permissions]  

Madhusudan Rao Puchakayala and Kevin K. Tremper

Brown-Séquard Syndrome Following Removal of a Cerebrospinal Fluid Drainage Catheter After Thoracic Aortic Surgery
Anesth Analg 2006 102: 1292. [Full Text] [PDF] [Request Permissions]  

Rajesh Mahajan, Rahul Gupta, and Anju Sharma

Complications After Thoracic Epidural Anesthesia
Anesth Analg 2006 102: 1292-1293. [Full Text] [PDF] [Request Permissions]  

Baljit Singh and Manoj Bhardwaj

A Live Foreign Body in the Breathing Circuit
Anesth Analg 2006 102: 1293. [Full Text] [PDF] [Request Permissions]  

E. Ottestad, C. Schmiessing, John G. Brock-Utne, V. Kulkarni, D. Parris, and J. B. Brodsky

Central Venous Access in Obese Patients: A Potential Complication
Anesth Analg 2006 102: 1293-1294. [Full Text] [PDF] [Request Permissions]  

Vidya Rattan and Suman Arora

Prolonged Temporomandibular Joint Dislocation in an Unconscious Patient After Airway Manipulation
Anesth Analg 2006 102: 1294. [Full Text] [PDF] [Request Permissions]  

Amitabh Dutta, Neelam Ganguly, Jayashree Sood, and V. P. Kumra

Intraoperative Nasogastric Tube Insertion with Non-ProSeal Laryngeal Mask Airway in Place
Anesth Analg 2006 102: 1294-1295. [Full Text] [PDF] [Request Permissions]  

W. Andrew Kofke, Albert T. Cheung, John G. Augoustides, James G. Hecker, and Joseph Bavaria

S-100 and NSE Changes After Cardiac Surgery: Evaluation of Multiple Single Nucleotide Polymorphisms
Anesth Analg 2006 102: 1295-1296. [Full Text] [PDF] [Request Permissions]  

Vincent Minville, Clément Chassery, Amina Benhaoua, Vincent Lubrano, Pierre Albaladejo, and Olivier Fourcade

Nerve Stimulator-Guided Brachial Plexus Block in a Patient with Severe Parkinson's Disease and Bilateral Deep Brain Stimulators
Anesth Analg 2006 102: 1296. [Full Text] [PDF] [Request Permissions]  

Inipavudu Baelani and Martin W. Dünser

Back to the Future: Intraoperative Fluid Restriction in Gastrointestinal Surgery—A New Practice to the West, but an Old One to Sub-Sahara Africa
Anesth Analg 2006 102: 1297. [Full Text] [PDF] [Request Permissions]  

Philip J. Balestrieri, Paul H. Ting, and Randal S. Blank

Efficacy of Postoperative Epidural Morphine for Postpartum Tubal Ligation
Anesth Analg 2006 102: 1297-1298. [Full Text] [PDF] [Request Permissions]  

R-Jay Marcus

Efficacy of Postoperative Epidural Morphine for Postpartum Tubal Ligation
Anesth Analg 2006 102: 1298. [Full Text] [PDF] [Request Permissions]  

Masashi Nishikawa and Shinichi Inomata

Cautious Use of Trachlight^TM in Infants
Anesth Analg 2006 102: 1298. [Full Text] [PDF] [Request Permissions]  

David M. Bandola and Shailendra Joshi

Prone View® with Mayfield Head Frames
Anesth Analg 2006 102: 1298-1299. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Edward C. Nemergut

Perioperative Drug Manual. 2nd ed.
Anesth Analg 2006 102: 1300. [Full Text] [PDF] [Request Permissions]  

Norig Ellison

American Society of Anesthesiologists: A Century of Challenges and Progress.
Anesth Analg 2006 102: 1300. [Full Text] [PDF] [Request Permissions]  

Kok-Yuen Ho and Tong J. Gan

The Year in Anaesthesia and Critical Care, vol. 1.
Anesth Analg 2006 102: 1300. [Full Text] [PDF] [Request Permissions]  

Zdravka Zafirova and John E. Ellis

Critical Care: The Requisites in Anesthesiology Series.
Anesth Analg 2006 102: 1301. [Full Text] [PDF] [Request Permissions]  

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