CARDIOVASCULAR ANESTHESIA:

Pascal Alfonsi, Antoine Vieillard-Baron, Marc Coggia, Bruno Guignard, Olivier Goeau-Brissonniere, François Jardin, and Marcel Chauvin

Cardiac Function During Intraperitoneal CO₂ Insufflation for Aortic Surgery: A Transesophageal Echocardiographic Study
Anesth Analg 2006 102: 1304-1310. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Left ventricular dysfunction during a 14 mm Hg pneumoperitoneum in patients scheduled for abdominal aortic repair in the supine or lateral position is more likely a consequence of a cardiac workload increase than of a venous return impairment.

Peter Rosenberger, Stanton K. Shernan, Prem S. Shekar, Jayshree K. Tuli, Thomas Weissmüller, Sary F. Aranki, and Holger K. Eltzschig

Acute Hemodynamic Collapse After Induction of General Anesthesia for Emergent Pulmonary Embolectomy
Anesth Analg 2006 102: 1311-1315. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In patients undergoing pulmonary embolectomy, severe hypotension after anesthesia induction, which requires emergent institution of cardiopulmonary bypass, occurs frequently (19%) and is unpredictable. Therefore, we recommend preparing and draping patients before induction of general anesthesia for surgical pulmonary embolectomy.

Roger C. Carroll, Jack J. Chavez, Jeffery W. Simmons, Carolyn C. Snider, Dale C. Wortham, Stuart J. Bresee, and Eli Cohen

Measurement of Patients' Bivalirudin Plasma Levels by a Thrombelastograph® Ecarin Clotting Time Assay: A Comparison to a Standard Activated Clotting Time
Anesth Analg 2006 102: 1316-1319. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated a Thrombelastograph(R) ecarin clotting time assay and found that it correlated better than a standard activated clotting time test with plasma bivalirudin levels.

Stefano Romagnoli, Sergio Bevilacqua, Sandro Gelsomino, Silvia Pradella, Lorenzo Ghilli, Carlo Rostagno, Gian Franco Gensini, and Carlo Sorbara

Small-Dose Recombinant Activated Factor VII (NovoSeven®) in Cardiac Surgery
Anesth Analg 2006 102: 1320-1326. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Recombinant FVIIa reduced postoperative bleeding, transfusion of red blood cells, fresh-frozen plasma, and platelet transfusion, as well as intensive care unit stay and re-exploration rate.

Peter L. Bailey, Emmett E. Whitaker, Linda S. Palmer, and Laurent G. Glance

The Accuracy of the Central Landmark Used for Central Venous Catheterization of the Internal Jugular Vein
Anesth Analg 2006 102: 1327-1332. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ultrasound evaluation indicates that use of the central landmark approach for right internal jugular catheterization results in more medial needle insertion than desired, with risk of carotid puncture or failure to catheterize the jugular vein.

María F. Martín Cancho, María S. Carrasco-Jiménez, Juan R. Lima, Laura Luis, Verónica Crisóstomo, and Jesús Usón-Gargallo

The Measurement of Neurovegetative Activity During Anesthesia and Surgery in Swine: An Evaluation of Different Techniques
Anesth Analg 2006 102: 1333-1340. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This pilot study performed in sevoflurane-anesthetized pigs suggests that the ANSiscopeTM monitor may be useful for representing and measuring neurovegetative activity during general inhaled anesthesia.

David A. Zvara, Andrew J. Bryant, Dwight D. Deal, Mario P. DeMarco, Kevin M. Campos, Carol M. Mansfield, and Michael Tytell

Anesthetic Preconditioning with Sevoflurane Does Not Protect the Spinal Cord After an Ischemic-Reperfusion Injury in the Rat
Anesth Analg 2006 102: 1341-1347. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Paraplegia remains a devastating consequence of descending and thoracoabdominal aortic operations that have a period of obligate spinal cord ischemia. This research demonstrated no benefit of anesthetic preconditioning in attenuating this type of injury.

Paul S. Pagel, John G. Krolikowski, Donald A. Neff, Dorothee Weihrauch, Martin Bienengraeber, Judy R. Kersten, and David C. Warltier

Inhibition of Glycogen Synthase Kinase Enhances Isoflurane-Induced Protection Against Myocardial Infarction During Early Reperfusion In Vivo
Anesth Analg 2006 102: 1348-1354. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Inhibition of the regulatory protein, glycogen synthase kinase, enhances protection against myocardial infarction by isoflurane administered immediately before and during early reperfusion after prolonged coronary artery occlusion via a mitochondrial permeability transition pore-dependent mechanism.

Chen Wang, Donald A. Neff, John G. Krolikowski, Dorothee Weihrauch, Martin Bienengraeber, David C. Warltier, Judy R. Kersten, and Paul S. Pagel

The Influence of B-Cell Lymphoma 2 Protein, an Antiapoptotic Regulator of Mitochondrial Permeability Transition, on Isoflurane-Induced and Ischemic Postconditioning in Rabbits
Anesth Analg 2006 102: 1355-1360. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Inhibition of the antiapoptotic regulatory protein Bcl-2 abolishes myocardial protection produced by brief exposure to isoflurane or repetitive, transient ischemic episodes during early reperfusion in rabbits. In contrast, inhibition of Bcl-2 did not affect protection afforded by cyclosporin A, a direct mitochondrial permeability transition pore (mPTP) antagonist. The results suggest that Bcl-2 mediates isoflurane-induced and ischemic postconditioning by indirectly modulating mPTP activity in vivo.

Jessica L. Willert, Douglas Shook, and Michael N. D'Ambra

3D Transesophageal Echocardiography: Systolic Anterior Motion with Hypertrophic Obstructive Cardiomyopathy (Echo Rounds)
Anesth Analg 2006 102: 1361-1362. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

Thomas F. Kindl, Ali M. Hassan, Robert L. Booth, Jr, Samuel J. Durham, and Thomas J. Papadimos

A Primary High-Grade Pleomorphic Pericardial Liposarcoma Presenting as Syncope and Angina (Echo Rounds)
Anesth Analg 2006 102: 1363-1364. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

PEDIATRIC ANESTHESIA:

Arja Hiller, Olli A. Meretoja, Reijo Korpela, Satu Piiparinen, and Tomi Taivainen

The Analgesic Efficacy of Acetaminophen, Ketoprofen, or Their Combination for Pediatric Surgical Patients Having Soft Tissue or Orthopedic Procedures
Anesth Analg 2006 102: 1365-1371. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared the analgesic efficacy of the combination of acetaminophen 60 mg/kg rectally plus 40 mg/kg orally per 24 h and ketoprofen (a traditional nonsteroidal antiinflammatory drug) 4 mg/kg per 24 h IV with the single drugs in pediatric surgical inpatients. The combination produced better pain treatment than either single drug when evaluated by 24-h morphine requirement or objective pain scores.

Devendra Gupta, Anil Agarwal, Sanjay Dhiraaj, Manish Tandon, Mukesh Kumar, Ravi Shankar Singh, Prabhat K. Singh, and Uttam Singh

An Evaluation of Efficacy of Balloon Inflation on Venous Cannulation Pain in Children: A Prospective, Randomized, Controlled Study
Anesth Analg 2006 102: 1372-1375. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Venipuncture is the most common painful event for hospitalized children. We observed that 20 s of forced exhalation during balloon inflation reduced both the incidence and severity of venipuncture pain. This reduction in venipuncture pain may be the combined effect of distraction and Valsalva.

Giovanni Cucchiaro, John T. Farrar, Jessica W. Guite, and Yuelin Li

What Postoperative Outcomes Matter to Pediatric Patients?
Anesth Analg 2006 102: 1376-1382. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated, for the first time, which postoperative outcome is most important to pediatric patients using standard gamble techniques. The results suggest a difference between boys and girls, as well as a difference between children's and adults' preferences.

Ulla Lankinen, Risto Avela, and Pekka Tarkkila

The Prevention of Emergence Agitation With Tropisetron or Clonidine After Sevoflurane Anesthesia in Small Children Undergoing Adenoidectomy
Anesth Analg 2006 102: 1383-1386. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Preoperative tropisetron 0.1 mg/kg could effectively reduce the incidence of postoperative agitation after sevoflurane anesthesia for day-case adenoidectomy in small children. The effect of clonidine 1.5 {micro}g/kg did not differ from placebo.

AMBULATORY ANESTHESIA:

Paul F. White, Jun Tang, Mohamed A. Hamza, Babatunde Ogunnaike, Monica Lo, Ronald H. Wender, Robert Naruse, Alexander Sloninsky, Robert Kariger, Scott Cunneen, and Ted Khalili

The Use of Oral Granisetron Versus Intravenous Ondansetron for Antiemetic Prophylaxis in Patients Undergoing Laparoscopic Surgery: The Effect on Emetic Symptoms and Quality of Recovery
Anesth Analg 2006 102: 1387-1393. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Preoperative administration of granisetron, 1 mg per os, was not significantly different from ondansetron, 4 mg IV, in preventing emetic symptoms and improving recovery after laparoscopic surgery. However, ondansetron was more cost-effective than granisetron for routine prophylaxis as a result of its lower cost and comparable antiemetic efficacy and patient satisfaction.

Haleh Saadat, Jacqueline Drummond-Lewis, Inna Maranets, Deborah Kaplan, Anusha Saadat, Shu-Ming Wang, and Zeev N. Kain

Hypnosis Reduces Preoperative Anxiety in Adult Patients
Anesth Analg 2006 102: 1394-1396. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Hypnosis given before surgery will significantly reduce the anxiety and fear of adult patients.

ANESTHETIC PHARMACOLOGY:

Edmond I. Eger, II, Mark Liao, Michael J. Laster, Albert Won, John Popovich, Douglas E. Raines, Ken Solt, Robert C. Dutton, Franklin V. Cobos, II, and James M. Sonner

Contrasting Roles of the N-Methyl-d-Aspartate Receptor in the Production of Immobilization by Conventional and Aromatic Anesthetics
Anesth Analg 2006 102: 1397-1406. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Blockade of N-methyl-d-aspartate (NMDA) receptors by conventional inhaled anesthetics does not mediate the capacity of such anesthetics to produce immobility in the face of noxious stimulation. In contrast, for aromatic anesthetics, NMDA receptors mediate production of immobility in proportion to the capacity of such anesthetics to block the NMDA receptor.

Ken Solt, Edmond I. Eger, II, and Douglas E. Raines

Differential Modulation of Human N-Methyl-d-Aspartate Receptors by Structurally Diverse General Anesthetics
Anesth Analg 2006 102: 1407-1411. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We found that equianesthetic concentrations (1 minimum alveolar anesthetic concentration [MAC]) of 15 structurally diverse inhaled anesthetics produced a sixfold range of inhibition of the human N-methyl-d-aspartate (NMDA) receptor, a finding that may be useful in a determination of the contribution of NMDA receptor inhibition to the MAC of inhaled anesthetics.

Robert C. Dutton, Michael J. Laster, Yilei Xing, James M. Sonner, Douglas E. Raines, Ken Solt, and Edmond I. Eger, II

Do N-Methyl-d-Aspartate Receptors Mediate the Capacity of Inhaled Anesthetics to Suppress the Temporal Summation that Contributes to Minimum Alveolar Concentration?
Anesth Analg 2006 102: 1412-1418. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Blockade of N-methyl-d-aspartate receptors may explain the action of a few inhaled anesthetics, as defined by MAC, but may have minimal relevance for immobilization produced by most commonly used inhaled anesthetics.

Albert Won, Irene Oh, Mark Liao, James M. Sonner, R. Adron Harris, Michael J. Laster, Robert Brosnan, James R. Trudell, and Edmond I. Eger, II

The Minimum Alveolar Anesthetic Concentration of 2-, 3-, and 4-Alcohols and Ketones in Rats: Relevance to Anesthetic Mechanisms
Anesth Analg 2006 102: 1419-1426. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The position of the C-OH group of an alcohol or the C=O group of a ketone (that is, the length of the acyl carbon chain extending from the C-OH or C=O group) is not a better predictor of anesthetic potency than the total length of the carbon chain or the affinity of the alcohol or ketone to a lipid (olive oil) phase.

Thomas Ledowski, Michael J. Paech, Bhavesh Patel, and Stephan A. Schug

Bronchial Mucus Transport Velocity in Patients Receiving Propofol and Remifentanil Versus Sevoflurane and Remifentanil Anesthesia
Anesth Analg 2006 102: 1427-1430. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthetic drugs may depress bronchial clearance. Using an in vivo method, we demonstrated significantly more depression of bronchial clearance in patients anesthetized with sevoflurane compared with propofol. This might have an impact on the use of these drugs in patients at high risk for pulmonary complications.

Ira J. Rampil, Daryn H. Moller, and Achim H. Bell

Isoflurane Modulates Genomic Expression in Rat Amygdala
Anesth Analg 2006 102: 1431-1438. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: Isoflurane causes widespread alterations in which genes are expressed in the central nervous system. This article uses GeneChip technology to describe these changes and the implications for understanding a more complete picture of clinical anesthetic effect.

Enno Freye, Leo Latasch, and Joseph Victor Levy

S(+)-Ketamine Attenuates Increase in Electroencephalograph Activity and Amplitude Height of Sensory-Evoked Potentials During Rapid Opioid Detoxification
Anesth Analg 2006 102: 1439-1444. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We monitored central nervous system variables during rapid opiate detoxification for excitatory effects and their attenuation by the additional administration of the nonspecific N-methyl-d-aspartic acid-antagonist S(+)-ketamine.

Kuo-Sheng Liu, Jann-Inn Tzeng, Yu-Wen Chen, Kuo-Lun Huang, Chun-Hsiung Kuei, and Jhi-Joung Wang

Novel Depots of Buprenorphine Prodrugs Have a Long-Acting Antinociceptive Effect
Anesth Analg 2006 102: 1445-1451. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The antinociceptive effects of three novel depots of buprenorphine esters were evaluated. We found that the novel depots of buprenorphine esters buprenorphine propionate, enanthate, and decanoate had a long duration of antinociceptive effect after IM injections in rats. This result is valuable for the development of long-acting analgesia for pain management.

Mark Liao, Michael J. Laster, Edmond I. Eger, II, Michael Tang, and James M. Sonner

Naloxone Does Not Increase the Minimum Alveolar Anesthetic Concentration of Sevoflurane in Mice (Brief Report)
Anesth Analg 2006 102: 1452-1455. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The opioid antagonist naloxone does not increase the minimum alveolar anesthetic concentration of sevoflurane in mice. Opioid receptors do not mediate the capacity of inhaled anesthetics to suppress movement in response to noxious stimulation.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Richard Klaus Ellerkmann, Martin Soehle, Thorsten Michael Alves, Vidal-Markus Liermann, Ingobert Wenningmann, Heiko Roepcke, Sascha Kreuer, Andreas Hoeft, and Jörgen Bruhn

Spectral Entropy and Bispectral Index as Measures of the Electroencephalographic Effects of Propofol
Anesth Analg 2006 102: 1456-1462. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bispectral index seems to show slight advantages discriminating between anesthetic propofol effect-site concentrations in comparison with spectral entropy.

Stephen W. Cone, Lynne Gehr, Russell Hummel, and Ronald C. Merrell

Remote Anesthetic Monitoring Using Satellite Telecommunications and the Internet
Anesth Analg 2006 102: 1463-1467. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: To provide even remote areas with skilled, experienced anesthesiologists, an application of telemedicine resources was developed to transmit monitored patient data during anesthesia for consultation from a distance to improve patient outcome during anesthesia.

Bryan Harris and Matthew B. Weinger

An Insidious Failure of an Oxygen Analyzer (Case Report)
Anesth Analg 2006 102: 1468-1472. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case serves to illustrate the implications of monitor design and the potential impact of device failure in the absence of redundant monitoring of critical functionality.

PAIN MEDICINE:

Maneesh A. Deshpande, Ronald R. Holden, and Ian Gilron

The Impact of Therapy on Quality of Life and Mood in Neuropathic Pain: What Is the Effect of Pain Reduction?
Anesth Analg 2006 102: 1473-1479. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated the relationship between analgesia and mood/quality of life using outcomes from a recent clinical trial. Treatment-induced analgesia was shown to correlate with improvement in mood and quality of life. These results suggest that greater analgesic efficacy may lead to larger improvements in mood/quality of life.

A. Holzer, S. T. Jirecek, U. M. Illievich, J. Huber, and R. J. Wenzl

Laparoscopic Versus Open Myomectomy: A Double-Blind Study to Evaluate Postoperative Pain
Anesth Analg 2006 102: 1480-1484. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In a double-blind setting, laparoscopic surgery reduced postoperative pain and analgesic demand after myomectomy during the first 3 days after surgery compared with open surgery.

Chiang Siau and Gary J. Bennett

Dysregulation of Cellular Calcium Homeostasis in Chemotherapy-Evoked Painful Peripheral Neuropathy
Anesth Analg 2006 102: 1485-1490. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Paclitaxel and vincristine often produce a pain syndrome that compromises their usefulness as anticancer drugs. The experiments described here suggest that the pain may be caused by an impairment of neuronal or glial ability to properly regulate intracellular Ca2+. A possible underlying pathology could be impaired mitochondrial Ca2+ regulation.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Franklin Dexter, Jack C. Yue, and Angella J. Dow

Predicting Anesthesia Times for Diagnostic and Interventional Radiological Procedures
Anesth Analg 2006 102: 1491-1500. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthesia times for individual diagnostic radiological procedures (e.g., magnetic resonance imaging) can be based on systematic rules from the facility's experts. In contrast, a series of interventional radiological procedures performed on the same day can be scheduled consecutively up to a calculated time (e.g., 4 pm), assuring that the anesthesia team usually finishes before the end of the workday (6 pm).

Ira Todd Cohen and Kantilal Patel

Peer Review Interrater Concordance of Scientific Abstracts: A Study of Anesthesiology Subspecialty and Component Societies (Brief Report)
Anesth Analg 2006 102: 1501-1503. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated the selection process for subspecialty meeting abstracts. There was poor to moderate agreement among reviewers. We suggest that the review process can be improved by using clear evaluation criteria and scoring abstracts using interval scales.

CRITICAL CARE AND TRAUMA:

Lars Kjærsgaard Hansen, Erik Sloth, Jonas Nielsen, Jacob Koefoed-Nielsen, Per Lambert, Søren Lunde, and Anders Larsson

Selective Recruitment Maneuvers for Lobar Atelectasis: Effects on Lung Function and Central Hemodynamics: An Experimental Study in Pigs
Anesth Analg 2006 102: 1504-1510. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lobar lung collapse is common after anesthesia and surgery. A standard, general (global) lung inflation maneuver is usually effective in improving lung function but may cause significant cardiovascular depression. This experimental study shows that selective inflation of a collapsed lobe via a balloon catheter is effective and has no significant circulatory side effects.

Cyril Charron, Christine Fessenmeyer, Claudine Cosson, Jean-Xavier Mazoit, Jean-Louis Hebert, Dan Benhamou, and Alain R. Edouard

The Influence of Tidal Volume on the Dynamic Variables of Fluid Responsiveness in Critically Ill Patients
Anesth Analg 2006 102: 1511-1517. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The respiratory-related changes in stroke volume and arterial pulse pressure have the same predictive value for cardiac responsiveness to intravascular fluid administration in mechanically ventilated patients. The influence of tidal volume on pulse pressure variability may increase the sensitivity of the test.

Ruy J. Cruz, Jr, Margareth M. Yada-Langui, Luiz F. Poli de Figueiredo, Sueli Sinosaki, and Mauricio Rocha e Silva

The Synergistic Effects of Pentoxifylline on Systemic and Regional Perfusion After Hemorrhage and Hypertonic Resuscitation
Anesth Analg 2006 102: 1518-1524. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pentoxifylline (PTX) has beneficial effects when administrated after hemorrhagic shock, restoring cardiac output and improving splanchnic perfusion. We tested the hypothesis that a combination of small volumes of hypertonic saline solution and PTX in the initial treatment of hemorrhagic shock provides synergistic hemodynamic benefits.

Michael Imhoff and Silvia Kuhls

Alarm Algorithms in Critical Care Monitoring (Review Article)
Anesth Analg 2006 102: 1525-1537. [Abstract] [Full Text] [PDF] [Request Permissions]  

NEUROSURGICAL ANESTHESIA:

Ihab R. Kamel, Elizabeth T. Drum, Stephen A. Koch, Joseph A. Whitten, John P. Gaughan, Rodger E. Barnette, and Woodrow W. Wendling

The Use of Somatosensory Evoked Potentials to Determine the Relationship Between Patient Positioning and Impending Upper Extremity Nerve Injury During Spine Surgery: A Retrospective Analysis
Anesth Analg 2006 102: 1538-1542. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The lateral decubitus and prone "superman" positions were identified as high-risk positions for upper extremity somatosensory evoked potential changes in spine surgery. Somatosensory evoked potential changes were reversible by upper extremity position modification and were not associated with postoperative neurological deficits.

Armin Schubert, Anupa Deogaonkar, and John C. Drummond

Precordial Doppler Probe Placement for Optimal Detection of Venous Air Embolism During Craniotomy
Anesth Analg 2006 102: 1543-1547. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: For early detection of venous air embolism, accurate precordial Doppler probe verification with test injections is crucial. Left parasternal Doppler probe placement was at least as sensitive to test injections as right parasternal placement. Vigorous central test injection may result in false positive verification of laterally placed precordial Doppler probes.

Satoki Inoue, Daniel P. Davis, John C. Drummond, Daniel J. Cole, and Piyush M. Patel

The Combination of Isoflurane and Caspase 8 Inhibition Results in Sustained Neuroprotection in Rats Subject to Focal Cerebral Ischemia
Anesth Analg 2006 102: 1548-1555. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study investigates the combined efficacy of an anti-excitotoxic and an anti-apoptotic drug in preventing ischemic neuronal death in a rat model. The role of the extrinsic caspase pathway in ischemia is explored using IETD, a specific caspase 8 inhibitor.

Thomas A. Moore, II, James M. Markert, and Robert C. Knowlton

Dexmedetomidine as Rescue Drug During Awake Craniotomy for Cortical Motor Mapping and Tumor Resection (Case Report)
Anesth Analg 2006 102: 1556-1558. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this report, we discuss the use of dexmedetomidine as a rescue drug during an awake craniotomy for cortical motor mapping and tumor resection. The procedure was begun using a combination of continuous infusions of propofol and remifentanil, our prior standard regimen for these procedures.

REGIONAL ANESTHESIA:

Vincent Minville, Olivier Fourcade, David Grousset, Clément Chassery, Luc Nguyen, Karim Asehnoune, Aline Colombani, Lounès Goulmamine, and Kamran Samii

Spinal Anesthesia Using Single Injection Small-Dose Bupivacaine Versus Continuous Catheter Injection Techniques for Surgical Repair of Hip Fracture in Elderly Patients
Anesth Analg 2006 102: 1559-1563. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study showed that continuous spinal anesthesia provided fewer episodes of hypotension than single injection with 7.5 mg isobaric bupivacaine for surgical repair of hip fracture in elderly patients.

Harish Lecamwasam, James Mayfield, Laura Rosow, Yuchiao Chang, Christopher Carter, and Carl Rosow

Stimulation of the Posterior Cord Predicts Successful Infraclavicular Block
Anesth Analg 2006 102: 1564-1568. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Peripheral nerve stimulation was used to guide placement of local anesthetic during infraclavicular block of the brachial plexus. The fastest onset of motor block and the greatest clinical success occurred when the posterior cord was located before injection.

Catherine Marcucci, Neil B. Sandson, Eric M. Thorn, and Denis L. Bourke

Unrecognized Drug-Drug Interactions: A Cause of Intraoperative Cardiac Arrest? (Case Report)
Anesth Analg 2006 102: 1569-1572. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report uses the emerging literature on the hepatic CYP450 enzyme system to provide an analysis of how multiple drug-drug interactions had a catastrophic effect in a patient receiving an otherwise uncomplicated anesthetic. We believe that evaluations in the field of anesthetic pharmacology will increasingly be based on this type of analysis.

GENERAL ARTICLES:

Ahmet Eroglu, Figen Celep, and Nesrin Erciyes

A Comparison of Sister Chromatid Exchanges in Lymphocytes of Anesthesiologists to Nonanesthesiologists in the Same Hospital
Anesth Analg 2006 102: 1573-1577. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This prospective study demonstrates that the incidence of sister chromatid exchanges in anesthesiologists exposed to waste anesthetic gases such as sevoflurane and nitrous oxide is more frequent in unexposed physicians in the same hospital. The increase of sister chromatid exchanges in anesthesiologists is reversible if they work free from exposure for 2 mo.

Florent Capron, Louis-Philippe Fortier, Sébastien Racine, and François Donati

Tactile Fade Detection with Hand or Wrist Stimulation Using Train-of-Four, Double-Burst Stimulation, 50-Hertz Tetanus, 100-Hertz Tetanus, and Acceleromyography
Anesth Analg 2006 102: 1578-1584. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: To detect residual neuromuscular blockade, tactile evaluation of 50-Hz tetanic, train-of-four (TOF), or double-burst fade lacks sensitivity. Fade after a 100-Hz tetanus is unreliable. An acceleromyographic TOF ratio of 1.0 is recommended to exclude residual paralysis. Stimulation at the hand and the wrist yields similar results for tactile evaluation.

LETTER TO THE EDITOR:

Samer N. Narouze

Epidural Steroid Injections After Epidurography May Prevent Otherwise Devastating Complications
Anesth Analg 2006 102: 1585. [Full Text] [PDF] [Request Permissions]  

Mukesh Tripathi

Epidural Steroid Injections After Epidurography May Prevent Otherwise Devastating Complications
Anesth Analg 2006 102: 1585. [Full Text] [PDF] [Request Permissions]  

Samer N. Narouze

Is It Time to Perform All Thoracic Epidural Placements Under Fluoroscopy?
Anesth Analg 2006 102: 1585. [Full Text] [PDF] [Request Permissions]  

Mukesh Tripathi

Is It Time to Perform All Thoracic Epidural Placements Under Fluoroscopy?
Anesth Analg 2006 102: 1585-1586. [Full Text] [PDF] [Request Permissions]  

Ban C. H. Tsui

Is It Time to Perform All Thoracic Epidural Placements Under Fluoroscopy?
Anesth Analg 2006 102: 1586. [Full Text] [PDF] [Request Permissions]  

Muhammad A. Munir, Rahul Rastogi, and Srdjan Nedeljkovic

Fluoroscopy and Safety of Spinal Interventional Procedures
Anesth Analg 2006 102: 1586. [Full Text] [PDF] [Request Permissions]  

Mukesh Tripathi

Fluoroscopy and Safety of Spinal Interventional Procedures
Anesth Analg 2006 102: 1587. [Full Text] [PDF] [Request Permissions]  

Meda S. Raghavendra, Kenneth Candido, Mariadas Chinthagada, and Vikram Patel

Comments on the Case Report of Paraplegia After Intracord Injection
Anesth Analg 2006 102: 1587. [Full Text] [PDF] [Request Permissions]  

Michael B. Furman and Ninad D. Sthalekar

Minimizing Complications in Epidural Steroid Injections
Anesth Analg 2006 102: 1587-1588. [Full Text] [PDF] [Request Permissions]  

Narasimhan Jagannathan

Vascular Cut-Down: Is There a Role for the Anesthesiologist?
Anesth Analg 2006 102: 1588. [Full Text] [PDF] [Request Permissions]  

Catalin S. Ezaru

Preinduction Check-Up of the Anesthesia Machine
Anesth Analg 2006 102: 1588-1589. [Full Text] [PDF] [Request Permissions]  

Barbara Hunter, María Mercedes Kleinert, Javier Osatnik, and Elisa Soria

Serotonergic Syndrome and Abnormal Ocular Movements: Worsening of Rigidity by Remifentanil?
Anesth Analg 2006 102: 1589. [Full Text] [PDF] [Request Permissions]  

M. Lim and P. Ellahee

Recommendations for Postinduction Hypotension: Are They Supported by the Evidence?
Anesth Analg 2006 102: 1589-1590. [Full Text] [PDF] [Request Permissions]  

David L. Reich and Carol A. Bodian

Recommendations for Postinduction Hypotension: Are They Supported by the Evidence?
Anesth Analg 2006 102: 1590. [Full Text] [PDF] [Request Permissions]  

Yoshihiro Fujiwara, Yasuyuki Shibata, Shuji Kurokawa, Yuko Satou, and Toru Komatsu

Ventricular Tachycardia in a Patient with Brugada Syndrome During General Anesthesia Combined with Thoracic Paravertebral Block
Anesth Analg 2006 102: 1590-1591. [Full Text] [PDF] [Request Permissions]  

Charles D. Boucek and Kareem Abu El Magd

Alternative Route Transfusion for Transplantation Surgery in Patients Lacking Accessible Veins
Anesth Analg 2006 102: 1591-1592. [Full Text] [PDF] [Request Permissions]  

David A. Zvara, Randy W. Calicott, and Deborah M. Whelan

Positioning for Intubation in Morbidly Obese Patients
Anesth Analg 2006 102: 1592. [Full Text] [PDF] [Request Permissions]  

Thiruvenkatarajan Venkatesan

Desflurane's Effect on QTc Interval: Electrophysiological Mechanisms Need to Be Explored
Anesth Analg 2006 102: 1592-1593. [Full Text] [PDF] [Request Permissions]  

Radoslaw Owczuk, Magdalena A. Wujtewicz, Wioletta Sawicka, Jerzy Lasek, and Maria Wujtewicz

Desflurane's Effect on QTc Interval: Electrophysiological Mechanisms Need to Be Explored
Anesth Analg 2006 102: 1593. [Full Text] [PDF] [Request Permissions]  

Halil Yildirim

Desflurane's Effect on QTc Interval: Electrophysiological Mechanisms Need to Be Explored
Anesth Analg 2006 102: 1593. [Full Text] [PDF] [Request Permissions]  

Francisco A. Lobo and Pedro Amorim

Anesthesia for Craniotomy with Intraoperative Awakening: How to Avoid Respiratory Depression and Hypertension?
Anesth Analg 2006 102: 1593-1594. [Full Text] [PDF] [Request Permissions]  

John Keifer

Anesthesia for Craniotomy with Intraoperative Awakening: How to Avoid Respiratory Depression and Hypertension?
Anesth Analg 2006 102: 1594. [Full Text] [PDF] [Request Permissions]  

Ángel Martínez Navas

Stimulating Catheters in Continuous Popliteal Block
Anesth Analg 2006 102: 1594. [Full Text] [PDF] [Request Permissions]  

Andrea Casati, Francois Singelyn, and Zbignew Koscielniak-Nielsen

Stimulating Catheters in Continuous Popliteal Block
Anesth Analg 2006 102: 1594-1595. [Full Text] [PDF] [Request Permissions]  

Babak Roboubi and Santhosh M. Kodgi

Accidental Subdural Injection of Ropivacaine
Anesth Analg 2006 102: 1595. [Full Text] [PDF] [Request Permissions]  

Takashi Asai, Takako Sakai, Kohei Murao, Kentaro Kojima, and Koh Shingu

More Difficulty in Removing an Arrow Epidural Catheter
Anesth Analg 2006 102: 1595-1596. [Full Text] [PDF] [Request Permissions]  

Frank Overdyk, Rickey Carter, and Ray Maddox

New JCAHO Pain Standard Bigger Threat to Patient Safety Than Envisioned
Anesth Analg 2006 102: 1596. [Full Text] [PDF] [Request Permissions]  

Hector Vila, Jr and John B. Downs

New JCAHO Pain Standard Bigger Threat to Patient Safety Than Envisioned
Anesth Analg 2006 102: 1596-1597. [Full Text] [PDF] [Request Permissions]  

Fernando Altermatt, Luis I. Cortínez, and Hernán Muñoz

Plasma Levels of Levobupivacaine After Combined Posterior Lumbar Plexus and Sciatic Nerve Blocks
Anesth Analg 2006 102: 1597. [Full Text] [PDF] [Request Permissions]  

Judith M. Kahn, Helmut M. Müller, Alexander Kulier, Astrid Keusch-Preininger, and Karl-Heinz Tscheliessnigg

Veno-Arterial Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrome Caused by Leptospire Sepsis
Anesth Analg 2006 102: 1597-1598. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Kenneth A. Haselby

Laryngeal Mask Anesthesia: Principles and Practice. 2nd ed.
Anesth Analg 2006 102: 1599. [Full Text] [PDF] [Request Permissions]  

Rebecca Barnett

Liver Transplant Anesthesia and Critical Care Forum, www.litac.net.
Anesth Analg 2006 102: 1599-1600. [Full Text] [PDF] [Request Permissions]  

Adam J. Cambray

Anesthesia and Uncommon Diseases, 5th ed.
Anesth Analg 2006 102: 1600. [Full Text] [PDF] [Request Permissions]  

ERRATA:

Erratum
Anesth Analg 2006 102: 1332. [Full Text] [PDF] [Request Permissions]  

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