CARDIOVASCULAR ANESTHESIA:

Andrew D. Maslow, Gary Stearns, Parag Batula, Carl S. Schwartz, Jeffrey Gough, and Arun K. Singh

The Hemodynamic Effects of Methylene Blue When Administered at the Onset of Cardiopulmonary Bypass
Anesth Analg 2006 103: 2-8. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We studied the hemodynamic effects of methylene blue, administered at the onset of cardiopulmonary bypass to patients with a history of hypertension treated with an angiotensin-converting enzyme inhibitor. Methylene blue administration resulted in increased arterial blood pressure and systemic vascular resistance, a lower serum lactate level, and decreased perioperative cardiopulmonary bypass vasopressor requirement. This study demonstrates that methylene blue, administered during cardiopulmonary bypass, has significant benefit.

Patrick Lecomte, Alexandre Ouattara, Yannick Le Manach, Marc Landi, Pierre Coriat, and Bruno Riou

The Coronary and Myocardial Effects of Remifentanil and Sufentanil in the Erythrocyte-Perfused Isolated Rabbit Heart
Anesth Analg 2006 103: 9-14. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In an erythrocyte-perfused and isolated rabbit heart model, remifentanil is devoid of significant direct coronary effects. These results suggest that the myocardial ischemia, which may occur during remifentanil-induced hemodynamic instability, especially in cardiac patients, does not involve direct changes in coronary vasomotor tone.

Sukhjeewan Basran, Robert J. Frumento, Allison Cohen, Samuel Lee, Yuling Du, Ervant Nishanian, Harold S. Kaplan, Mark Stafford-Smith, and Elliott Bennett-Guerrero

The Association Between Duration of Storage of Transfused Red Blood Cells and Morbidity and Mortality After Reoperative Cardiac Surgery
Anesth Analg 2006 103: 15-20. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The duration of storage of transfused red blood cells may impact morbidity and mortality after repeat sternotomy for cardiac surgery.

Charles W. Hogue, Jr, Christopher A. Palin, and Joseph E. Arrowsmith

Cardiopulmonary Bypass Management and Neurologic Outcomes: An Evidence-Based Appraisal of Current Practices (Review Article)
Anesth Analg 2006 103: 21-37. [Abstract] [Full Text] [PDF] [Request Permissions]  

C. Perruchoud, C. Blanc, P. Ruchat, P. G. Chassot, S. Brenn, and D. R. Spahn

Transesophageal Echocardiography for the Diagnosis and Management of Massive Pulmonary Embolism (Echo Rounds)
Anesth Analg 2006 103: 38-39. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

Mark S. Adams, Theodore A. Alston, and Jennifer D. Walker

Detection of an Ill-Poised Thread of Lint by Transesophageal Echocardiography After Aortic Valve Replacement (Echo Rounds)
Anesth Analg 2006 103: 40. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

Cheng-Wei Lu, Tzu-Yu Lin, and Ming-Jiuh Wang

Large Coronary Arteriovenous Fistula to the Main Pulmonary Artery (Echo Rounds)
Anesth Analg 2006 103: 41-42. [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

PEDIATRIC ANESTHESIA:

Joseph R. Tobin, Steven L. Shafer, and Peter J. Davis

Pediatric Research and Scholarship: Another Gordian Knot? (Editorial)
Anesth Analg 2006 103: 43-48. [Full Text] [PDF] [Request Permissions]  

Lex W. Schultheis, Lisa L. Mathis, Rigoberto A. Roca, Arthur F. Simone, Sharon H. Hertz, and Bob A. Rappaport

Pediatric Drug Development in Anesthesiology: An FDA Perspective (Editorial)
Anesth Analg 2006 103: 49-51. [Full Text] [PDF] [Request Permissions]  

Ahmed M. Mukhtar, Eman M. Obayah, and Amira M. Hassona

The Use of Dexmedetomidine in Pediatric Cardiac Surgery (Editorial)
Anesth Analg 2006 103: 52-56. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The {alpha}2 agonist dexmedetomidine attenuates increases in heart rate, arterial blood pressure, plasma cortisol, and catecholamine concentrations in pediatric patients undergoing open heart surgery.

Keira P. Mason, Steven E. Zgleszewski, Jennifer L. Dearden, Raymond S. Dumont, Michele A. Pirich, Cynthia D. Stark, Peggy D'Angelo, Shann MacPherson, Paulette J. Fontaine, Linda Connor, and David Zurakowski

Dexmedetomidine for Pediatric Sedation for Computed Tomography Imaging Studies (Editorial)
Anesth Analg 2006 103: 57-62. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This is the first study that prospectively evaluates the sedation profile of a dexmedetomidine pilot program for pediatric sedation for radiological imaging studies.

Ahmet Koroglu, Huseyin Teksan, Ozlem Sagir, Aytaç Yucel, Huseyin I. Toprak, and Ozcan M. Ersoy

A Comparison of the Sedative, Hemodynamic, and Respiratory Effects of Dexmedetomidine and Propofol in Children Undergoing Magnetic Resonance Imaging (Editorial)
Anesth Analg 2006 103: 63-67. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated the sedative, hemodynamic, and respiratory effects of dexmedetomidine and propofol in children undergoing magnetic resonance imaging examination. Although propofol provided faster induction and recovery times, it caused hypotension and desaturation. Thus, dexmedetomidine could be an alternative reliable sedative drug to propofol in selected patients.

David A. Rosen and Jason T. Daume

Short Duration Large Dose Dexmedetomidine in a Pediatric Patient During Procedural Sedation (Case Report)
Anesth Analg 2006 103: 68-69. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Adult dosing strategies for dexmedetomidine often produce inadequate cooperation in the pediatric patient. This case demonstrates that dexmedetomidine, at doses larger than those used in adults, may be effective in pediatric patients. More studies are needed to determine optimal dosing for this drug in the pediatric patient and to investigate the efficacy of non-IV administration of this drug.

AMBULATORY ANESTHESIA:

Francis Whalen, Juraj Sprung, Christopher M. Burkle, Darrell R. Schroeder, and David O. Warner

Recent Smoking Behavior and Postoperative Nausea and Vomiting
Anesth Analg 2006 103: 70-75. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The protective aspect of smoking on postoperative nausea and vomiting is not likely to be attributable to an acute action of smoke constituents.

Paul F. White, Quinlan Amos, Yunan Zhang, Louis Stool, Mustafa M. Husain, Larry Thornton, Michael Downing, Shawn McClintock, and Sarah H. Lisanby

Anesthetic Considerations for Magnetic Seizure Therapy: A Novel Therapy for Severe Depression
Anesth Analg 2006 103: 76-80. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Magnetic seizure therapy (MST) is a novel therapy for depression. It is associated with a more rapid recovery of cognitive function compared with conventional electroconvulsive therapy (ECT). To minimize residual paralysis after MST treatments, a reduced dose of succinylcholine should be administered. Of importance, these preliminary data suggest that MST may produce less effective seizure activity than ECT.

ANESTHETIC PHARMACOLOGY:

Albert Won, Irene Oh, Michael J. Laster, John Popovich, Edmond I. Eger, II, and James M. Sonner

Chirality in Anesthesia I: Minimum Alveolar Concentration of Secondary Alcohol Enantiomers
Anesth Analg 2006 103: 81-84. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: MAC for the enantiomers of 2-butanol and 2-pentanol differ by 17% and 38%, respectively, approximately the same amount as reported for the isomers of isoflurane. These findings open the door to studies of chirality in anesthesia using inexpensive volatile compounds.

Robert Brosnan, Diane Gong, Joseph Cotten, Bharat Keshavaprasad, C. Spencer Yost, Edmond I. Eger, II, and James M. Sonner

Chirality in Anesthesia II: Stereoselective Modulation of Ion Channel Function by Secondary Alcohol Enantiomers
Anesth Analg 2006 103: 86-91. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Enantioselectivity should not be used as a test of relevance for molecular targets mediating the capacity of anesthetics to produce immobility in the face of noxious stimulation because of the poor sensitivity and specificity of this test.

Robert A. Whittington and László Virág

Isoflurane Decreases Extracellular Serotonin in the Mouse Hippocampus
Anesth Analg 2006 103: 92-98. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In the mouse hippocampus, isoflurane significantly decreased serotonin, a neurotransmitter linked to awareness, cognition, depression, and anxiety. This decrease was larger in the absence of the serotonin transporter, the protein responsible for the synaptic reuptake of serotonin, and persisted for several hours after isoflurane exposure.

Uriah Guevara-López, Alfredo Covarrubias-Gómez, Hilario Gutierrez-Acar, J. Antonio Aldrete, Francisco J. López-Muñoz, and Braulio Martínez-Benítez

Chronic Subarachnoid Administration of 1-(4chlorobenzoyl)-5methoxy-2methyl-1H-indole-3 Acetic Acid (Indomethacin): An Evaluation of Its Neurotoxic Effects in an Animal Model
Anesth Analg 2006 103: 99-102. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Epidural nonsteroidal antiinflammatory drug administration has been considered as an alternative in pain management. We administered subarachnoid indomethacin in guinea pigs and evaluated whether this procedure promoted changes suggestive of histological neurotoxicity. No suggestive neurotoxicity was found. Further research is required before considering human administration of indomethacin by this route.

Ferenc Peták, Zoltán Hantos, Ágnes Adamicza, Hristifor Gálity, and Walid Habre

Development of Bronchoconstriction After Administration of Muscle Relaxants in Rabbits with Normal or Hyperreactive Airways
Anesth Analg 2006 103: 103-109. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bronchial hyperreactivity substantially increases the magnitude and rate of airway constriction after the administration of mivacurium or succinylcholine, whereas pipecuronium responses are milder. Anesthesiologists should be alert when considering the former anesthetics in the presence of airway hyperresponsiveness.

Tao Luo and Zhengyuan Xia

A Small Dose of Hydrogen Peroxide Enhances Tumor Necrosis Factor-Alpha Toxicity in Inducing Human Vascular Endothelial Cell Apoptosis: Reversal with Propofol
Anesth Analg 2006 103: 110-116. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Hydrogen peroxide, at a small concentration (10 {micro}M) that did not cause significant lipid peroxidation per se, significantly enhanced tumor necrosis factor (TNF)-{alpha}-induced endothelial cell lipid peroxidation and programmed cell death. Propofol prevented this synergistic effect of hydrogen peroxide and TNF-{alpha} and may be beneficial in some clinical circumstances associated with increased oxidative stress.

Yuki Sato, Norimasa Seo, and Eiji Kobayashi

Ethanol-Induced Hypnotic Tolerance Is Absent in N-Methyl-d-Aspartate Receptor 1 Subunit Knockout Mice
Anesth Analg 2006 103: 117-120. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Although hypnotic sensitivity to a single injection of ethanol in NMDA receptor {varepsilon}1 subunit knockout mice did not differ from that in wild-type mice, hypnotic tolerance to ethanol was absent in knockout mice.

Maurizia Capuzzo, Barbara Zanardi, Elisa Schiffino, Cosimetta Buccoliero, Daniela Gragnaniello, Stefano Bianchi, and Raffaele Alvisi

Melatonin Does Not Reduce Anxiety More than Placebo in the Elderly Undergoing Surgery (Brief Report)
Anesth Analg 2006 103: 121-123. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Melatonin has been proposed as a drug suitable for reducing preoperative anxiety without cognitive impairment. This finding could be relevant in elderly patients undergoing elective surgery. Nevertheless, 90 min after study medication administration, anxiety was reduced to a similar degree in the patients receiving melatonin and placebo.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Michael F. Keresztury, Andrew G. Newman, Aruna Kode, and Woodrow W. Wendling

A Surprising Twist: An Unusual Failure of a Keyed Filling Device Specific for a Volatile Inhaled Anesthetic (Case Report)
Anesth Analg 2006 103: 124-125. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe two cases in which keyed filling devices specific for sevoflurane bottles were inadvertently screwed onto isoflurane bottles. The mishaps occurred because of a combination of active error (a slip or lapse) and latent errors (user inexperience and an unusual equipment failure of the keyed filling device).

ECONOMICS, EDUCATION, AND POLICY:

C. Philip Larson, Jr and Randolph H. Steadman

An Advanced Specialty Training Program in Anesthesiology: A Special Educational Fellowship Designed to Return Community Anesthesiologists to Clinical Practice (Special Article)
Anesth Analg 2006 103: 126-130. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Updating the skills of anesthesiologists takes less time than training medical school graduates new to the field. However, there are few programs for this purpose. Given the current shortage of anesthesiologists, opportunities for such training are needed. We describe a continuing education program designed to update anesthesiologists who are currently in practice as well as those who have been away from the specialty for a variable period.

Michael M. Vigoda and David A. Lubarsky

The Medicolegal Importance of Enhancing Timeliness of Documentation When Using an Anesthesia Information System and the Response to Automated Feedback in an Academic Practice
Anesth Analg 2006 103: 131-136. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Automated feedback using data extracted from an anesthesia information management system is an effective and enduring method to improve compliance with departmental documentation practices.

Getúlio Rodrigues de Oliveira Filho and Leonardo Schonhorst

Attitudes of Residents and Anesthesiologists Toward Basic Sciences
Anesth Analg 2006 103: 137-143. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A survey addressing the relevance of basic sciences to clinical practice revealed that, compared with residents, fully trained anesthesiologists were more likely to acknowledge the clinical relevance of basic science knowledge and value a deeper and more formal approach to learning.

CRITICAL CARE AND TRAUMA:

David A. Story, Hiroshi Morimatsu, and Rinaldo Bellomo

Hyperchloremic Acidosis in the Critically Ill: One of the Strong-Ion Acidoses?
Anesth Analg 2006 103: 144-148. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In 300 critically ill patients, plasma bicarbonate had a stronger association with the measured strong-ion difference than with chloride alone. The hyperchloremia in acidosis and hypochloremia in alkalosis is relative to the cations. Management of acid-base disorders involves controlling these relative strong-ion differences.

Ran Lv, Zhi-Qiang Zhou, Hai-Wei Wu, Yi Jin, Wei Zhou, and Jian-Guo Xu

Hydroxyethyl Starch Exhibits Antiinflammatory Effects in the Intestines of Endotoxemic Rats
Anesth Analg 2006 103: 149-155. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Infusion of hydroxyethyl starch (HES) might attenuate the inflammatory response in the intestines of endotoxemic rats. This antiinflammatory effect of HES may act through suppression of nuclear factor-{kappa}B and activator protein-1 activations. These findings may help clinicians choose the most appropriate plasma substitute in sepsis.

Craig Charleston, Rudolph Puana, Russell K. McAllister, Felicia A. Hunter, and Ed W. Childs

Morphine Sulfate Attenuates Hemorrhagic Shock- Induced Hyperpermeability
Anesth Analg 2006 103: 156-161. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Morphine sulfate attenuated hyperpermeability after hemorrhagic shock. Our results suggest that instead of aggravating the inflammatory response after hemorrhagic shock, morphine may provide protection to the microvasculature.

NEUROSURGICAL ANESTHESIA:

Brigid C. Flynn and Edward C. Nemergut

Postoperative Nausea and Vomiting and Pain After Transsphenoidal Surgery: A Review of 877 Patients
Anesth Analg 2006 103: 162-167. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: An intraoperative cerebrospinal fluid leak and subsequent fat grafting, the use of lumbar intrathecal catheter, and patients presenting for the resection of a craniopharyngiomas were found to be associated with an increased risk of postoperative nausea and vomiting after transsphenoidal surgery. Most patients undergoing transsphenoidal procedures have relatively small postoperative narcotic requirements.

Yuji Kadoi, Ken-ichiro Takahashi, Shigeru Saito, and Fumio Goto

The Comparative Effects of Sevoflurane Versus Isoflurane on Cerebrovascular Carbon Dioxide Reactivity in Patients with Diabetes Mellitus
Anesth Analg 2006 103: 168-172. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We showed that cerebrovascular CO2 reactivity in insulin-dependent diabetic patients is impaired under both sevoflurane and isoflurane anesthesia.

Monika Pape, Kristin Engelhard, Eva Eberspächer, Regina Hollweck, Kristine Kellermann, Susanne Zintner, Peter Hutzler, and Christian Werner

The Long-Term Effect of Sevoflurane on Neuronal Cell Damage and Expression of Apoptotic Factors After Cerebral Ischemia and Reperfusion in Rats
Anesth Analg 2006 103: 173-179. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Experiments in rats subjected to incomplete hemispheric cerebral ischemia with reperfusion revealed a sustained neuroprotective effect of sevoflurane. Anesthesia with sevoflurane inhibited eosinophilic injury up to 28 days from insult and reduced promoters of apoptotic cell death for 3 days. Compared with necrotic damage, apoptosis involving caspase-3 plays a minor role in this ischemia model.

David L. McDonagh, Idi N. Allen, John C. Keifer, and David S. Warner

Induction of Hypothermia After Intraoperative Hypoxic Brain Insult (Case Report)
Anesth Analg 2006 103: 180-181. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case of suspected intraoperative hypoxic brain injury treated with moderate hypothermia. Anesthesiologists should be aware of the option of this therapy and how to use it in the setting of suspected hypoxic brain injury.

OBSTETRIC ANESTHESIA:

Filiep M. Soetens, Maurits A. Soetens, and Marcel P. Vercauteren

Levobupivacaine-Sufentanil With or Without Epinephrine During Epidural Labor Analgesia
Anesth Analg 2006 103: 182-186. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Adding epinephrine to levobupivacaine and sufentanil decreases hourly drug consumption and rescue dosing and provides faster maternal comfort during epidural labor analgesia. Apgar scores at 1 and 5 min were lower in the epinephrine group, but the incidences of scores <7 were not different between groups.

Marc Van de Velde, Dominique Van Schoubroeck, Jacques Jani, An Teunkens, Carlo Missant, and J. Deprest

Combined Spinal-Epidural Anesthesia for Cesarean Delivery: Dose-Dependent Effects of Hyperbaric Bupivacaine on Maternal Hemodynamics
Anesth Analg 2006 103: 187-190. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Maternal hypotension is an important side effect of spinal anesthesia during cesarean delivery. This randomized trial demonstrates that reducing the spinal dose of local anesthetic as part of a combined spinal-epidural technique improves maternal hemodynamic stability without affecting the quality of anesthesia but is associated with reduced duration of anesthesia.

GENERAL ARTICLES:

Joachim Boldt, Thilo Schölhorn, Jochen Mayer, Sven Piper, and Stefan Suttner

The Value of an Albumin-Based Intravascular Volume Replacement Strategy in Elderly Patients Undergoing Major Abdominal Surgery
Anesth Analg 2006 103: 191-199. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In elderly patients undergoing major abdominal surgery, human albumin (HA) showed no advantages over a third generation hydroxyethyl starch (HES; 130/0.4) preparation. Although total protein was higher in the HA group, HA was not superior for hemodynamics, coagulation, and kidney function. Inflammatory response and endothelial activation-injury increased less in the HES patients.

Jung Hong and Loreta Grecu

Laryngospasm After Autologous Blood Transfusion (Case Report)
Anesth Analg 2006 103: 200-202. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report suggests that autologous blood transfusions can trigger a febrile nonhemolytic transfusion reaction, which may present with airway compromise.

Stephen P. Fischer, Clifford A. Schmiesing, Cosmin G. Guta, and John G. Brock-Utne

General Anesthesia and Chronic Amphetamine Use: Should the Drug Be Stopped Preoperatively? (Case Report)
Anesth Analg 2006 103: 203-206. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Amphetamine therapy is prescribed for patients with narcolepsy, exogenous obesity, Parkinson's disease, attention deficit disorder, and other psychiatric diagnoses. The significant effects of these potent sympathomimetic amines can potentially affect a patient's hemodynamic stability during anesthesia. We report eight cases of patients receiving chronic amphetamine therapy who underwent general anesthesia without adverse events or outcomes.

PAIN MEDICINE:

Lino Becerra, Kim Harter, R. Gilberto Gonzalez, and David Borsook

Functional Magnetic Resonance Imaging Measures of the Effects of Morphine on Central Nervous System Circuitry in Opioid-Naive Healthy Volunteers
Anesth Analg 2006 103: 208-216. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using functional magnetic resonance imaging, we evaluated the effects of small doses of morphine on brain function in healthy volunteers. Functional magnetic resonance imaging measurements of the specific effects of drugs allows for an understanding of how these drugs act on specific circuits, including desirable effects (e.g., on analgesic circuits) and undesirable effects (e.g., addiction).

Ulrich Grundmann, Clemens Wörnle, Andreas Biedler, Sascha Kreuer, Marc Wrobel, and Wolfram Wilhelm

The Efficacy of the Non-Opioid Analgesics Parecoxib, Paracetamol and Metamizol for Postoperative Pain Relief After Lumbar Microdiscectomy
Anesth Analg 2006 103: 217-222. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Systemic administration of analgesics is the most widely used method for pain therapy after lumbar disk surgery. Because parecoxib, the only parenterally administered coxib, has not been investigated under these conditions and, even more important, a comparison with other injectable non-opioid analgesics is still missing, we studied the analgesic efficacy of parecoxib, paracetamol, and metamizol for postoperative pain relief in 80 patients undergoing lumbar microdiscectomy.

REGIONAL ANESTHESIA:

James R. Hebl, Terese T. Horlocker, and Darrell R. Schroeder

Neuraxial Anesthesia and Analgesia in Patients with Preexisting Central Nervous System Disorders
Anesth Analg 2006 103: 223-228. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Patients with preexisting neurologic disease may be at increased risk of subsequent neurologic injury secondary to patient, surgical, and anesthetic risk factors. However, the current investigation suggests that neuraxial anesthesia and analgesia may not worsen neurologic outcome and should therefore not be considered an absolute contraindication within this patient population.

Alain Borgeat, Stephan Blumenthal, Maud Lambert, Panagiotis Theodorou, and Patrick Vienne

The Feasibility and Complications of the Continuous Popliteal Nerve Block: A 1001-Case Survey
Anesth Analg 2006 103: 229-233. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In 1001 patients we prospectively evaluated the feasibility and complications associated with the continuous popliteal catheter by using the modified posterior approach. This study demonstrated that this technique was associated with frequent success and few acute and delayed complications.

Andrea Casati, Giorgio Danelli, Marco Berti, Augusto Fioro, Andrea Fanelli, Cristina Benassi, Gioacchino Petronella, and Guido Fanelli

Intrathecal 2-Chloroprocaine for Lower Limb Outpatient Surgery: A Prospective, Randomized, Double-Blind, Clinical Evaluation
Anesth Analg 2006 103: 234-238. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This prospective, randomized, double-blind investigation demonstrated that 40 and 50 mg of 1% plain 2-chlorprocaine provided adequate surgical block in outpatients undergoing lower limb surgery of 45-60 min duration. Reducing the dose of 2-chloroprocaine to 30 mg resulted in a spinal block of insufficient duration and had no advantages in terms of home discharge time.

Eilish M. Galvin, Sjoerd Niehof, Serge JC Verbrugge, Iscandar Maissan, Alexander Jahn, Jan Klein, and Jasper van Bommel

Peripheral Flow Index Is a Reliable and Early Indicator of Regional Block Success
Anesth Analg 2006 103: 239-243. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This is a prospective study that validates peripheral flow index (PFI) as a simple, early and objective assessment of the success and failure of peripheral nerve blocks. Our results demonstrate that PFI is a more reliable indicator of block outcome than either cold or pinprick testing.

Manuel Taboada, Jaime Rodríguez, Cristina Valiño, Miriam Vazquez, Araceli Laya, Manuel Garea, Javier Carceller, Julian Alvarez, Vanessa Atanassoff, and Peter G. Atanassoff

A Prospective, Randomized Comparison Between the Popliteal and Subgluteal Approaches for Continuous Sciatic Nerve Block with Stimulating Catheters (Brief Report)
Anesth Analg 2006 103: 244-247. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Comparison of two different continuous sciatic blocks with stimulating catheters demonstrated that the two approaches were effective; however, a larger volume of local anesthetic is necessary after the distal posterior popliteal approach as compared with the proximal subgluteal approach.

COCHRANE CORNER:

H. HG Handoll and Z. J. Koscielniak-Nielsen

Single, Double, or Multiple Injection Techniques for Axillary Brachial Plexus Block for Hand, Wrist, or Forearm Surgery
Anesth Analg 2006 103: 248. [Full Text] [PDF] [Request Permissions]  

LETTER TO THE EDITOR:

Paula M. Bokesch

Untying the Gordian Knot
Anesth Analg 2006 103: 249-250. [Full Text] [PDF] [Request Permissions]  

Ahmed M. Mukhtar, Eman M. Obayah, and Amira M. Hassona

Preliminary Experience with Dexmedetomidine in Pediatric Anesthesia
Anesth Analg 2006 103: 250. [Full Text] [PDF] [Request Permissions]  

Lynn M. Broadman and Igor Semenov

The Use of "Off-Label" Drugs
Anesth Analg 2006 103: 250-251. [Full Text] [PDF] [Request Permissions]  

Virginie Luce, Yves Auroy, and Dan Benhamou

What Good are Large Databases of Intraoperative Data?
Anesth Analg 2006 103: 251-252. [Full Text] [PDF] [Request Permissions]  

David L. Reich, Sabera Hossain, and Carol A. Bodian

What Good are Large Databases of Intraoperative Data?
Anesth Analg 2006 103: 252. [Full Text] [PDF] [Request Permissions]  

Baljit Singh

Mandibular Nerve Block for the Removal of Dentures During Trismus Caused by Tetanus
Anesth Analg 2006 103: 252-253. [Full Text] [PDF] [Request Permissions]  

Eric Meaudre, Bruno Palmier, and Jacques Ripart

Mandibular Nerve Block for the Removal of Dentures During Trismus Caused by Tetanus
Anesth Analg 2006 103: 253. [Full Text] [PDF] [Request Permissions]  

C. Chamorro, M. A. Romera, and M. Valdivia

Rocuronium in Emergent Intubation
Anesth Analg 2006 103: 253-254. [Full Text] [PDF] [Request Permissions]  

Rajesh Mahajan, Rahul Gupta, and Anju Sharma

Tube Design for Nasotracheal Intubation
Anesth Analg 2006 103: 254. [Full Text] [PDF] [Request Permissions]  

Jae-Hyon Bahk and Jong-Hwan Lee

Tube Design for Nasotracheal Intubation
Anesth Analg 2006 103: 254. [Full Text] [PDF] [Request Permissions]  

Ashraf A. Dahaba, Helmar Bornemann, Peter H. Rehak, and Helfried Metzler

Electromagnetic Emission of High-Energy Extracorporeal Shockwave Lithotripsy to the Shoulder does not Cause Disruption of Bispectral Index Monitoring of Propofol or Sevoflurane Anesthesia
Anesth Analg 2006 103: 254-256. [Full Text] [PDF] [Request Permissions]  

Ju-Mei Ng

Total Intravenous Anesthesia with Propofol and Remifentanil for Video-Assisted Thoracoscopic Thymectomy in Patients with Myasthenia Gravis
Anesth Analg 2006 103: 256-257. [Full Text] [PDF] [Request Permissions]  

Ling Ye, Jin Liu, and Tao Zhu

A Useful Modification of the Bier’s Block
Anesth Analg 2006 103: 257. [Full Text] [PDF] [Request Permissions]  

Dmitri Chamchad, Mark Finnegan, and Jay C. Horrow

Spinal, but Not Epidural Anesthesia, for Pubic Symphysis Separation
Anesth Analg 2006 103: 258. [Full Text] [PDF] [Request Permissions]  

Abderrahmane Bouaggad, Fahd Bennani, Rachid Al Harrar, Moulay Ahmed Bouderka, and Abdessalem Harti

Anesthesia for a Patient with Tracheal Tumor Using Laryngeal Mask Airway
Anesth Analg 2006 103: 258-259. [Full Text] [PDF] [Request Permissions]  

Balachundhar Subramaniam and Peter J. Panzica

Failure to Advance a Guidewire During Internal Jugular Venous Cannulation: An Unusual Cause
Anesth Analg 2006 103: 259. [Full Text] [PDF] [Request Permissions]  

Uriel A. Yodfat and Sonia J. Vaida

Unexpected Falsely Low Pulse Oximeter Measurements in a Child with Hemoglobin Cheverly
Anesth Analg 2006 103: 259-260. [Full Text] [PDF] [Request Permissions]  

Maurice Lippmann and Clinton Kakazu

Hemodynamics with Propofol: Is Propofol Dangerous in Classes III-V Patients?
Anesth Analg 2006 103: 260. [Full Text] [PDF] [Request Permissions]  

Gentian Meta, Ahmed Ghaleb, W. Brooks Gentry, and Juan Firnhaber

Intrathecal Therapy-Associated Masses
Anesth Analg 2006 103: 260-261. [Full Text] [PDF] [Request Permissions]  

Jonathan V. Roth

The Use of Vasopressin Bolus to Treat Refractory Hypotension Secondary to Reperfusion During Orthotopic Liver Transplantation
Anesth Analg 2006 103: 261. [Full Text] [PDF] [Request Permissions]  

Katarzyna Natasza Charbucinska, Gilles Godet, Omar Itani, Marie-Hélène Fleron, Michèle Bertrand, Mario Rienzo, and Pierre Coriat

Anticoagulation Management for Patients with Drug-Eluting Stents Undergoing Vascular Surgery
Anesth Analg 2006 103: 261-263. [Full Text] [PDF] [Request Permissions]  

Chandra K. Pandey, Promod Patra, Kailash C. Pant, and Prabhat K. Singh

Gabapentin for the Treatment of Refractory Dysesthetic Pain After Open Cholecystectomy
Anesth Analg 2006 103: 263. [Full Text] [PDF] [Request Permissions]  

Yigal Leykin and Tommaso Pellis

A Model of Postanesthesia Care Unit-Based Acute Pain Service
Anesth Analg 2006 103: 263-264. [Full Text] [PDF] [Request Permissions]  

Robert Hanss, Peter H. Tonner, Jens Scholz, and Berthold Bein

Heart Rate Variability as a Promising Tool to Predict Hypotension
Anesth Analg 2006 103: 264. [Full Text] [PDF] [Request Permissions]  

Sonia J. Vaida and Uriel A. Yodfat

Angulation of the Airway Tube in the AMBU Laryngeal Mask Could Be Responsible for Improved Insertion Success
Anesth Analg 2006 103: 264. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Andrew W. Murray

Perioperative Care in Cardiac Anesthesia and Surgery
Anesth Analg 2006 103: 265. [Full Text] [PDF] [Request Permissions]  

J. Kent Garman

Healthcare Informatics
Anesth Analg 2006 103: 266. [Full Text] [PDF] [Request Permissions]  

ERRATA:

ERRATUM
Anesth Analg 2006 103: 85. [Full Text] [PDF] [Request Permissions]  

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