EDITORIALS:

Charles W. Hogue and Martin J. London

Aprotinin Use During Cardiac Surgery: A New or Continuing Controversy? (Editorial)
Anesth Analg 2006 103: 1067-1070. [Full Text] [PDF] [Request Permissions]  

Jeffrey M. Feldman

Can Clinical Monitors Be Used as Scientific Instruments? (Editorial)
Anesth Analg 2006 103: 1071-1072. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Wulf Dietrich, Raimund Busley, and Monika Kriner

High-Dose Aprotinin in Cardiac Surgery: Is High-Dose High Enough?: An Analysis of 8281 Cardiac Surgical Patients Treated with Aprotinin
Anesth Analg 2006 103: 1074-1081. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In 8281 cardiac surgical patients, we retrospectively tested the hypothesis that higher doses of aprotinin may be more effective in reducing bleeding and transfusion requirements compared to lower doses. In a dose-dependent manner, aprotinin reduced postoperative chest tube drainage, transfusion requirement, and the incidence of rethoracotomy, while there was no detrimental effect on renal function.

David Royston, Jerrold H. Levy, Jane Fitch, Wulf Dietrich, Simon C. Body, John M. Murkin, Bruce D. Spiess, and Andrea Nadel

Full-Dose Aprotinin Use in Coronary Artery Bypass Graft Surgery: An Analysis of Perioperative Pharmacotherapy and Patient Outcomes
Anesth Analg 2006 103: 1082-1088. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We sought to determine if large-dose aprotinin therapy had any benefit to patients having myocardial revascularization other than reduction in transfusion. Analysis of a database of 1723 patients participating in randomized, blinded, placebo-controlled studies showed that, in patients when given this therapy, stroke and need for therapy to maintain cardiovascular stability were significantly less.

Kenji Yoshitani, Fellery de Lange, Qing Ma, Hilary P. Grocott, and G. Burkhard Mackensen

Reduction in Air Bubble Size Using Perfluorocarbons During Cardiopulmonary Bypass in the Rat
Anesth Analg 2006 103: 1089-1093. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Perfluorocarbon administration significantly reduced the volume of bubbles within the cardiopulmonary bypass (CPB) circuit, suggesting that it may be advantageous for reducing bubble-associated damage during CPB.

Félix R. Montes, Darío Echeverri, Lorena Buitrago, Isabel Ramírez, Juan C. Giraldo, Javier D. Maldonado, and Juan P. Umaña

The Vasodilatory Effects of Levosimendan on the Human Internal Mammary Artery
Anesth Analg 2006 103: 1094-1098. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Levosimendan is a potent, endothelium-independent, direct vasodilator of the internal mammary artery (IMA). These in vitro data suggest that levosimendan might be a useful drug for the inhibition of IMA vasospasm in myocardial revascularization surgery.

Jan-P. Breuer, Vera von Dossow, Christian von Heymann, Markus Griesbach, Michael von Schickfus, Elise Mackh, Cornelia Hacker, Ulrike Elgeti, Wolfgang Konertz, Klaus-D. Wernecke, and Claudia D. Spies

Preoperative Oral Carbohydrate Administration to ASA III-IV Patients Undergoing Elective Cardiac Surgery
Anesth Analg 2006 103: 1099-1108. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Preoperative fasting before major surgery is detrimental to patients' pre- and postoperative well-being and increases postoperative insulin resistance. Clear fluid intake (400 mL) 2 h before surgery reduced thirst without increasing gastric fluid volume. Oral administration of carbohydrate-rich beverages did not affect insulin resistance, but was associated with intraoperative reduced inotropic requirements after initiation of cardiopulmonary bypass weaning until end of operation.

Dmitri Chamchad, George Djaiani, Hyun Ju Jung, Lev Nakhamchik, Jo Carroll, and Jay C. Horrow

Nonlinear Heart Rate Variability Analysis May Predict Atrial Fibrillation After Coronary Artery Bypass Grafting (Brief Report)
Anesth Analg 2006 103: 1109-1112. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Atrial fibrillation after coronary artery surgery prolongs hospital stay and complicates care. Predicting this outcome would allow targeted prophylaxis. Heart rate variability measures in this study indicate that peak point correlation dimension (PD2), a nonlinear measure, best associates with cardiac arrhythmias, warranting further investigation.

Kevin W. Hatton, Lawrence C. Kilinski, Chandrashekar Ramaiah, and Randall M. Schell

Multiple Failed External Defibrillation Attempts During Robot-Assisted Internal Mammary Harvest for Myocardial Revascularization (Case Report)
Anesth Analg 2006 103: 1113-1114. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report describes failed defibrillation during robot-assisted internal mammary harvesting during coronary artery bypass surgery. A discussion of pertinent factors that affect successful defibrillation and resuscitation during robot-assisted thoracic surgery follows the case report.

PEDIATRIC ANESTHESIA:

John C. Sanders, Melinda A. King, Ronald B. Mitchell, and James P. Kelly

Perioperative Complications of Adenotonsillectomy in Children with Obstructive Sleep Apnea Syndrome
Anesth Analg 2006 103: 1115-1121. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Adenotonsillectomy is a common surgical therapy for obstructive sleep apnea syndrome (OSAS) in children. This prospective study identifies perioperative complications and the risk factors associated with adenotonsillectomy in children with OSAS. Children with OSAS have a higher rate of complications after adenotonsillectomy than children undergoing the procedure for recurrent adenotonsillitis.

Suman Arora, Vidya Rattan, and Neerja Bhardwaj

An Evaluation of the Retromolar Space for Oral Tracheal Tube Placement for Maxillofacial Surgery in Children
Anesth Analg 2006 103: 1122-1125. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There is enough space in the retromolar region for endotracheal tube placement in children. Retromolar intubation can be used in children during surgery when intraoperative maxillomandibular fixation, and simultaneous access to the nose and oral cavity are required.

Gligor Gucev, David T. Raphael, Shlomo Elspas, and Gary Glass

Pediatric Airway and Esophageal Profiles with Acoustic Reflectometry
Anesth Analg 2006 103: 1126-1130. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Acoustic reflectometry profiles of the pediatric airway and esophagus were studied in children, aged 2-12 yr, intubated with endotracheal tubes (ETT) of 4.5-6 mm inner diameter (ID) The characteristic tracheal, esophageal, and bronchial profiles seen in adults were likewise seen in these pediatric patients. A case of possible ETT abutment against a bronchial wall, and its acoustic reflectometry detection, is discussed.

Nina A. Guzzetta, Bruce E. Miller, Kathy Todd, Fania Szlam, Renee H. Moore, Keith K. Brosius, Elizabeth C. Wilson, Anna M. Cohen, and Steven R. Tosone

Clinical Measures of Heparin’s Effect and Thrombin Inhibitor Levels in Pediatric Patients with Congenital Heart Disease
Anesth Analg 2006 103: 1131-1138. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Antithrombin III-deficient neonates presenting for cardiac surgery have lower than expected levels of {alpha}2M, a significant inhibitor of thrombin during the neonatal period. Our data raise concern about the ability to adequately anticoagulate these neonates during cardiopulmonary bypass and question the meaning of the prolonged activated clotting times values often seen in these children.

Kathryn Rouine-Rapp, Kenneth P. Rouillard, Wanda Miller-Hance, Norman H. Silverman, Kathryn K. Collins, Michael K. Cahalan, Alan Bostrom, and Isobel A. Russell

Segmental Wall-Motion Abnormalities After an Arterial Switch Operation Indicate Ischemia
Anesth Analg 2006 103: 1139-1146. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This prospective study of infants undergoing an arterial switch operation used echocardiography to detect myocardial motion abnormalities after repair. Infants with multiple abnormal myocardial segments had greater biochemical and electrocardiographic evidence of ischemia in the immediate postoperative period. This shows that segmental wall motion abnormalities after an arterial switch operation may be associated with ischemia.

AMBULATORY ANESTHESIA:

Rachel Eshima McKay, Alan Bostrom, Michel C. Balea, and Warren R. McKay

Airway Responses During Desflurane Versus Sevoflurane Administration via a Laryngeal Mask Airway in Smokers
Anesth Analg 2006 103: 1147-1154. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We find that smokers do not differ in unwanted respiratory responses (coughing, breath holding, or laryngospasm) during delivery of anesthesia with desflurane versus sevoflurane, via a laryngeal mask airway. A retrospective comparison of these results with those from our previous study of 100 nonsmokers demonstrates that smoking, but not anesthetic choice, increases the incidence of unwanted respiratory responses.

Matthew T. V. Chan, Kai C. Choi, Tony Gin, Po Tong Chui, Timothy G. Short, Pong Mo Yuen, Amy H. Y. Poon, Christian C. Apfel, and Tong J. Gan

The Additive Interactions Between Ondansetron and Droperidol for Preventing Postoperative Nausea and Vomiting
Anesth Analg 2006 103: 1155-1162. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In patients undergoing gynecologic laparoscopic procedures, the combination of ondansetron 4 mg IV and droperidol 1.25 mg IV produced an additive effect for preventing postoperative nausea and vomiting. The observed change in the QTc interval was small and not increased by the combination when compared with each drug was given separately.

ANESTHETIC PHARMACOLOGY:

Matthias Haenggi, Heidi Ypparila, Kathrin Hauser, Claudio Caviezel, Ilkka Korhonen, Jukka Takala, and Stephan M. Jakob

The Effects of Dexmedetomidine/Remifentanil and Midazolam/Remifentanil on Auditory-Evoked Potentials and Electroencephalogram at Light-to-Moderate Sedation Levels in Healthy Subjects
Anesth Analg 2006 103: 1163-1169. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Long-latency auditory-evoked potentials provide evidence of persistent cortical processing in volunteers sedated with a combination of dex/remi compared to mida/remi at the same clinical sedation levels. Electrophysiologic methods for monitoring sedation should be applied in the context of the sedative drugs used.

Wolfgang Koppert, Katrin Frötsch, Nilofar Huzurudin, Wolfgang Böswald, Norbert Griessinger, Volker Weisbach, Roland E. Schmieder, and Jürgen Schüttler

The Effects of Paracetamol and Parecoxib on Kidney Function in Elderly Patients Undergoing Orthopedic Surgery
Anesth Analg 2006 103: 1170-1176. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Glomerular and tubular functions were transiently affected in elderly patients after orthopedic surgery. A transient decrease of creatinine clearance was observed during the first 2 h after the initial dose of parecoxib, but the differences between the treatment groups were small and not clinically relevant.

Yasumasa Tanifuji, Yi Zhang, Mark Liao, Edmond I. Eger, II, Michael J. Laster, and James M. Sonner

Do Dopamine Receptors Mediate Part of MAC?
Anesth Analg 2006 103: 1177-1181. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Because we found that droperidol administration, and thus blockade of D2 dopamine receptors, does not alter MAC for several conventional inhaled anesthetics or for etomidate, we conclude that dopamine receptors do not mediate the capacity of inhaled anesthetics to produce immobility in the face of noxious stimulation.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Giuseppe Natalini, Antonio Rosano, Maria E. Franceschetti, Paola Facchetti, and Achille Bernardini

Variations in Arterial Blood Pressure and Photoplethysmography During Mechanical Ventilation
Anesth Analg 2006 103: 1182-1188. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Photoplethysmographic heart rate variation in response to positive pressure ventilation was related to pulse pressure variation in the arterial pressure waveform. Because pulse pressure variation can predict fluid responsiveness, photoplethysmography could be used as a noninvasive predictor of fluid responsiveness.

Vivian L. B. Oei-Lim, Marcel G. W. Dijkgraaf, Marc D. de Smet, Martin White, and Cor J. Kalkman

Does Cerebral Monitoring Improve Ophthalmic Surgical Operating Conditions During Propofol-Induced Sedation?
Anesth Analg 2006 103: 1189-1195. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this study, the performance of bispectral index XP and auditory-evoked potential monitors were assessed during light-to-moderate propofol-induced sedation for ophthalmic surgery in 100 patients.

George Takla, John H. Petre, D. John Doyle, Mayumi Horibe, and Bala Gopakumaran

The Problem of Artifacts in Patient Monitor Data During Surgery: A Clinical and Methodological Review (Review Article)
Anesth Analg 2006 103: 1196-1204. [Abstract] [Full Text] [PDF] [Request Permissions]  

ECONOMICS, EDUCATION, AND POLICY:

Kevin W. Hatton, Seth Price, Lori Craig, and Jay S. Grider

Educating Anesthesiology Residents to Perform Percutaneous Cricothyrotomy, Retrograde Intubation, and Fiberoptic Bronchoscopy Using Preserved Cadavers
Anesth Analg 2006 103: 1205-1208. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that the use of cadavers in anesthesiology training improves the confidence of residents in using percutaneous cricothyrotomy and retrograde intubation.

Steven H. Rose, Christopher M. Burkle, and Beth A. Elliott

Trends in Gender Distribution Among Anesthesiology Residents: Do They Matter?
Anesth Analg 2006 103: 1209-1212. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Fewer women are enrolled in anesthesiology training programs than in those in other specialties. Women may shun anesthesiology residencies because of the lack of women role models, gender discrimination, misperceptions of the physician-patient relationship in anesthesiology, and inflexible practice scheduling requirements.

CRITICAL CARE AND TRAUMA:

Michael R. Pinsky, Edgar Delgado, and Bernard Hete

The Effect of Tracheal Gas Insufflation on Gas Exchange Efficiency
Anesth Analg 2006 103: 1213-1218. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Transtracheal gas insufflation (TGI) improves gas exchange but causes hyperinflation. We showed that a new and simple bidirectional TGI and flow compensation system improves gas exchange efficiency and prevents hyperinflation.

Suzana M. Lobo, Francisco R. M. Lobo, Flavio Lopes-Ferreira, Daliana Peres Bota, Christian Melot, and Jean-Louis Vincent

Initial and Delayed Onset of Acute Respiratory Failure: Factors Associated with Development and Outcome
Anesth Analg 2006 103: 1219-1223. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In a prospective observational study of adult intensive care unit admissions with acute respiratory failure (ARF), mortality was related more to the presence of multiple organ failure than to initial lung function. Initial and delayed onset ARF have different patterns of associated organ dysfunction, and the monitoring of nonpulmonary organ function may be useful in assessing outcome.

NEUROSURGICAL ANESTHESIA:

Irene Rozet, Saipin Muangman, Monica S. Vavilala, Lorri A. Lee, Michael J. Souter, Karen J. Domino, Jefferson C. Slimp, Robert Goodkin, and Arthur M. Lam

Clinical Experience with Dexmedetomidine for Implantation of Deep Brain Stimulators in Parkinson's Disease
Anesth Analg 2006 103: 1224-1228. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Implantation of deep brain stimulators (DBS) is an accepted treatment for patients with advanced Parkinson's disease. The anesthetic management of these procedures is challenging because sedative and anesthetic drugs may interfere with electrophysiologic monitoring. Sedation with the {alpha}-2 agonist, dexmedetomidine, in DBS implantations may be advantageous, allowing for better blood pressure control without interfering with microelectrode recording.

Vincent Degos, Thomas Lescot, Abderrezak Zouaoui, Harold Hermann, Françoise Préteux, Pierre Coriat, and Louis Puybasset

Computed Tomography-Estimated Specific Gravity of Noncontused Brain Areas as a Marker of Severity in Human Traumatic Brain Injury
Anesth Analg 2006 103: 1229-1236. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The estimated specific gravity of the overall intracranial content and of noncontused hemispheric areas derived from computed tomography DICOM images is a marker of the severity of brain injury in the first 24 h after severe traumatic brain injury in humans.

Christian Ayoub, François Girard, Daniel Boudreault, Philippe Chouinard, Monique Ruel, and Robert Moumdjian

A Comparison Between Scalp Nerve Block and Morphine for Transitional Analgesia After Remifentanil-Based Anesthesia in Neurosurgery
Anesth Analg 2006 103: 1237-1240. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Scalp nerve block provides transitional analgesia that is equivalent to morphine after remifentanil-based anesthesia in patients undergoing supratentorial craniotomy.

Kevin W. Hatton, J. Thomas McLarney, Thomas Pittman, and Brenda G. Fahy

Vagal Nerve Stimulation: Overview and Implications for Anesthesiologists (Review Article)
Anesth Analg 2006 103: 1241-1249. [Abstract] [Full Text] [PDF] [Request Permissions]  

OBSTETRIC ANESTHESIA:

Selda Sen, Galip Ozmert, Hakan Turan, Eray Caliskan, Alper Onbasili, and Duran Kaya

The Effects of Spinal Anesthesia on QT Interval in Preeclamptic Patients
Anesth Analg 2006 103: 1250-1255. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: QTc interval may be prolonged in women with severe preeclampsia because of hypertension and hypocalcemia. Spinal anesthesia may normalize prolonged QTc intervals due to sympathetic blockade.

GENERAL ARTICLES:

George A. Mashour and Warren S. Sandberg

Craniocervical Extension Improves the Specificity and Predictive Value of the Mallampati Airway Evaluation
Anesth Analg 2006 103: 1256-1259. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The modified Mallampati examination is a standard method of predicting difficult laryngoscopy. We report that performing this examination with the patient in craniocervical extension decreases the classification scores and improves both specificity and positive predictive value.

Kiyo Tominaga and Toshiyuki Nakahara

The Twenty-Degree Reverse-Trendelenburg Position Decreases the Incidence and Severity of Postoperative Nausea and Vomiting After Thyroid Surgery
Anesth Analg 2006 103: 1260-1263. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The 20{degrees} reverse-Trendelenburg position effectively ameliorates postoperative nausea or vomiting in patients undergoing thyroid surgery.

Thomas C. Mort

Laryngeal Mask Airway and Bougie Intubation Failures: The Combitube as a Secondary Rescue Device for In-Hospital Emergency Airway Management (Brief Report)
Anesth Analg 2006 103: 1264-1266. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The practitioner responsible for emergency intubation must have a strategy to manage the failure of conventional intubation methods as well as a backup accessory device when other advanced airway devices fail.

Patrick W. Hogan and Maged Argalious

Total Airway Obstruction After Maxillomandibular Advancement Surgery for Obstructive Sleep Apnea (Case Report)
Anesth Analg 2006 103: 1267-1269. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Maxillomandibular advancement (MMA) surgery is increasingly used as a surgical option in the treatment of obstructive sleep apnea. We report a case of life-threatening airway obstruction after MMA and discuss the etiology of airway compromise after these surgeries.

ANALGESIA:

Scott S. Reuben, Asokumar Buvanendran, Jeffrey S. Kroin, and Karthik Raghunathan

The Analgesic Efficacy of Celecoxib, Pregabalin, and Their Combination for Spinal Fusion Surgery
Anesth Analg 2006 103: 1271-1277. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The perioperative administration of a combination of celecoxib and pregabalin improved analgesia and caused fewer side effects than either analgesic drug alone after spinal fusion surgery.

Frédéric Adam, Christophe Ménigaux, Daniel I. Sessler, and Marcel Chauvin

A Single Preoperative Dose of Gabapentin (800 Milligrams) Does Not Augment Postoperative Analgesia in Patients Given Interscalene Brachial Plexus Blocks for Arthroscopic Shoulder Surgery
Anesth Analg 2006 103: 1278-1282. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A single dose of 800 mg of oral gabapentin did not prolong recovery or cause apparent side effects. It may thus have a role in ambulatory surgery. However, this dose of gabapentin did not augment postoperative analgesia in patients with interscalene nerve blocks.

Brendan Carvalho, Martin S. Angst, Andrea J. Fuller, Eric Lin, Anbu D. Mathusamy, and Edward T. Riley

Experimental Heat Pain for Detecting Pregnancy-Induced Analgesia in Humans
Anesth Analg 2006 103: 1283-1287. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Although animal studies suggest pregnancy-induced antinociceptive effects, human studies are conflicting and often lack a nonpregnant control group. We determined the sensitivity to experimental pain in pregnant and nonpregnant women and found pregnancy-induced analgesic effects to heat pain.

Chuanyao Tong, Dawn Conklin, and James C. Eisenach

A Pain Model After Gynecologic Surgery: The Effect of Intrathecal and Systemic Morphine
Anesth Analg 2006 103: 1288-1293. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pain after gynecologic surgery has both somatic and visceral components. We describe a new model of postoperative pain in rodents in which these can be distinguished and selectively studied so as to improve treatment of pain after gynecologic surgery.

James R. Hebl, Sandra L. Kopp, Darrell R. Schroeder, and Terese T. Horlocker

Neurologic Complications After Neuraxial Anesthesia or Analgesia in Patients with Preexisting Peripheral Sensorimotor Neuropathy or Diabetic Polyneuropathy
Anesth Analg 2006 103: 1294-1299. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Patients with preexisting neural compromise may be at an increased risk of further neurologic injury after neuraxial anesthesia or analgesia. This retrospective review found the risk of severe postoperative neurologic dysfunction in patients with a stable peripheral sensorimotor neuropathy undergoing neuraxial anesthesia or analgesia to be 0.4% (95% CI 0.1%-1.3%). Although this rate represents a relatively uncommon event, the risk appears to be higher than that reported for the general population.

Robert Doty, Jr, Radha Sukhani, Mark C. Kendall, Edward Yaghmour, Antoun Nader, Alina Brodskaia, Tripti C. Kataria, and Robert McCarthy

Evaluation of a Proximal Block Site and the Use of Nerve-Stimulator-Guided Needle Placement for Posterior Tibial Nerve Block
Anesth Analg 2006 103: 1300-1305. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Nerve-stimulator-guided needle placement improves the success and decreases the latency for posterior tibial nerve block at the distal site. A proximal block site 7 cm above the medial malleolus is an alternative to the traditional distal approach particularly in patients with restricted access to the distal site.

John T. Sullivan, Sharon Grouper, Matthew T. Walker, Todd B. Parrish, Robert J. McCarthy, and Cynthia A. Wong

Lumbosacral Cerebrospinal Fluid Volume in Humans Using Three-Dimensional Magnetic Resonance Imaging
Anesth Analg 2006 103: 1306-1310. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lumbosacral cerebrospinal fluid (CSF) volume, a factor in the clinical response to spinal anesthesia, is widely variable among patients. Using a three-dimensional magnetic resonance image and computer postprocessing technique, we found that lumbosacral CSF volume is inversely proportional to body mass index and decreased in patients with radiographic diagnoses of spinal stenosis.

Michael R. Schenk, Michael Putzier, Bjoern Kügler, Stephan Tohtz, Kristina Voigt, Tania Schink, Wolfgang J. Kox, Claudia Spies, and Thomas Volk

Postoperative Analgesia After Major Spine Surgery: Patient-Controlled Epidural Analgesia Versus Patient-Controlled Intravenous Analgesia
Anesth Analg 2006 103: 1311-1317. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Epidural analgesia with ropivacaine provided significantly better analgesia and higher patient satisfaction than IV analgesia with morphine after major spine surgery.

W. Anton Visser, Mathieu J. M. Gielen, Janneke L. P. Giele, and Gert J. Scheffer

A Comparison of Epidural Pressures and Incidence of True Subatmospheric Epidural Pressure Between the Mid-Thoracic and Low-Thoracic Epidural Space
Anesth Analg 2006 103: 1318-1321. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There are differences in epidural pressure between the low-thoracic and mid-thoracic epidural space. The influence on the distribution of local anesthetic and sensory blockade in thoracic epidural anesthesia remains undetermined.

William Corcoran, John Butterworth, Robert S. Weller, Jonathan C. Beck, J. C. Gerancher, Timothy T. Houle, and Leanne Groban

Local Anesthetic-Induced Cardiac Toxicity: A Survey of Contemporary Practice Strategies Among Academic Anesthesiology Departments
Anesth Analg 2006 103: 1322-1326. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Among 91 survey respondents, there appears to be no consensus as to how best to prepare for the rare episode of local anesthetic cardiac toxicity, or how to optimally manage such a catastrophe.

LETTER TO THE EDITOR:

Anthony M.-H. Ho, Peggy T. Y. Li, and Manoj K. Karmakar

Risk of Hematoma After Epidural Anesthesia and Analgesia for Cardiac Surgery
Anesth Analg 2006 103: 1327. [Full Text] [PDF] [Request Permissions]  

Mark A. Chaney

Risk of Hematoma After Epidural Anesthesia and Analgesia for Cardiac Surgery
Anesth Analg 2006 103: 1327-1328. [Full Text] [PDF] [Request Permissions]  

J. Antonio Aldrete

American Board of Anesthesiology Examination Versus Simulators
Anesth Analg 2006 103: 1328. [Full Text] [PDF] [Request Permissions]  

Steven H. Rose

American Board of Anesthesiology Examination Versus Simulators
Anesth Analg 2006 103: 1328-1329. [Full Text] [PDF] [Request Permissions]  

Raymond M. Planinsic, Ibtesam A. Hilmi, and Tetsuro Sakai

Prevention of Intracardiac/Pulmonary Thrombosis During Liver Transplantation
Anesth Analg 2006 103: 1329. [Full Text] [PDF] [Request Permissions]  

Miriam J. P. Harnett, Jean M. Carabuena, Lawrence C. Tsen, and Bhavani S. Kodali

Anesthesia for Interventional Radiology in Parturients at Risk of Major Hemorrhage at Cesarean Section Delivery
Anesth Analg 2006 103: 1329-1330. [Full Text] [PDF] [Request Permissions]  

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

Anesthesia for Interventional Radiology in Parturients at Risk of Major Hemorrhage at Cesarean Section Delivery
Anesth Analg 2006 103: 1330. [Full Text] [PDF] [Request Permissions]  

Mohammad El-Orbany

Laryngeal Exposure Using the Flexiblade^TM Laryngoscope
Anesth Analg 2006 103: 1330-1331. [Full Text] [PDF] [Request Permissions]  

Michael Irwin and Rochelle Cheung

Laryngeal Exposure Using the Flexiblade^TM Laryngoscope
Anesth Analg 2006 103: 1331. [Full Text] [PDF] [Request Permissions]  

Yushi U. Adachi, Hideki Sano, Matsuyuki Doi, and Shigehito Sato

Preemptive Analgesia by Nonsteroidal Antiinflammatory Drugs
Anesth Analg 2006 103: 1331-1332. [Full Text] [PDF] [Request Permissions]  

Hans-F. Gramke and Marco A. E. Marcus

Preemptive Analgesia by Nonsteroidal Antiinflammatory Drugs
Anesth Analg 2006 103: 1332. [Full Text] [PDF] [Request Permissions]  

Neus Fàbregas, Ivan Bel, Lydia Salvador, Ricard Valero, Enrique Carrero, and Jordi Rumià

Jugular Bulb Oxygen-Desaturation Episodes During Functional Cerebral Hemispherotomies
Anesth Analg 2006 103: 1332-1333. [Full Text] [PDF] [Request Permissions]  

Natalie F. Holt and Zeev N. Kain

What Every Physician Should Know About the National Practitioner Data Bank
Anesth Analg 2006 103: 1333. [Full Text] [PDF] [Request Permissions]  

Taras I. Usichenko, Michaela Dinse, Dragan Pavlovic, and Christian Lehmann

Hemorrhage After Auricular Acupuncture due to Postoperative Dilutional Thrombocytopenia
Anesth Analg 2006 103: 1333-1334. [Full Text] [PDF] [Request Permissions]  

Robert Sheu, Marc Goloff, Santiago Esteban, Nityanada Podder, and Ricardo A. Cruciani

Panic Attacks After Spinal Cord Stimulator Implantation
Anesth Analg 2006 103: 1334-1335. [Full Text] [PDF] [Request Permissions]  

Sandra Prins, Monique van Dijk, and Dick Tibboel

The Auditory Evoked Potential Monitor: First Data from Infants Outside the Operation Room
Anesth Analg 2006 103: 1335. [Full Text] [PDF] [Request Permissions]  

Adam Wolpert and Hiroshi Goto

Exchanging an Endotracheal Tube from Oral to Nasal Intubation During Continuous Ventilation
Anesth Analg 2006 103: 1335. [Full Text] [PDF] [Request Permissions]  

John M. Chapman

BIS and BOTOX: A Hazardous Combination?
Anesth Analg 2006 103: 1335-1336. [Full Text] [PDF] [Request Permissions]  

Lakshmi Jayaraman, Nitin Sethi, Arvind Kumar, and Jayashree Sood

Modification of the Gum Elastic Bougie
Anesth Analg 2006 103: 1336-1337. [Full Text] [PDF] [Request Permissions]  

Nirmala Jonnavithula

"Kratschmer" Reflex During Rhinoplasty
Anesth Analg 2006 103: 1337-1338. [Full Text] [PDF] [Request Permissions]  

Indu Sen, Jyotsna Wig, Suman Arora, Vipul Nanda, and Ramesh K. Sharma

Dental Cast Model as an Airway Management Planning Tool
Anesth Analg 2006 103: 1338-1339. [Full Text] [PDF] [Request Permissions]  

Yatindra K. Batra and S. Rajeev

Infusion Pump for Managing Endotracheal Tube Cuff Incompetence
Anesth Analg 2006 103: 1339. [Full Text] [PDF] [Request Permissions]  

Daisuke Takizawa, Eri Takizawa, Sohtaro Miyoshi, Fuminori Kawahara, and Haruhiko Hiraoka

The Increase in Total and Unbound Propofol Concentrations During Accidental Hemorrhagic Shock in Patients Undergoing Liver Transplantation
Anesth Analg 2006 103: 1339-1340. [Full Text] [PDF] [Request Permissions]  

Wolfram Schummer, Claudia Schummer, and Samir G. Sakka

A Persistent Left Superior Vena Cava: Erroneous Measurement of Cardiac Output
Anesth Analg 2006 103: 1340-1341. [Full Text] [PDF] [Request Permissions]  

Ka-Young Rhee, Rong-Min Baek, and Kyu-Joong Ahn

Airway Management in a Patient with Focal Dermal Hypoplasia
Anesth Analg 2006 103: 1342. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Philip D. Lumb

Critical Care Handbook of the Massachusetts General Hospital, 4th ed.
Anesth Analg 2006 103: 1343. [Full Text] [PDF] [Request Permissions]  

Michael H. Wall

Perioperative Transfusion Medicine, 2nd ed.
Anesth Analg 2006 103: 1343-1344. [Full Text] [PDF] [Request Permissions]  

John Fisher and Stuart J. Weiss

Innovations in Cardiovascular Care: A Society of Cardiovascular Anesthesiologists’ Monograph
Anesth Analg 2006 103: 1344-1345. [Full Text] [PDF] [Request Permissions]  

LIST OF BOOKS RECEIVED FOR ANESTHESIA AND ANALGESIA
Anesth Analg 2006 103: 1345. [Full Text] [PDF] [Request Permissions]  

To see an article, click its [Full Text] or [PDF] link. To review many abstracts, check the boxes to the left of the titles you want, and click the 'Get All Checked Abstract(s)' button. To see one abstract at a time, click its [Abstract] link.