EDITORIALS:

Steven L. Shafer

New Affiliates, New Opportunities
Anesth Analg 2008 106: 1-2. [Full Text] [PDF]  

Steven L. Shafer and Vladimir Nekhendzy

Anesthesia Matters: Statistical Anomaly or New Paradigm?
Anesth Analg 2008 106: 3-4. [Full Text] [PDF]  

CARDIOVASCULAR ANESTHESIOLOGY:

Kazuhiro Kaneda, Masami Miyamae, Shingo Sugioka, Chika Okusa, Yoshitaka Inamura, Naochika Domae, Junichiro Kotani, and Vincent M. Figueredo

Sevoflurane Enhances Ethanol-Induced Cardiac Preconditioning Through Modulation of Protein Kinase C, Mitochondrial K_ATP Channels, and Nitric Oxide Synthase, in Guinea Pig Hearts
Anesth Analg 2008 106: 9-16. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Sevoflurane enhances cardiac preconditioning induced by regular ethanol consumption, an effect, mediated in part by protein kinase and mitochondrial KATP channels. Modulation of nitric oxide synthase expression by regular ethanol consumption may also play a role in this enhanced cardioprotection.

Eliana Lucchinetti, Marina Jamnicki, Gregor Fischer, and Michael Zaugg

Preconditioning by Isoflurane Retains Its Protection Against Ischemia-Reperfusion Injury in Postinfarct Remodeled Rat Hearts
Anesth Analg 2008 106: 17-23. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Protection by isoflurane preconditioning is highly effective in diseased postinfarct remodeled rat hearts and depends on activation of the two well-established key signaling elements, protein kinase B and mitochondrial ATP-dependent potassium channel.

Fellery de Lange, Kenji Yoshitani, Alan D. Proia, G. Burkhard Mackensen, and Hilary P. Grocott

Perfluorocarbon Administration During Cardiopulmonary Bypass in Rats: An Inflammatory Link to Adverse Outcome?
Anesth Analg 2008 106: 24-31. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Administration of the perfluorocarbon perfluoro-tert-butylcyclohexane during cardiopulmonary bypass resulted in an excessive inflammatory response, hypotension, myocardial contraction band necrosis, and a high mortality rate in rats. This study suggests that further investigations are warranted before clinical administration of this compound is pursued.

Marieke T. de Boer, Michael C. Christensen, Mikael Asmussen, Christian S. van der Hilst, Herman G. D. Hendriks, Maarten J. H. Slooff, and Robert J. Porte

The Impact of Intraoperative Transfusion of Platelets and Red Blood Cells on Survival After Liver Transplantation
Anesth Analg 2008 106: 32-44. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Platelet transfusions are risk factors for patient survival after liver transplantation, which appears to be independent from other well-known risk factors. These findings call for a cautious use of platelet transfusions in patients undergoing liver transplantation.

Simon T. Schäfer, Jochen Lindemann, Peter Brendt, Gernot Kaiser, and Jürgen Peters

Intracardiac Transvenous Echocardiography Is Superior to Both Precordial Doppler and Transesophageal Echocardiography Techniques for Detecting Venous Air Embolism and Catheter-Guided Air Aspiration
Anesth Analg 2008 106: 45-54. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The optimal method for detecting venous air embolism has not been well defined. We compared a new technology, transvenous intracardiac echocardiography with transesophageal echocardiography and precordial Doppler in a swine model, evaluating detection and image-guided catheter aspiration of venous air embolism. The greater sensitivity of intracardiac echocardiography in this model suggests that clinical studies may be warranted.

Claas Siegmueller, Alexander Bell, Tarun Mittal, and Shane George

Inadvertent Aortic Cannulation with a Pulmonary Artery Catheter Detected by Transesophageal Echocardiography (Case Report)
Anesth Analg 2008 106: 55-57. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We present a case in which pulmonary artery catheterization via the left internal jugular approach resulted in positioning of the catheter in the ascending aorta. Subsequent postmortem examination revealed the presence of a partial anomalous pulmonary venous connection between the left brachocephalic vein and an otherwise normally developed left upper pulmonary vein. Anatomic considerations suggest that such placement may be more likely with left-sided cannulation approaches.

Gordon N. Finlayson, Albert B. Chiang, Jay B. Brodsky, and Walter B. Cannon

Intraoperative Contralateral Tension Pneumothorax During Pneumonectomy (Case Report)
Anesth Analg 2008 106: 58-60. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: During thoracotomy, a tension pneumothorax should be considered in the presence of increasing airway pressures, even in the absence of marked hypoxemia and hypotension.

Koji Hosokawa and Yasufumi Nakajima

An Evaluation of Acute Cardiac Tamponade by Transesophageal Echocardiography (Echo Rounds)
Anesth Analg 2008 106: 61-62. [Full Text] [PDF] [CME] [Echo Loops]   

Brian Fitzsimons and Colleen Gorman Koch

Transverse Sinus Hemangioma (Echo Rounds)
Anesth Analg 2008 106: 63-64. [Full Text] [PDF] [CME] [Echo Loops]   

Prabhat Tewari and Rahul Basu

Left Ventricular Outflow Tract Obstruction After Mitral Valve Replacement (Echo Rounds)
Anesth Analg 2008 106: 65-66. [Full Text] [PDF] [CME] [Echo Loops]   

Florent Wallet, Sébastien Perbet, Marie-Hélène Fléron, Victor De Castro, Gilles Godet, Michèle Bertrand, Edouard Kieffer, Pierre Coriat, and Jean-Pierre Goarin

Elephant Trunk Prosthesis Kinking: Transesophageal Echocardiography Diagnosis (Echo Rounds)
Anesth Analg 2008 106: 67-69. [Full Text] [PDF] [CME] [Echo Loops]   

PEDIATRIC ANESTHESIOLOGY:

Terri Voepel-Lewis, Shobha Malviya, Alan R. Tait, Sandra Merkel, Roxie Foster, Elliot J. Krane, and Peter J. Davis

A Comparison of the Clinical Utility of Pain Assessment Tools for Children with Cognitive Impairment
Anesth Analg 2008 106: 72-78. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study found that clinicians rated the complexity, compatibility, relative advantage, and overall clinical utility higher for the r-FLACC and NAPI compared with the NCCPC-PV, suggesting that these tools may be more readily adopted into clinical practice.

Gregory B. Hammer, David R. Drover, Hong Cao, Ethan Jackson, Glyn D. Williams, Chandra Ramamoorthy, George F. Van Hare, Alisa Niksch, and Anne M. Dubin

The Effects of Dexmedetomidine on Cardiac Electrophysiology in Children
Anesth Analg 2008 106: 79-83. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In this prospective study of the effects of dexmedetomidine (DEX) on cardiac electrophysiology in 12 children, we found that DEX significantly depressed sinus and atrioventricular nodal function. Heart rate decreased and arterial blood pressure increased during administration of DEX. The use of DEX may not be desirable during electrophysiology study and may be associated with adverse effects in patients at risk for bradycardia or atrioventricular nodal block.

Ahmed M. Mukhtar, Gihan M. Obayah, Ashraf Elmasry, and Nabil M. Dessouky

The Therapeutic Potential of Intraoperative Hypercapnia During Video-Assisted Thoracoscopy in Pediatric Patients
Anesth Analg 2008 106: 84-88. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Therapeutic hypercapnia, which is used to deliberately increase CO2, may also be used for minimizing the deleterious effect of CO2 insufflation during pediatric video-assisted thoracoscopic surgery.

Marion Weintraud, Peter Marhofer, Adrian Bösenberg, Stephan Kapral, Harald Willschke, Michael Felfernig, and Stephan Kettner

Ilioinguinal/Iliohypogastric Blocks in Children: Where Do We Administer the Local Anesthetic Without Direct Visualization?
Anesth Analg 2008 106: 89-93. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Accurate placement of local anesthetic around the ilioinguinal/iliohypogastric nerves in children is seldom possible when landmark-based techniques are used. In the majority of patients, the local anesthetic was inaccurately placed in adjacent anatomical structures with unpredictable block results.

Vrushali C. Ponde

Continuous Infraclavicular Brachial Plexus Block: A Modified Technique to Better Secure Catheter Position in Infants and Children
Anesth Analg 2008 106: 94-96. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Continuous infraclavicular block offers good intraoperative and postoperative pain relief for an extended period. There is always an issue of catheter dislodgement. Slight modifications in the technique can help to secure the catheter.

Donald Schwartz, Karthik Raghunathan, Steven Dunn, and Neil Roy Connelly

Ultrasonography and Pediatric Caudals (Case Report)
Anesth Analg 2008 106: 97-99. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The authors describe the use of ultrasound to guide placement of a caudal block in an infant with difficult anatomy.

AMBULATORY ANESTHESIOLOGY:

Donald M. Mathews, Vijay Gaba, Bledi Zaku, and George G. Neuman

Can Remifentanil Replace Nitrous Oxide During Anesthesia for Ambulatory Orthopedic Surgery with Desflurane and Fentanyl?
Anesth Analg 2008 106: 101-108. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The study demonstrates that the clinical outcome after an infusion of remifentanil 0.085 {micro}g {middle dot} kg 1 {middle dot} min 1 compares favorably with 66% N2O in a desflurane/fentanyl anesthetic during ambulatory orthopedic surgery. Therefore, using an infusion of remifentanil may be an effective strategy for those who wish to avoid N2O yet want to achieve similarly rapid recovery profiles.

Chien-Chuan Chen, Chia-Shiang Lin, Yuan-Pi Ko, Yu-Chun Hung, Hsuan-Chih Lao, and Yung-Wei Hsu

Premedication with Mirtazapine Reduces Preoperative Anxiety and Postoperative Nausea and Vomiting
Anesth Analg 2008 106: 109-113. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Mirtazapine is a new antidepressant whose mechanism of action includes blockade of the 5-HT2 and 5-HT3 receptors. Premedication with mirtazapine reduced preoperative anxiety and postoperative nausea and vomiting.

Kenan Kaygusuz, Gokhan Gokce, Sinan Gursoy, Semih Ayan, Caner Mimaroglu, and Yener Gultekin

A Comparison of Sedation with Dexmedetomidine or Propofol During Shockwave Lithotripsy: A Randomized Controlled Trial
Anesth Analg 2008 106: 114-119. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We compared the hemodynamic, analgesic, sedative, and respiratory effects of dexmedetomidine and propofol in combination with small-dose fentanyl during extracorporeal shockwave lithotripsy (ESWL). Dexmedetomidine in combination with small-dose fentanyl can be useful during ESWL and it may be a valuable alternative to propofol.

Emine Arzu Kose, Didem Dal, Seda Banu Akinci, Fatma Saricaoglu, and Ulku Aypar

The Efficacy of Ketamine for the Treatment of Postoperative Shivering (Brief Report)
Anesth Analg 2008 106: 120-122. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: IV ketamine 0.5 and 0.75 mg/kg provides a more rapid onset of effect than meperidine 25 mg for the treatment of postoperative shivering, but these doses of ketamine had a greater incidence of side effects.

Yuan-Yi Chia, Shih-Wei Lee, and Kan Liu

Propofol Causes Less Postoperative Pharyngeal Morbidity Than Thiopental After the Use of a Laryngeal Mask Airway (Brief Report)
Anesth Analg 2008 106: 123-126. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Laryngeal mask airway anesthesia induced with propofol reduced acute postoperative pharyngeal morbidity in terms of sore throat, dysphonia, dysphagia, nausea, and vomiting, compared with thiopental. The benefits should encourage the use of propofol for induction of laryngeal mask airway anesthesia.

ANESTHETIC PHARMACOLOGY:

Elina Salmi, Ruut M. Laitio, Sargo Aalto, Anu T. Maksimow, Jaakko W. Långsjö, Kaike K. Kaisti, Riku Aantaa, Vesa Oikonen, Liisa Metsähonkala, Kjell Någren, Esa R. Korpi, and Harry Scheinin

Xenon Does Not Affect -Aminobutyric Acid Type A Receptor Binding in Humans
Anesth Analg 2008 106: 129-134. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Xenon does not affect 11C-flumazenil binding in the living human brain, indicating that the anesthetic effect of xenon is not mediated via the {gamma}-aminobutyric acid type A receptor system.

Coert J. Zuurbier, Peter J. M. Keijzers, Anneke Koeman, Harry B. Van Wezel, and Markus W. Hollmann

Anesthesia's Effects on Plasma Glucose and Insulin and Cardiac Hexokinase at Similar Hemodynamics and Without Major Surgical Stress in Fed Rats
Anesth Analg 2008 106: 135-142. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We examined how different anesthetics per se affect variables of glucose metabolism in nonfasted rats, i.e., under similar hemodynamic conditions and in the absence of major surgical stress. Our results indicate that choice of anesthetic strategies may be an important determinant whether, and to what degree, hyperglycemia develops.

Jeroen Wink, Bernadette Th. Veering, Michel Kruit, Anton G. L. Burm, Gunilla A. I. Huledal, Gunilla Y. Ekström, Rudolf Stienstra, and Jack W. van Kleef

The Effect of a Long–Term Epidural Infusion of Ropivacaine on CYP2D6 Activity
Anesth Analg 2008 106: 143-146. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A continuous epidural infusion of ropivacaine inhibits CYP2D6 activity, but not enough to affect the metabolism of other drugs in patients with normal CYP2D6 activity.

TECHNICAL COMMUNICATIONS:

Soledad Levano, Dagmar Keller, Elektra Schobinger, Albert Urwyler, and Thierry Girard

Rapid and Accurate Detection of Atypical– and Kalow–Variants in the Butyrylcholinesterase Gene Using Denaturing High–Performance Liquid Chromatography (Technical Communication)
Anesth Analg 2008 106: 147-151. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We present a protocol for the rapid detection of the atypical- and Kalow-variant in the butyrylcholinesterase gene. Detection of these frequent variants is useful in pharmacokinetic studies investigating drugs metabolized by this enzyme.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Grégoire Weil, Sylvie Passot, Frédérique Servin, and Valérie Billard

Does Spectral Entropy Reflect the Response to Intubation or Incision During Propofol-Remifentanil Anesthesia?
Anesth Analg 2008 106: 152-159. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Spectral entropy predicts motor but not hemodynamic response to intubation and skin incision.

Koichi Yamashita, Takehiro Okabayashi, Takeshi Yokoyama, Tomoaki Yatabe, Hiromichi Maeda, Masanobu Manabe, and Kazuhiro Hanazaki

The Accuracy of a Continuous Blood Glucose Monitor During Surgery
Anesth Analg 2008 106: 160-163. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study shows that the STG-22TM provides continuous glucose measurement; however, the need to confirm measurements with another reliable device is not eliminated.

Musa Sesay, Patrick Tauzin-Fin, Philippe Gosse, Philippe Ballanger, and Pierre Maurette

Real-Time Heart Rate Variability and Its Correlation with Plasma Catecholamines During Laparoscopic Adrenal Pheochromocytoma Surgery
Anesth Analg 2008 106: 164-170. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Low frequency heart rate variability correlates with plasma norepinephrine, arterial blood pressure, and heart rate during pheochromocytoma surgery.

Friederike Compton, Marc Wittrock, Juergen-Heiner Schaefer, Walter Zidek, Martin Tepel, and Alexandra Scholze

Noninvasive Cardiac Output Determination Using Applanation Tonometry-Derived Radial Artery Pulse Contour Analysis in Critically Ill Patients (Technical Communication)
Anesth Analg 2008 106: 171-174. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Noninvasive radial artery tonometry is not suitable to determine cardiac output in critically ill hemodynamically unstable patients.

CRITICAL CARE AND TRAUMA:

Stefan Maisch, Hajo Reissmann, Bernd Fuellekrug, Dieter Weismann, Thomas Rutkowski, Gerardo Tusman, and Stephan H. Bohm

Compliance and Dead Space Fraction Indicate an Optimal Level of Positive End-Expiratory Pressure After Recruitment in Anesthetized Patients
Anesth Analg 2008 106: 175-181. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Changes in dead space fraction can be used to evaluate the response to recruitment maneuvers in perioperative patients.

Mehdi Benkhadra, François Lenfant, Wolfgang Nemetz, Friedrich Anderhuber, Georg Feigl, and Jean Fasel

A Comparison of Two Emergency Cricothyroidotomy Kits in Human Cadavers (Brief Report)
Anesth Analg 2008 106: 182-185. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A new modified technique for emergency cricothyroidotomy offers no relevant advantages over the standard technique.

OBSTETRIC ANESTHESIOLOGY:

John G. McDonnell, Gerard Curley, John Carney, Aoife Benton, Joseph Costello, Chrisen H. Maharaj, and John G. Laffey

The Analgesic Efficacy of Transversus Abdominis Plane Block After Cesarean Delivery: A Randomized Controlled Trial
Anesth Analg 2008 106: 186-191. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The transversus abdominis plane block, when used as part of a multimodal analgesic regimen, resulted in better analgesia and decreased supplemental opioid consumption after cesarean delivery.

ECONOMICS, EDUCATION, AND POLICY:

Warren S. Sandberg, Elisabeth H. Sandberg, Andreas R. Seim, Shaji Anupama, Jesse M. Ehrenfeld, Stephen F. Spring, and John L. Walsh

Real-Time Checking of Electronic Anesthesia Records for Documentation Errors and Automatically Text Messaging Clinicians Improves Quality of Documentation
Anesth Analg 2008 106: 192-201. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Software continuously scanned anesthesia information system data for missing clinical documentation. A one-time prompt was sent via pager to the anesthesiologist. Within 5 days, missing documentation decreased by more than 70%, and the improvement was sustained even on days when no prompts were sent.

Cornelie Salzwedel, Corinna Petersen, Irmgard Blanc, Uwe Koch, Alwin E. Goetz, and Martin Schuster

The Effect of Detailed, Video-Assisted Anesthesia Risk Education on Patient Anxiety and the Duration of the Preanesthetic Interview: A Randomized Controlled Trial
Anesth Analg 2008 106: 202-209. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Video-assisted preanesthesia patient education increased patients' knowledge, but did not reduce their anxiety nor increase their satisfaction. The duration of the preanesthetic interview was markedly extended (e.g., from patients' questions) among patients both viewing the video and scheduled for anesthesia with invasive monitoring.

Brenda G. Fahy, Destiny F. Chau, and Meriem Bensalem Owen

The Effectiveness of a Simple Novel Approach on Electroencephalograph Instruction for Anesthesiology Residents
Anesth Analg 2008 106: 210-214. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Significant electroencephalogram (EEG) experience is an Accreditation Council for Graduate Medical Education requirement for anesthesiology training. This article provides a new educational EEG teaching methodology combining the expertise of a fellowship-trained neurophysiologist and neurology attending during the neurosurgical intensive care unit rotation to provide additional educational opportunities.

Ruth E. Wachtel and Franklin Dexter

Tactical Increases in Operating Room Block Time for Capacity Planning Should Not Be Based on Utilization (Special Article)
Anesth Analg 2008 106: 215-226. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Tactical planning of additional operating room block time for capacity expansion must be differentiated from a second, operational stage of matching staffing to expected workload. Ten reasons are presented to explain why tactical planning of block time should not be based on utilization.

NEUROSURGICAL ANESTHESIOLOGY:

Mijeung Gwak, Pyonghwan Park, Kisoo Kim, Keunho Lim, Sungmoon Jeong, Chongwha Baek, and Jonghwan Lee

The Effects of Dantrolene on Hypoxic-Ischemic Injury in the Neonatal Rat Brain
Anesth Analg 2008 106: 227-233. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Dantrolene, given into the cerebral ventricles reduced necrotic, but not apoptotic, injury in this neonatal rodent model of cerebral ischemia with hypoxia.

Marek Czosnyka, Piotr Smielewski, Andrea Lavinio, John D. Pickard, and Ronney Panerai

An Assessment of Dynamic Autoregulation from Spontaneous Fluctuations of Cerebral Blood Flow Velocity: A Comparison of Two Models, Index of Autoregulation and Mean Flow Index
Anesth Analg 2008 106: 234-239. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We compared two different models of assessment of dynamic cerebral autoregulation. They agreed relatively well in a cohort of 50 severely head-injured patients. The outcome after head injury was better in patients with preserved cerebral autoregulation.

Martin Smith

Monitoring Intracranial Pressure in Traumatic Brain Injury (Review Article)
Anesth Analg 2008 106: 240-248. [Abstract] [Full Text] [PDF] [CME]  

NEUROSURGICAL ANESTHESIA:

Giuseppina Magni, Carmela Imperiale, Giovanni Rosa, and Roberto Favaro

Nonfatal Cerebral Air Embolism After Dental Surgery (Case Report)
Anesth Analg 2008 106: 249-251. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Third molar extraction was followed by coma due to nonfatal cerebral air embolism from the use of a high speed dental drill.

GENERAL ARTICLES:

Anthony G. Doufas, Nobutada Morioka, Adel N. Maghoub, Edward Mascha, and Daniel I. Sessler

Lower-Body Warming Mimics the Normal Epidural-Induced Reduction in the Shivering Threshold
Anesth Analg 2008 106: 252-256. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Shivering threshold reduction during neuraxial anesthesia may result from an apparent increase in the lower body skin temperature.

Takashi Asai, Yoshiro Enomoto, Keiko Shimizu, Koh Shingu, and Yasuhisa Okuda

The Pentax-AWS Video-Laryngoscope: The First Experience in One Hundred Patients (Brief Report)
Anesth Analg 2008 106: 257-259. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We studied the efficacy of the Pentax-AWS (Tokyo, Japan), a new portable, battery-operated video-laryngoscope, in 100 patients. A full view of the glottis was obtained in 99 patients, and tracheal intubation was successful in 98 patients.

Thomas M. Hemmerling and David Bracco

Subcutaneous Cervical and Facial Emphysema with the Use of the Bonfils Fiberscope and High-Flow Oxygen Insufflation (Case Report)
Anesth Analg 2008 106: 260-262. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A facial emphysema occurred while using the Bonfils fiberscope and high-flow oxygen insufflation.

ANALGESIA:

Sean S. Cheng, Janet Yeh, and Pamela Flood

Anesthesia Matters: Patients Anesthetized with Propofol Have Less Postoperative Pain than Those Anesthetized with Isoflurane
Anesth Analg 2008 106: 264-269. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: There is less postoperative pain and morphine use after general anesthesia with propofol than with isoflurane, a finding unaffected by the use of nicotine.

Sjoerd P. Niehof, Annemerle Beerthuizen, Frank J. P. M. Huygen, and Freek J. Zijlstra

Using Skin Surface Temperature to Differentiate Between Complex Regional Pain Syndrome Type 1 Patients After a Fracture and Control Patients with Various Complaints After a Fracture
Anesth Analg 2008 106: 270-277. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: To distinguish acute complex regional pain syndrome type I fracture patients from control fracture patients with and without complaints, thermographic recordings of extremities under resting conditions can be used only as a supplementary diagnostic tool.

Michael J. Paech, Kenneth F. Ilett, L. Peter Hackett, Madhu Page-Sharp, and Richard W. Parsons

Disposition and Clinical Outcome After Intraperitoneal Meperidine and Ropivacaine Administration During Laparoscopic Surgery
Anesth Analg 2008 106: 278-286. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: After laparoscopic surgery, intraperitoneal meperidine and ropivacaine, alone or in combination, did not produce better pain relief or opioid dose-sparing compared with systemic opioid.

Gorazd Sveticic, Farzan Farzanegan, Patrick Zmoos, Sandra Zmoos, Urs Eichenberger, and Michele Curatolo

Is the Combination of Morphine with Ketamine Better than Morphine Alone for Postoperative Intravenous Patient-Controlled Analgesia?
Anesth Analg 2008 106: 287-293. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The addition of ketamine in a 1:1 ratio to morphine IV patient-controlled analgesia did not benefit postoperative analgesia

Donal F. Harney, Michelle Dooley, Brendan Harhen, Niall McGuiness, Gerard Cagney, Connail McCrory, Desmond J. Fitzgerald, and Noreen P. Dowd

Nimesulide 90 mg Orally Twice Daily Does Not Influence Postoperative Morphine Requirements After Major Chest Surgery
Anesth Analg 2008 106: 294-300. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We postulated that perioperative cyclooxygenase 2 inhibition would significantly reduce postoperative morphine requirements after major thoracic surgery and investigated the site of this potential analgesic effect. Nimesulide, at a dose of 90 mg twice daily, does not influence pain scores and morphine requirements after major thoracic surgery and does not appear to influence cerebrospinal fluid prostaglandin levels perioperatively.

Johannes G. Förster, Hilkka M. Lumme, Vilja J. Palkama, Per H. Rosenberg, and Mikko T. Pitkänen

Epinephrine 4 µg/mL Added to a Low-Dose Mixture of Ropivacaine and Fentanyl for Lumbar Epidural Analgesia After Total Knee Arthroplasty
Anesth Analg 2008 106: 301-304. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In this study, the addition of epinephrine 4 {micro}g/mL (12 32 {micro}g/h) to a low-dose mixture of ropivacaine and fentanyl did not improve lumbar continuous epidural analgesia after total knee arthroplasty. This confirms earlier findings that lower dose epinephrine as an adjuvant to continuous epidural analgesia given at a lumbar level has no, or only limited, beneficial effects on postoperative pain relief.

Alain C. Van Elstraete, Myriam Tirault, Thierry Lebrun, Ignace Sandefo, Jean-Christophe Bernard, Bruno Polin, Patrick Vally, and Jean-Xavier Mazoit

The Median Effective Dose of Preemptive Gabapentin on Postoperative Morphine Consumption After Posterior Lumbar Spinal Fusion (Brief Report)
Anesth Analg 2008 106: 305-308. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The median effective analgesic dose (median value and 95% confidence interval) of preemptive gabapentin in patients undergoing elective posterior lumbar spinal fusion was 21.7 mg/kg (19.9 23.5 mg/kg).

Hakki Unlugenc, Mehmet Ali Vardar, and Sibel Tetiker

A Comparative Study of the Analgesic Effect of Patient-Controlled Morphine, Pethidine, and Tramadol for Postoperative Pain Management After Abdominal Hysterectomy (Brief Report)
Anesth Analg 2008 106: 309-312. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We evaluated the analgesic effectiveness and side effects of IV patient-controlled morphine, pethidine and tramadol for postoperative pain management. The use of these drugs resulted in equivalent pain scores and side effects, but our tramadol group required more rescue analgesic doses of fentanyl.

Chiyo Sato, Atsushi Sakai, Yumiko Ikeda, Hidenori Suzuki, and Atsuhiro Sakamoto

The Prolonged Analgesic Effect of Epidural Ropivacaine in a Rat Model of Neuropathic Pain
Anesth Analg 2008 106: 313-320. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Repetitive administration of epidural ropivacaine starting 7 days after injury partly reverses the thermal hyperalgesia and mechanical allodynia that develops after chronic constrictive injury in rats.

Sharon M. Gordon, Brian P. Chuang, Xiao Min Wang, May A. Hamza, Janet S. Rowan, Jaime S. Brahim, and Raymond A. Dionne

The Differential Effects of Bupivacaine and Lidocaine on Prostaglandin E₂ Release, Cyclooxygenase Gene Expression and Pain in a Clinical Pain Model
Anesth Analg 2008 106: 321-327. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Bupivacaine stimulates cyclooxygenase-2 gene expression after tissue injury. This may increase overall prostaglandin E2 production, resulting in an enhanced inflammatory response and postoperative pain.

Kjell Axelsson, Anil Gupta, Eva Johanzon, Elisabeth Berg, Gustav Ekbäck, Narinder Rawal, Peter Enström, and Ulf Nordensson

Intraarticular Administration of Ketorolac, Morphine, and Ropivacaine Combined with Intraarticular Patient-Controlled Regional Analgesia for Pain Relief After Shoulder Surgery: A Randomized, Double-Blind Study
Anesth Analg 2008 106: 328-333. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The combination of intraarticular morphine, ketorolac, and ropivacaine combined with intraarticular patient-controlled regional analgesia using an elastomeric pump for delivery of local anesthetics is more effective than IV ketorolac, but only during the initial postoperative period.

Argyro Fassoulaki, Vassiliki Chatziara, Aikaterini Melemeni, Marianna Zotou, and Constantine Sarantopoulos

Preoperative Gabapentin: The Effect on Ropivacaine Subarachnoid Block and Hemodynamics
Anesth Analg 2008 106: 334-338. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Pretreatment with oral gabapentin had no effect on the spread of sensory block or the regression of motor block but was associated with lower systolic arterial blood pressure values in patients undergoing spinal anesthesia with ropivacaine.

Miguel Angel Reina, María Concepción Villanueva, Fabiola Machés, Ana Carrera, Andrés López, and José Antonio De Andrés

The Ultrastructure of the Human Spinal Nerve Root Cuff in the Lumbar Spine
Anesth Analg 2008 106: 339-344. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We examined ultrastructural aspects of spinal nerve root cuffs such as their cellular and fibrillar components using special histological staining methods, transmission and scanning electron microscopy from six human cadavers. The presence of few capillaries and short distance between fat and axons may affect the passage of epidurally injected substances towards nerve root axons.

COCHRANE CORNER:

Helen C. Hamilton and D. R. Foxcroft

Central Venous Access Sites for the Prevention of Venous Thrombosis, Stenosis, and Infection in Patients Requiring Long-Term Intravenous Therapy
Anesth Analg 2008 106: 345. [Full Text] [PDF]  

Marc Davison, S. Padroni, C. Bunce, and H. Rüschen

Sub-Tenon’s Anesthesia Versus Topical Anesthesia for Cataract Surgery
Anesth Analg 2008 106: 345-346. [Full Text] [PDF]  

Daniel G. Ezra

Topical Anesthesia Alone Versus Topical Anesthesia with Intracameral Lidocaine for Phacoemulsification
Anesth Analg 2008 106: 346. [Full Text] [PDF]  

Arturo J. Martí-Carvajal

Human Recombinant Activated Protein C for Severe Sepsis
Anesth Analg 2008 106: 346. [Full Text] [PDF]  

LETTERS TO THE EDITOR:

Kyle T. S. Pattinson, Richard Rogers, Stephen D. Mayhew, Bradley J. MacIntosh, Michael C. Lee, and Richard G. Wise

Remifentanil-Induced Cerebral Blood Flow Effects in Normal Humans: Dose and ApoE Genotype
Anesth Analg 2008 106: 347. [Full Text] [PDF]  

Ramachandran Ramani

Remifentanil-Induced Cerebral Blood Flow Effects
Anesth Analg 2008 106: 347. [Full Text] [PDF]  

W. Andrew Kofke, John A. Detre, Jiongjiong Wang, and Patricia A. Blissitt

Remifentanil-Induced Cerebral Blood Flow Effects
Anesth Analg 2008 106: 347-348. [Full Text] [PDF]  

Nial F. Quiney, Amish Patel, and William J. Fawcett

Factors Affecting Morphine Metabolism Following Major Liver Resection
Anesth Analg 2008 106: 348-349. [Full Text] [PDF]  

Åsa Rudin and Mads U. Werner

Factors Affecting Morphine Metabolism Following Major Liver Resection
Anesth Analg 2008 106: 349. [Full Text] [PDF]  

Michael J. O’Sullivan

Patient Comfort in Regional Anesthesia
Anesth Analg 2008 106: 349. [Full Text] [PDF]  

Vincent Minville and David Samson

Patient Comfort in Regional Anesthesia
Anesth Analg 2008 106: 349-350. [Full Text] [PDF]  

Sofia Anagnostopoulou, Georgia Kostopanagiotou, Tilemachos Paraskeuopoulos, Anastasia Alevizou, and Theodosis Saranteas

Obturator Nerve Block: From Anatomy to Ultrasound Guidance
Anesth Analg 2008 106: 350. [Full Text] [PDF]  

Yoshihiro Fujiwara, Yutaka Sato, Masato Kitayama, Yasuyuki Shibata, Toru Komatsu, and Kazuyoshi Hirota

Obturator Nerve Block: From Anatomy to Ultrasound Guidance
Anesth Analg 2008 106: 350-351. [Full Text] [PDF]  

Emily A. Zayac, Evan G. Pivalizza, and Robert L. Levine

Thrombelastography in a Patient with Heparin-Induced Thrombocytopenia Treated with Argatroban
Anesth Analg 2008 106: 351-352. [Full Text] [PDF]  

Rajesh Mahajan, Rahul Gupta, and Anju Sharma

Beneficial Effects of Statin Therapy on Infection Related Mortality in Patients with Atherosclerotic and Cardiovascular Disease
Anesth Analg 2008 106: 352. [Full Text] [PDF]  

Philip D. Bailey, Jr

USNS Comfort: Caring for the Sick at Sea
Anesth Analg 2008 106: 353. [Full Text] [PDF]  

BOOK AND MULTIMEDIA REVIEWS:

T. Kyle Harrison and David M. Gaba

New Vistas in Patient Safety and Simulation. In Anesthesia Clinics, Vol. 25, No. 2
Anesth Analg 2008 106: 354. [Full Text] [PDF]  

Martin S. Angst

Postoperative Pain Therapy: An Update. In Best Practice & Research Clinical Anaesthesiology, Vol. 21, No. 1 (March 2007)
Anesth Analg 2008 106: 354-355. [Full Text] [PDF]  

ERRATA:

Erratum
Anesth Analg 2008 106: 355. [Full Text] [PDF]  

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