EDITORIALS:

Frank E. Block, Jr

"For if the trumpet give an uncertain sound, who shall prepare himself to the battle?" (I Corinthians 14:8, KJV)
Anesth Analg 2008 106: 357-359. [Full Text] [PDF]  

CARDIOVASCULAR ANESTHESIOLOGY:

Jean-Luc Hanouz, Yohann Repesse, Lan Zhu, Sandrine Lemoine, René Rouet, Laurent Sallé, Benoît Plaud, and Jean-Louis Gérard

The Electrophysiological Effects of Racemic Ketamine and Etomidate in an In Vitro Model of "Border Zone" Between Normal and Ischemic/Reperfused Guinea Pig Myocardium
Anesth Analg 2008 106: 365-370. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Under normoxic conditions and in clinically relevant concentrations, ketamine and etomidate had no effect on action potential variables of guinea pig ventricular myocardium. In contrast, during simulated ischemia and reperfusion, ketamine, but not etomidate, decreased ischemia-induced action potential shortening and dispersion as well as reperfusion-induced ventricular arrhythmias.

Pilar Sánchez-Conde, José M. Rodríguez-López, Juan L. Nicolás, Francisco S. Lozano, Francisco J. García-Criado, Carlos Cascajo, Rogelio González-Sarmiento, and Clemente Muriel

The Comparative Abilities of Propofol and Sevoflurane to Modulate Inflammation and Oxidative Stress in the Kidney After Aortic Cross-Clamping
Anesth Analg 2008 106: 371-378. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Propofol leads to modulation of markers of systemic inflammation after ischemia-reperfusion injury in experimental abdominal aortic surgery compared with propofol.

David Amar, Dawn P. Desiderio, Paul M. Heerdt, Anne C. Kolker, Hao Zhang, and Howard T. Thaler

Practice Patterns in Choice of Left Double-Lumen Tube Size for Thoracic Surgery
Anesth Analg 2008 106: 379-383. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In 300 adults undergoing lung or esophageal surgery requiring one-lung isolation, the use of a 35 FR left-sided double-lumen tube, regardless of gender or height, was associated with a similar incidence of hypoxemia and one-lung isolation failure as with use of conventional sizing.

Andreas Redel, Markus Lange, Virginija Jazbutyte, Christopher Lotz, Thorsten M. Smul, Norbert Roewer, and Franz Kehl

Activation of Mitochondrial Large-Conductance Calcium-Activated K⁺ Channels via Protein Kinase A Mediates Desflurane-Induced Preconditioning
Anesth Analg 2008 106: 384-391. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Potassium channels are important for anesthetic-induced preconditioning. Here we demonstrate that mitochondrial large-conductance calcium-activated K+ channels mediate desflurane-induced preconditioning, and that activation of these channels by desflurane is mediated by protein kinase.

Jerrold H. Levy and N. Franklin Adkinson, Jr

Anaphylaxis During Cardiac Surgery: Implications for Clinicians (Review Article)
Anesth Analg 2008 106: 392-403. [Abstract] [Full Text] [PDF] [CME]  

Ioanna Apostolidou, Michael F. Sweeney, Emil Missov, Lyle D. Joyce, Ranjit John, and Richard C. Prielipp

Acute Left Atrial Thrombus After Recombinant Factor VIIa Administration During Left Ventricular Assist Device Implantation in a Patient with Heparin-Induced Thrombocytopenia (Case Report)
Anesth Analg 2008 106: 404-408. [Abstract] [Full Text] [PDF] [Videos]   

IMPLICATIONS: A patient with heparin-induced thrombocytopenia who required repeat implantation of a left ventricular assist device underwent cardiopulmonary bypass with bivalirudin for anticoagulation. Profuse bleeding after surgery was treated with massive transfusion therapy, recombinant factor VIIa, and was complicated by an acute left atrial thrombus.

Jonathan Frogel, Lisa Soranno, and Tara Humphrey

Aortic Insufficiency Confounding Transesophageal Echocardiograph Assessment of Left Ventricular Diastolic Function (Echo Rounds)
Anesth Analg 2008 106: 409-411. [Full Text] [PDF] [CME] [Echo Loops]   

Jörn Karhausen, Martina Nowak, Gregory S. Couper, Vladimir Formanek, Valbona Mirakaj, Andrew Locke, Stanton K. Shernan, and Peter Rosenberger

Right Ventricular Dissection Diagnosed on Transesophageal Echocardiography (Echo Rounds)
Anesth Analg 2008 106: 412-414. [Full Text] [PDF] [CME] [Echo Loop]   

Joyce L. Onwere, Thomas N. Spackman, and Roger L. Click

Intraoperative Hypoxemia from Compression of the Right Pulmonary Artery Caused by a Sternal Retractor (Echo Rounds)
Anesth Analg 2008 106: 415-416. [Full Text] [PDF] [CME] [Echo Loops]   

PEDIATRIC ANESTHESIOLOGY:

Nina A. Guzzetta, Tanya Bajaj, Tom Fazlollah, Fania Szlam, Elizabeth Wilson, Anna Kaiser, Steven R. Tosone, and Bruce E. Miller

A Comparison of Heparin Management Strategies in Infants Undergoing Cardiopulmonary Bypass
Anesth Analg 2008 106: 419-425. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Compared with a standard weight-based heparin management protocol monitored solely by activated clotting time values, heparin management in infants <6-mo-of-age monitored by Hepcon heparin management system plus-calculated heparin concentrations led to a significant reduction in thrombin generation and a significant preservation of factor VIII levels.

Adelaida Lamas, Jesús López-Herce, Luis Sancho, Santiago Mencía, Ángel Carrillo, Maria José Santiago, and Vicente Martínez

Bispectral Index and Middle Latency Auditory Evoked Potentials in Children Younger Than Two-Years-Old
Anesth Analg 2008 106: 426-432. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Bispectral index and midlatency auditory evoked potentials could be used in healthy children younger than 2-yr-of-age during wakefulness and natural sleep, though they show poor agreement with clinical assessments.

AMBULATORY ANESTHESIOLOGY:

Jeff E. Mandel, Jonathan W. Tanner, Gary R. Lichtenstein, David C. Metz, David A. Katzka, Gregory G. Ginsberg, and Michael L. Kochman

A Randomized, Controlled, Double-Blind Trial of Patient-Controlled Sedation with Propofol/Remifentanil Versus Midazolam/Fentanyl for Colonoscopy
Anesth Analg 2008 106: 434-439. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The combination of propofol and remifentanil significantly reduces the time required for sedation and recovery to ambulation in patients undergoing colonoscopy when compared with midazolam and fentanyl given via patient-controlled sedation (PCS). Respiratory depression requiring anesthesiologist intervention was seen in 8% of patients. When combined with anesthesiologist rescue, PCS propofol and remifentanil can markedly improve throughput in colonoscopy.

Julie B. Schnur, Dana H. Bovbjerg, Daniel David, Kristin Tatrow, Alisan B. Goldfarb, Jeffrey H. Silverstein, Christina R. Weltz, and Guy H. Montgomery

Hypnosis Decreases Presurgical Distress in Excisional Breast Biopsy Patients
Anesth Analg 2008 106: 440-444. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study demonstrates that a brief period of hypnosis is effective in controlling presurgical distress in women awaiting diagnostic breast cancer surgery. Thus, study adds to the body of literature demonstrating the utility of alternative medicine strategies in enhancing the perioperative experience of patients.

Sven Bercker, Willi Schmidbauer, Thomas Volk, Gottfried Bogusch, Hans Peter Bubser, Mario Hensel, and Thoralf Kerner

A Comparison of Seal in Seven Supraglottic Airway Devices Using a Cadaver Model of Elevated Esophageal Pressure
Anesth Analg 2008 106: 445-448. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Using a cadaver model to assess the performance of seven supraglottic airway devices, protection against aspiration can be achieved either by a tight esophageal seal, as was obtained with the Intubating Laryngeal Mask Airway, the Easytube, and the Combitube, or with an esophageal lumen to direct regurgitated fluid out of the mouth.

ANESTHETIC PHARMACOLOGY:

Theodore H. Stanley, Talmage D. Egan, and Hugo Van Aken

A Tribute to Dr. Paul A. J. Janssen: Entrepreneur Extraordinaire, Innovative Scientist, and Significant Contributor to Anesthesiology (Special Article)
Anesth Analg 2008 106: 451-462. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Few in the field of anesthesiology appreciate the sheer magnitude of Dr. Janssen's numerous contributions to various fields in human, botanical, and veterinary medicine. From the invention and development of over 80 pharmaceutical compounds to his monumental merger of Janssen Pharmacuetica with Johnson and Johnson, Dr. Paul Janssen truly embodies what it means to be a productive scientist and an entrepreneur extraordinaire.

Kim K. Lemberg, Antti O. Siiskonen, Vesa K. Kontinen, Jari T. Yli-Kauhaluoma, and Eija A. Kalso

Pharmacological Characterization of Noroxymorphone as a New Opioid for Spinal Analgesia
Anesth Analg 2008 106: 463-470. [Abstract] [Full Text] [PDF] [Data Supplement]   

IMPLICATIONS: Noroxymorphone is a promising opioid for spinal analgesia with a significantly longer lasting antinociceptive effect compared with oxycodone and morphine after intrathecal administration in rats. Its safety for spinal administration should be assessed before clinical use.

Ken B. Johnson, Noah D. Syroid, Dhanesh K. Gupta, Sandeep C. Manyam, Talmage D. Egan, Jeremy Huntington, Julia L. White, Diane Tyler, and Dwayne R. Westenskow

An Evaluation of Remifentanil Propofol Response Surfaces for Loss of Responsiveness, Loss of Response to Surrogates of Painful Stimuli and Laryngoscopy in Patients Undergoing Elective Surgery
Anesth Analg 2008 106: 471-479. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We explored the use of remifentanil-propofol response surface interaction models to predict loss and return of responsiveness, presence or absence of a response to laryngoscopy and pain after surgery. The interaction models predicted responses to selected pertinent events in patients undergoing a propofol-remifentanil-based anesthetic for surgery. Significant model error was evident during rapid changes in predicted effect-site propofol-remifentanil concentration pairs.

Rudolph Puana, Russell K. McAllister, Felicia A. Hunter, Julie Warden, and Ed W. Childs

Morphine Attenuates Microvascular Hyperpermeability via a Protein Kinase A-Dependent Pathway
Anesth Analg 2008 106: 480-485. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Instead of aggravating the inflammatory response secondary to histamine release, morphine sulfate actually provides protection to the microvasculature by attenuating the phosphoinositol/MAP kinase cascade via protein kinase A.

Rita Katznelson, Leonid Minkovich, Zeev Friedman, Ludvik Fedorko, W. Scott Beattie, and Joseph A. Fisher

Accelerated Recovery from Sevoflurane Anesthesia with Isocapnic Hyperpnoea
Anesth Analg 2008 106: 486-491. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Isocapnic hyperpnoea accelerates recovery from sevoflurane anesthesia and shortens operating room and postanesthetic care unit stay.

Ge Liang, Qiujun Wang, Yujuan Li, Baobin Kang, Maryellen F. Eckenhoff, Roderic G. Eckenhoff, and Huafeng Wei

A Presenilin-1 Mutation Renders Neurons Vulnerable to Isoflurane Toxicity
Anesth Analg 2008 106: 492-500. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Mutations in presenilin-1 are a common genetic cause of familial Alzheimer's disease. We found that PC12 cells transfected with mutated presenilin-1 were vulnerable to isoflurane-induced cytotoxicity, and demonstrated higher calcium release from the endoplasmic reticulum IP3 receptors than observed in wild type cells. Sevoflurane and desflurane at equipotent exposure induced neither cytotoxicity nor changes in intracellular calcium. Patients with familial Alzheimer's disease may be more vulnerable to isoflurane neurotoxicity than normal individuals.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Alexandra N. Wee and Penelope M. Sanderson

Are Melodic Medical Equipment Alarms Easily Learned?
Anesth Analg 2008 106: 501-508. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Clinicians have difficulty learning the recommended IEC 60601-1-8 melodic alarms for medical electrical equipment and persistently confuse certain pairs of alarms. Redesign and formal testing with representative users is needed.

Abraham Rosenbaum, Heike C. Howard, and Peter H. Breen

Novel Portable Device Measures Preoperative Patient Metabolic Gas Exchange
Anesth Analg 2008 106: 509-516. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A novel system, comprising of an airway bymixer, fast response temperature and humidity sensor, flowmeter, and nonrebreathing valve, can conveniently measure airway Vo2 and Vco2 during spontaneous breathing in awake patients.

PATIENT SAFETY:

Kareem Eltaki, Heba Abdulla, and Raymond S. Sinatra

A Severe Inflammatory Cutaneous Reaction After Continuous Epidural Analgesia (Case Report)
Anesth Analg 2008 106: 517-519. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Cutaneous reactions to epidural catheter placement are rare, and usually related to the antiseptic solutions. Proper assessment and treatment is the key to avoiding serious complications.

Stephen Howell and Richard P. Driver, Jr

Unintentional Intracerebroventricular Administration of Etomidate and Rocuronium (Case Report)
Anesth Analg 2008 106: 520-522. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Based on this case report, intracerebroventricular etomidate appears to produce anesthetic effects similar to those in the rat model, as evidenced by excellent conditions for direct laryngoscopy and endotracheal intubation. The long-term effects of intracerebroventricular rocuronium and etomidate cannot be predicted.

CRITICAL CARE AND TRAUMA:

George Dimopoulos, Fotinie Ntziora, George Rachiotis, Apostolos Armaganidis, and Matthew E. Falagas

Candida Albicans Versus Non-Albicans Intensive Care Unit-Acquired Bloodstream Infections: Differences in Risk Factors and Outcome
Anesth Analg 2008 106: 523-529. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In critically ill nonimmunosuppressed patients, candidemia caused by non-albicans species, which is associated with higher mortality, was more likely to occur in patients with medical devices or receiving steroids.

Yuichi Yatsu, Toshihito Tsubo, Hironori Ishihara, Hitomi Nakamura, and Kazuyoshi Hirota

A New Method to Estimate Regional Pulmonary Blood Flow Using Transesophageal Echocardiography
Anesth Analg 2008 106: 530-534. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Estimates of changes in regional lung perfusion may be obtained using transesophageal echocardiography.

Holger Herff, Peter Paal, Achim von Goedecke, Thomas Mitterlechner, Thomas Danninger, and Volker Wenzel

Minimizing Stomach Inflation Versus Optimizing Chest Compressions (Technical Communication)
Anesth Analg 2008 106: 535-537. [Abstract] [Full Text] [PDF] [Data Supplement]   

IMPLICATIONS: The Smart Bag(R) MO, a bag-valve device with a built-in, flow-limiting safety feature decreasing maximum inspiratory gas flow, was developed to decrease the risk of stomach inflation in the unprotected airway. The use of the flow-limiting feature in short ventilation pauses, e.g., during cardiopulmonary resuscitation with uninterrupted chest compressions, may result in hypoventilation.

OBSTETRIC ANESTHESIOLOGY:

Robert Whitty, Michael Moore, and Alison Macarthur

Identification of the Lumbar Interspinous Spaces: Palpation Versus Ultrasound (Brief Report)
Anesth Analg 2008 106: 538-540. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study compared the lumbar interspinous space estimated by palpation during obstetric neuraxial anesthesia to that estimated by ultrasound examination. There was poor agreement between the two methods, and when there was disagreement, the ultrasound estimate was more often higher than the palpitation estimate.

Ashraf S. Habib, Ronald B. George, Terrence K. Allen, and Adeyemi J. Olufolabi

A Pilot Study to Compare the Episure^TM Autodetect^TM Syringe with the Glass Syringe for Identification of the Epidural Space in Parturients (Brief Report)
Anesth Analg 2008 106: 541-543. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The EpisureTM AutoDetectTM syringe, a spring-loaded syringe, was compared with the glass syringe for identification of the epidural space in 325 parturients. There was no failed epidural analgesia and no inadvertent dural punctures with the AutoDetect syringe.

ECONOMICS, EDUCATION, AND POLICY:

Franklin Dexter and Richard H. Epstein

Calculating Institutional Support That Benefits Both the Anesthesia Group and Hospital (Special Article)
Anesth Analg 2008 106: 544-553. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Two types of agreements between hospitals and anesthesia groups for institutional support are shown to be rational. When such agreements are negotiated, the potential impact on incentives for improving OR management should be considered.

Yan Xiao, Franklin Dexter, Peter Hu, and Richard P. Dutton

The Use of Distributed Displays of Operating Room Video When Real-Time Occupancy Status Was Available (Special Article)
Anesth Analg 2008 106: 554-560. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Distributed video displays with degraded images are accepted and used by operating room (OR) staff in all job categories. Tests of such systems in a 6-OR trauma suite and a 19-OR general suite demonstrated that staff used them regularly and extensively even when real-time OR occupancy status was available continually at the sites of video displays.

Danielle Masursky, Franklin Dexter, Colin J. L. McCartney, Sheldon A. Isaacson, and Nancy A. Nussmeier

Predicting Orthopedic Surgeons’ Preferences for Peripheral Nerve Blocks for Their Patients (Special Article)
Anesth Analg 2008 106: 561-567. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A surgeon's preference for peripheral nerve block for him or herself strongly predicted his or her preference for patients (concordance >= 87%). There was no additional predictive value for the surgeon's patients in knowing the surgeon's perception of the incremental time to perform a block or the rate of successful blocks.

Getúlio Rodrigues de Oliveira Filho, Pablo Escovedo Helayel, Diogo Brüggemann da Conceição, Ivo Sebastião Garzel, Patrícia Pavei, and Maurício Sperotto Ceccon

Learning Curves and Mathematical Models for Interventional Ultrasound Basic Skills (Special Article)
Anesth Analg 2008 106: 568-573. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Learning curves and mathematical models were constructed for the acquisition of ultrasound-related skills: optimizing needle-beam alignment and reaching a target inside a phantom. Subjects became proficient at variable rates, as assessed by the cumulative sum method. Mathematical models predicted the average numbers of trials to attain 95% success rates.

Jeffrey B. Cooper, Richard H. Blum, John S. Carroll, Mark Dershwitz, David M. Feinstein, David M. Gaba, John C. Morey, and Aneesh K. Singla

Differences in Safety Climate Among Hospital Anesthesia Departments and the Effect of a Realistic Simulation-Based Training Program (Special Article)
Anesth Analg 2008 106: 574-584. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Anesthesia providers' perceptions of the safety climate of operating rooms varied substantially among hospital anesthesia groups. Simulation-based anesthesia crisis resource management training showed no benefit to affecting safety climate in this group randomized trial.

NEUROSURGICAL ANESTHESIOLOGY:

Adrian W. Gelb, Rosemary A. Craen, G. S. Umamaheswara Rao, K. R. Madhusudan Reddy, Joseph Megyesi, Bibek Mohanty, Hari H. Dash, Kai C. Choi, and Mathew T. V. Chan

Does Hyperventilation Improve Operating Condition During Supratentorial Craniotomy? A Multicenter Randomized Crossover Trial
Anesth Analg 2008 106: 585-594. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This multicenter randomized crossover trial in 265 adult patients with supratentorial brain tumors demonstrated that intraoperative hyperventilation decreases intracranial pressure and improves surgeon-assessed brain bulk.

GENERAL ARTICLES:

Syed Z. Ali, Hendrik Bracht, Vladimir Krejci, Mario Beck, Michael Stalder, Luzius Hiltebrand, Jukka Takala, Sebastian Brandt, and Stephan M. Jakob

The Immediate and Sustained Effects of Volume Challenge on Regional Blood Flows in Pigs
Anesth Analg 2008 106: 595-600. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study demonstrates that volume challenges can persistently improve the perfusion of the brain, gut, and kidney in the postoperative period, even under hemodynamically stable conditions. This may result in clinical benefit if organ function is impaired after surgery.

ANALGESIA:

Shu-Ming Wang, Zeev N. Kain, and Paul White

Acupuncture Analgesia: I. The Scientific Basis (Review Article)
Anesth Analg 2008 106: 602-610. [Abstract] [Full Text] [PDF] [CME]  

Shu-Ming Wang, Zeev N. Kain, and Paul F. White

Acupuncture Analgesia: II. Clinical Considerations (Review Article)
Anesth Analg 2008 106: 611-621. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The peer-reviewed literature suggests that acupuncture and related forms of acustimulation provide temporary pain relief in patients with a wide variety of acute and chronic pain syndromes. There is minimal evidence, however, that these nonpharmacologic treatments provide longer-term benefits unless the treatments are administered on a continuing basis.

Aude Thévenin, Hélène Beloeil, Antonia Blanie, Dan Benhamou, and Jean-Xavier Mazoit

The Limited Efficacy of Tramadol in Postoperative Patients: A Study of ED₈₀ Using the Continual Reassessment Method (Review Article)
Anesth Analg 2008 106: 622-627. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Tramadol used as a sole drug after moderately painful surgery is effective in 80% of patients when the administered dose is 260 mg, significantly higher than the manufacturer-recommended dose.

Mark S. Wallace, Richard Rauck, Robert Fisher, Steven G. Charapata, David Ellis, Sanjeeva Dissanayake For the Ziconotide 98-022 Study Group

Intrathecal Ziconotide for Severe Chronic Pain: Safety and Tolerability Results of an Open-Label, Long-Term Trial (Review Article)
Anesth Analg 2008 106: 628-637. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study of the safety and tolerability of ziconotide suggests that the drug is a reasonable long-term treatment option for patients with severe chronic pain.

Kenneth D. Candido, Meda S. Raghavendra, Mariadas Chinthagada, Soraya Badiee, and Donald W. Trepashko

A Prospective Evaluation of Iodinated Contrast Flow Patterns with Fluoroscopically Guided Lumbar Epidural Steroid Injections: The Lateral Parasagittal Interlaminar Epidural Approach Versus the Transforaminal Epidural Approach (Review Article)
Anesth Analg 2008 106: 638-644. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Transforaminal and parasagittal interlaminar epidural steroid injections are methods of placing medication into the anterior epidural space to provide analgesia for inflammatory conditions of the lumbar spine. In this study, the parasagittal interlaminar technique was more reliable in placing dye in the ventral epidural space, and did so in less time, than the transforaminal technique. Outcomes were similar between the two groups of patients.

PAIN MEDICINE:

Antonio Siniscalchi, Emanuele Piraccini, Zuzana Miklosova, Stefania Taddei, Stefano Faenza, and Gerardo Martinelli

Opioid-Induced Hyperalgesia and Rapid Opioid Detoxification After Tacrolimus Administration (Case Report)
Anesth Analg 2008 106: 645-646. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The authors report a case of opioid-induced hyperalgesia in a patient receiving IV morphine with chronic neuropathic pain, and the favorable response to opioid detoxification.

Prashanth S. Manjunath, T. S. Jayalakshmi, G. P. Dureja, and A. Toby Prevost

Management of Lower Limb Complex Regional Pain Syndrome Type 1: An Evaluation of Percutaneous Radiofrequency Thermal Lumbar Sympathectomy Versus Phenol Lumbar Sympathetic Neurolysis—A Pilot Study (Brief Report)
Anesth Analg 2008 106: 647-649. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In a study of modest size (20 patients), radiofrequency lumbar sympathectomy appears to be comparable to phenol lumbar sympathectomy for the treatment of type 1 complex regional pain syndrome.

PAIN MECHANISMS:

Jian Liu, Weiyan Li, Juan Zhu, Jing Zhang, Xiaomei Feng, Ren Guan, and Jianguo Xu

The Effect of Pentoxifylline on Existing Hypersensitivity in a Rat Model of Neuropathy (Brief Report)
Anesth Analg 2008 106: 650-653. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Pentoxifylline did not show therapeutic action in a rodent model of neuropathic pain when applied after nerve injury. As previous research has suggested efficacy when applied before nerve injury, the authors conclude that pentoxifylline should be prescribed to patients in the early stage of diseases that pose a risk for the development of neuropathic pain.

REGIONAL ANESTHESIA:

Hiroaki Murata, Tetsuya Sakai, Shinichi Goto, and Koji Sumikawa

Three-Dimensional Computed Tomography for Difficult Thoracic Epidural Needle Placement
Anesth Analg 2008 106: 654-658. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The number of occluded mid-thoracic interlaminar spaces and the incidence of supraspinous ligament ossification observed in preoperative three-dimensional computed tomography images correlates with difficult thoracic epidural punctures. This suggests that anatomical information obtained by three-dimensional computed tomography imaging techniques may be useful in evaluating difficult thoracic epidural needle placement.

Kenneth E. Langen, Kenneth D. Candido, Michael King, Guido Marra, and Alon P. Winnie

The Effect of Motor Activity on the Onset and Progression of Brachial Plexus Block with Bupivacaine: A Randomized Prospective Study in Patients Undergoing Arthroscopic Shoulder Surgery
Anesth Analg 2008 106: 659-663. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Repetitive muscle contraction of the hand immediately after performance of interscalene brachial plexus block with bupivacaine does not decrease the onset time of conduction blockade.

Nathalie Valade, Jacques Ripart, Emmanuel Nouvellon, Philippe Cuvillon, Dominique Prat-Pradal, Jean-Yves Lefrant, and Jean-Emmanuel de La Coussaye

Does Sciatic Parasacral Injection Spread to the Obturator Nerve? An Anatomic Study
Anesth Analg 2008 106: 664-667. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Successful parasacral injection consistently spreads to the pelvic portion of the obturator nerve and to the sacral roots. Therefore, parasacral block should theoretically provide obturator and perineal blockade, and eliminate the need for systematic separate obturator nerve block.

LETTERS TO THE EDITOR:

William H. Rosenblatt

Interesting Anecdotes Cannot Validate Test Results
Anesth Analg 2008 106: 668. [Full Text] [PDF]  

J. Adam Law

Relying on Just a Few Predictors of Easy Airway Management May Bite Back¡
Anesth Analg 2008 106: 668. [Full Text] [PDF]  

Jeffrey L. Tong and Andrea J. Gait

The Upper Lip Bite Test to Predict Difficult Intubation
Anesth Analg 2008 106: 668-669. [Full Text] [PDF]  

Zahid Hussain Khan

The Upper Lip Bite Test to Predict Difficult Intubation
Anesth Analg 2008 106: 669. [Full Text] [PDF]  

Zafer Salim Tabboush

Fitness of Patients in Pain to Make Optimal Decisions
Anesth Analg 2008 106: 669. [Full Text] [PDF]  

Bruce Dick

Fitness of Patients in Pain to Make Optimal Decisions
Anesth Analg 2008 106: 669-670. [Full Text] [PDF]  

Sandra H. Johnson

Fitness of Patients in Pain to Make Optimal Decisions
Anesth Analg 2008 106: 670. [Full Text] [PDF]  

Joana K. Panni and Moeen K. Panni

Increased Anesthetic Depth, Not Metoprolol, May Have Caused the Change in Bispectral Index
Anesth Analg 2008 106: 670. [Full Text] [PDF]  

Prabhat Kumar Sinha, David Jacob, and Thomas Koshy

Increased Anesthetic Depth, Not Metoprolol, May Have Caused the Change in Bispectral Index
Anesth Analg 2008 106: 670-671. [Full Text] [PDF]  

Joseph Bayes

Management of Implanted Cardiac Defibrillators During Eye Surgery
Anesth Analg 2008 106: 671. [Full Text] [PDF]  

Marc Rozner

Management of Implanted Cardiac Defibrillators During Eye Surgery
Anesth Analg 2008 106: 671-672. [Full Text] [PDF]  

Sahar M. Siddik-Sayyid and Anis S. Baraka

Predistention of the Epidural Space with Saline Before Catheter Insertion
Anesth Analg 2008 106: 672. [Full Text] [PDF]  

Shmuel Evron and Tiberiu Ezri

Predistention of the Epidural Space with Saline Before Catheter Insertion
Anesth Analg 2008 106: 672-673. [Full Text] [PDF]  

Nathan Leon Pace

Nonignorable Covariates
Anesth Analg 2008 106: 673. [Full Text] [PDF]  

Yannick Le Manach

Nonignorable Covariates
Anesth Analg 2008 106: 673. [Full Text] [PDF]  

John G. T. Augoustides

Perioperative Echocardiographic Assessment of Left Ventricular Assist Device Implantation: Additional Causes of Inflow Cannula Obstruction
Anesth Analg 2008 106: 673-674. [Full Text] [PDF]  

Peter Hebbard

Subcostal Transversus Abdominis Plane Block Under Ultrasound Guidance
Anesth Analg 2008 106: 674-675. [Full Text] [PDF]  

Siriluk Chumnanvej and Marcos F. Vidal Melo

Perioperative Echocardiographic Assessment of Left Ventricular Assist Device Implantation: Additional Causes of Inflow Cannula Obstruction
Anesth Analg 2008 106: 674. [Full Text] [PDF]  

John G. Laffey and John G. McDonnell

Subcostal Transversus Abdominis Plane Block Under Ultrasound Guidance
Anesth Analg 2008 106: 675. [Full Text] [PDF]  

Mario Achim Klinkhammer, Friedrich Weber, Frank Wappler, and Samir G. Sakka

Uncertain Usefulness of Procalcitonin as Reliable Marker of Sepsis?
Anesth Analg 2008 106: 675-676. [Full Text] [PDF]  

Vladislav Rogozov, Ladislav Hess, Ales Brezina, and Jitka Schreibrova

The Effectiveness of 112-Year-Old Curare
Anesth Analg 2008 106: 676-677. [Full Text] [PDF]  

Kazuna Sugiyama and Koki Okushima

Difficult Intubation in a Patient Without a Mandibular Body
Anesth Analg 2008 106: 677-678. [Full Text] [PDF]  

Jamil S. Anwari

Pain Management: Citizenship or Human Right?
Anesth Analg 2008 106: 678. [Full Text] [PDF]  

BOOK AND MULTIMEDIA REVIEWS:

Robert A. Swarm

The Textbook of Regional Anesthesia and Acute Pain Management
Anesth Analg 2008 106: 679. [Full Text] [PDF]  

Bruce D. Spiess

Blood Transfusion, Vol. 21, No. 2 in Best Practice & Research, Clinical Anesthesiology
Anesth Analg 2008 106: 679-680. [Full Text] [PDF]  

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