EDITORIALS:

J. Lance Lichtor and Peter S. A. Glass

We’re Tired of Waiting
Anesth Analg 2008 107: 353-355. [Full Text] [PDF]  

Andreas Greinacher and Jerrold H. Levy

HIT Happens: Diagnosing and Evaluating the Patient with Heparin-Induced Thrombocytopenia
Anesth Analg 2008 107: 356-358. [Full Text] [PDF]  

Martin W. Dünser, Christian Torgersen, and Volker Wenzel

Treatment of Anaphylactic Shock: Where Is the Evidence?
Anesth Analg 2008 107: 359-361. [Full Text] [PDF]  

Diane E. Head and Paul Barash

Progress Is Precarious
Anesth Analg 2008 107: 362-364. [Full Text] [PDF]  

Max B. Kelz and Roderic G. Eckenhoff

Does It Add Up?
Anesth Analg 2008 107: 365-366. [Full Text] [PDF]  

CARDIOVASCULAR ANESTHESIOLOGY:

Mary P. Mullen, David L. Wessel, Kristen C. Thomas, Kimberlee Gauvreau, Ellis J. Neufeld, Francis X. McGowan, Jr, and James A. DiNardo

The Incidence and Implications of Anti-Heparin-Platelet Factor 4 Antibody Formation in a Pediatric Cardiac Surgical Population
Anesth Analg 2008 107: 371-378. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Heparin-induced thrombocytopenia is a rare occurrence in pediatric cardiac surgical patients. The incidence of anti-heparin-PF4 antibody seroconversion in children undergoing reoperation is approximately 50% at 10 days postoperatively; age and previous unfractionated heparin exposure correlate with this rate of seroconversion.

Suzanne M. Dellaria, Philip E. Greilich, and Ravindra Sarode

Urgent Cardiac Surgery in a Patient with a Remote History of Heparin-Induced Thrombocytopenia: Use of the Anti-PF4/Heparin ELISA Confirmatory Test (Case Report)
Anesth Analg 2008 107: 379-381. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The use of a clinicopathologic approach to the diagnosis of heparin-induced thrombocytopenia (HIT) requires caution when the antigen-based test for HIT antibodies is performed in patients with a low pretest probability of HIT. We describe here a valuable adjunct to the clinical history when recommending heparin use in patients with a positive enzyme-linked immunosorbent assay (ELISA) screening test result: an anti-PF4/heparin ELISA with a confirmatory procedure.

Sibylle A. Kozek-Langenecker, Cornelius Jungheinrich, Wilhelm Sauermann, and Philippe Van der Linden

The Effects of Hydroxyethyl Starch 130/0.4 (6%) on Blood Loss and Use of Blood Products in Major Surgery: A Pooled Analysis of Randomized Clinical Trials (Case Report)
Anesth Analg 2008 107: 382-390. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Blood loss and transfusion requirements can be significantly reduced in major surgery when using third generation hydroxyethyl starch 130/0.4.

Andinet M. Mengistu, Kerstin D. Röhm, Joachim Boldt, Jochen Mayer, Stefan W. Suttner, and Swen N. Piper

The Influence of Aprotinin and Tranexamic Acid on Platelet Function and Postoperative Blood Loss in Cardiac Surgery (Case Report)
Anesth Analg 2008 107: 391-397. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: After cardiopulmonary bypass, aprotinin and tranexamic acid were compared as measured by modified thrombelastography and whole blood aggregometry. Postoperative blood loss was reduced by aprotinin and platelet function was preserved as measured by whole blood aggregometry.

Evan G. Pivalizza and Miguel A. Escobar

Thrombelastography-Guided Factor VIIa Therapy in a Surgical Patient with Severe Hemophilia and Factor VIII Inhibitor (Case Report)
Anesth Analg 2008 107: 398-401. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Extremely large doses of rFVIIa may be required in hemophilia patients with inhibitors. We present a case where thrombelastography (TEG(R) and ROTEM(R)) were used to guide dosing and timing of large rFVIIa doses in a hemophiliac requiring surgical evacuation of a spinal hematoma.

Katherine M. H. James, Clare N. Melikian, Pratima Chowdary, and Susan V. Mallett

Thromboelastography-Guided Recombinant Factor VIIa Administration in a Patient with Refractory Autoimmune Idiopathic Thrombocytopenia (Case Report)
Anesth Analg 2008 107: 402-405. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Thromboelastography can be used to guide administering rVIIa in severe refractory thrombocytopenia during the perioperative period.

Benjamin J. Kober, Albertus M. Scheule, Vladimir Voth, Norbert Deschner, Eckhard Schmid, and Gerhard Ziemer

Anaphylactic Reaction After Systemic Application of Aprotinin Triggered by Aprotinin-Containing Fibrin Sealant (Case Report)
Anesth Analg 2008 107: 406-409. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Before aprotinin administration, we recommend that the patient's operative history be assessed in detail for exposure to aprotinin within the last 12 mo, which should be viewed as a contraindication. Exposure to aprotinin-containing fibrin sealant within the previous 12 mo should require a careful risk benefit assessment. Preoperative screening for aprotinin-specific IgG (qualitative or quantitative) may be helpful.

Kay B. Leissner, Feroze Mahmood, Jayashri R. Aragam, Abolhassan Amouzgar, and Rafael Ortega

Catecholamine-Induced Cardiomyopathy and Pheochromocytoma (Echo Rounds)
Anesth Analg 2008 107: 410-412. [Full Text] [PDF] [Video Loops]   

PEDIATRIC ANESTHESIOLOGY:

Anna M. Varughese, Todd G. Nick, Joel Gunter, Yu Wang, and C. Dean Kurth

Factors Predictive of Poor Behavioral Compliance During Inhaled Induction in Children
Anesth Analg 2008 107: 413-421. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Preoperative factors predicting poor behavioral compliance on anesthetic mask induction may identify children who could benefit from interventions in the preoperative clinic to reduce anxiety. Age, history of previous anesthesia, preoperative tour attendance, preoperative preparation time and anxiety state levels in the preoperative clinic demonstrated a strong relationship to poor behavioral compliance on induction. Race, gender, type of procedure, the American Society of Anesthesiologists class, midazolam premedication, and number of hours fasted demonstrated no relationship to poor behavioral compliance.

Melody C. Carter, Ashraf Uzzaman, Linda M. Scott, Dean D. Metcalfe, and Zenaide Quezado

Pediatric Mastocytosis: Routine Anesthetic Management for a Complex Disease
Anesth Analg 2008 107: 422-427. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Pediatric mastocytosis is characterized by a spectrum of clinical variants which have in common an increase in mast cells in various organ systems and that can be associated with unprovoked anaphylaxis. Given the complex nature of the disease, understanding the pathophysiology is important for the management of patients with pediatric mastocytosis. This article suggests that commonly administered anesthetics may be used for patients with pediatric mastocytosis.

AMBULATORY ANESTHESIA:

Peter H. Pan, Sherman C. Lee, and Lynne C. Harris

Antiemetic Prophylaxis for Postdischarge Nausea and Vomiting and Impact on Functional Quality of Living During Recovery in Patients with High Emetic Risks: A Prospective, Randomized, Double-Blind Comparison of Two Prophylactic Antiemetic Regimens
Anesth Analg 2008 107: 429-438. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Intraoperative IV dexamethasone and ondansetron plus an oral disintegrating ondansetron tablet administered at discharge and on the first two postoperative days significantly reduced incidences of postdischarge nausea and vomiting or reports of negative impact on quality of recovery.

Anthony L. Kovac, Leopold Eberhart, Jan Kotarski, Giuseppina Clerici, Christian Apfel, and The Palonosetron 04-07 Study Group

A Randomized, Double-Blind Study to Evaluate the Efficacy and Safety of Three Different Doses of Palonosetron Versus Placebo in Preventing Postoperative Nausea and Vomiting Over a 72-Hour Period
Anesth Analg 2008 107: 439-444. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Palonosetron 0.075 mg reduced the incidence of nausea and vomiting when compared with placebo in inpatients on the day of surgery (0-24 h) and 0-72 h postoperatively.

Keith A. Candiotti, Anthony L. Kovac, Timothy I. Melson, Giuseppina Clerici, Tong Joo Gan, and The Palonosetron 04–06 Study Group

A Randomized, Double-Blind Study to Evaluate the Efficacy and Safety of Three Different Doses of Palonosetron Versus Placebo for Preventing Postoperative Nausea and Vomiting
Anesth Analg 2008 107: 445-451. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Palonosetron 0.075 mg provided a statistically superior complete response rate for postoperative nausea and vomiting compared to placebo for at least 24 hrs.

Paul F. White, Jerome F. O'Hara, Charles R. Roberson, Ronald H. Wender, Keith A. Candiotti, and The POST-OP Study Group

The Impact of Current Antiemetic Practices on Patient Outcomes: A Prospective Study on High-Risk Patients
Anesth Analg 2008 107: 452-458. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The incidence of postoperative nausea and vomiting remains high in patients with known risk factors who are undergoing laparoscopic or major plastic surgery procedures despite multimodal antiemetic prophylaxis.

Paul F. White, Ozlem Sacan, Nina Nuangchamnong, Tiffany Sun, and Matthew R. Eng

The Relationship Between Patient Risk Factors and Early Versus Late Postoperative Emetic Symptoms
Anesth Analg 2008 107: 459-463. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Despite the frequent use of two or more antiemetic drugs for prophylaxis, the incidence of postoperative nausea and vomiting in the first 24 h after elective laparoscopic and plastic surgery procedures increased in proportion to the Apfel risk score. However, this risk scoring system was less predictive in the later recovery period (24-72 h after surgery).

ANESTHETIC PHARMACOLOGY:

Camilo Rojas, Marigo Stathis, Ajit G. Thomas, Edward B. Massuda, Jesse Alt, Jie Zhang, Ed Rubenstein, Silvia Sebastiani, Sergio Cantoreggi, Solomon H. Snyder, and Barbara Slusher

Palonosetron Exhibits Unique Molecular Interactions with the 5-HT₃ Receptor
Anesth Analg 2008 107: 469-478. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Palonosetron exhibits unique molecular interactions with the 5-HT3 receptor. Palonosetron's combined properties of allosteric binding, positive cooperativity, and long-term effect on receptor function make it a distinctive antagonist within the 5-HT3 receptor class.

Edmond I. Eger, II, Michael Tang, Mark Liao, Michael J. Laster, Ken Solt, Pamela Flood, Andrew Jenkins, Douglas Raines, Jan F. Hendrickx, Steven L. Shafer, Tanifuji Yasumasa, and James M. Sonner

Inhaled Anesthetics Do Not Combine to Produce Synergistic Effects Regarding Minimum Alveolar Anesthetic Concentration in Rats
Anesth Analg 2008 107: 479-485. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The divergent potencies of many inhaled anesthetics on ion channels suggest the possibility that combinations of such anesthetics might be superadditive (synergistic). However, we found that combinations of inhaled anesthetics do not produce synergistic interactions as regards MAC. Fifteen of 16 combinations produced additivity and one produced infraadditivity (antagonism), a result consistent with a common site of anesthetic action.

Andrew Jenkins, Ingrid A. Lobo, Diane Gong, James R. Trudell, Ken Solt, R. Adron Harris, and Edmond I. Eger, II

General Anesthetics Have Additive Actions on Three Ligand Gated Ion Channels
Anesth Analg 2008 107: 486-493. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study sought to detect synergistic modulation of ligand gated ion-channel function by pairs of general anesthetic drugs. Six drug combinations were used on three ion channels. All anesthetic interactions were found to be additive.

Jan F. A. Hendrickx, Edmond I. Eger, II, James M. Sonner, and Steven L. Shafer

Is Synergy the Rule? A Review of Anesthetic Interactions Producing Hypnosis and Immobility
Anesth Analg 2008 107: 494-506. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: IV anesthetics acting at different sites usually demonstrate synergy in humans and animals for the end-points of hypnosis and immobility, with the notable exception of ketamine. Inhaled anesthetics usually demonstrate synergy with IV anesthetics. However, no pair of inhaled anesthetics demonstrates synergy when administered together.

Steven L. Shafer, Jan F. A. Hendrickx, Pamela Flood, James Sonner, and Edmond I. Eger, II

Additivity Versus Synergy: A Theoretical Analysis of Implications for Anesthetic Mechanisms
Anesth Analg 2008 107: 507-524. [Abstract] [Full Text] [PDF] [Data Supplement]   

IMPLICATIONS: Drugs interact in an additive manner when two drugs compete for the same site of action, or when the concentrations responsible for the drug effect of interest are well below kd, the dissociation constant. If the concentration associated with clinical drug effect is at or above kd, then the interactions are necessarily synergistic.

Man Liu and James P. Dilger

Synergy Between Pairs of Competitive Antagonists at Adult Human Muscle Acetylcholine Receptors
Anesth Analg 2008 107: 525-533. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Synergistic interactions among pairs of nondepolarizing muscle relaxants were first described over 25 years ago, but a molecular explanation for this has been elusive. Here, we provide evidence that synergy can exist at the level of the adult human muscle nicotinic acetylcholine receptor. This is probably not the complete explanation, but it represents a large step forward.

Hao Wang, Zhanggang Xue, Qiong Wang, Xiaochen Feng, and Zonghou Shen

Propofol Protects Hepatic L02 Cells from Hydrogen Peroxide-Induced Apoptosis via Activation of Extracellular Signal-Regulated Kinases Pathway
Anesth Analg 2008 107: 534-540. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Our study present evidence that propofol protects hepatocytes against hydrogen peroxide-induced apoptosis. Interestingly, not consistent with previous reports, we found that extracellular signal-regulated kinases (ERK) are the target of propofol and that ERK activation contributes to the protective role of propofol. In addition, mRNA expression of Bad and Bax was repressed by propofol in an ERK-dependent manner. These results will add to research on the molecular mechanism underlying the protective role of propofol.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Alexander M. Mathes, Sascha Kreuer, Sven O. Schneider, Stephan Ziegeler, and Ulrich Grundmann

The Performance of Six Pulse Oximeters in the Environment of Neuronavigation
Anesth Analg 2008 107: 541-544. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Infrared pulse waves from stereotactical image guidance systems for neuronavigation may cause erroneous readings in certain types of pulse oximeters. This effect may be abolished by sufficiently shielding the probe. Placement of an aluminum sheet over the probe effectively eliminated interference.

Tomoki Nishiyama

The Effects of Auditory Evoked Potential Click Sounds on Bispectral Index and Entropy
Anesth Analg 2008 107: 545-548. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The click sounds increased Bispectral Index, state entropy, and response entropy transiently during different levels of propofol sedation during spinal anesthesia.

Nicolas Greib, Hervé Schlotterbeck, W. Allister Dow, Girish P. Joshi, Bernard Geny, and Pierre A. Diemunsch

An Evaluation of Gas Humidifying Devices as a Means of Intraperitoneal Local Anesthetic Administration for Laparoscopic Surgery (Technical Communication)
Anesth Analg 2008 107: 549-551. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Ropivacaine can be delivered during CO2 insufflation using a microvibrating nebulizer designed to humidify the insufflated gas, whereas evaporative humidifiers are less effective.

PATIENT SAFETY:

Lisa T. Newsome, Michael A. Kutcher, and Roger L. Royster

Coronary Artery Stents: Part I. Evolution of Percutaneous Coronary Intervention (Review Article)
Anesth Analg 2008 107: 552-569. [Abstract] [Full Text] [PDF]  

Lisa T. Newsome, Robert S. Weller, J. C. Gerancher, Michael A. Kutcher, and Roger L. Royster

Coronary Artery Stents: II. Perioperative Considerations and Management (Review Article)
Anesth Analg 2008 107: 570-590. [Abstract] [Full Text] [PDF] [CME]  

Farnaz M. Gazoni, Marcel E. Durieux, and Lynda Wells

Life After Death: The Aftermath of Perioperative Catastrophes (Review Article)
Anesth Analg 2008 107: 591-600. [Abstract] [Full Text] [PDF]  

Antonio Ojeda, Ana M. López, Xavier Borrat, and Ricard Valero

Failed Tracheal Intubation with the LMA-CTrach^TM in Two Patients with Lingual Tonsil Hyperplasia (Case Report)
Anesth Analg 2008 107: 601-602. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The LMA CTrachTM is a new airway management device with a fiberoptic viewer that has proven useful for ventilation and intubation of patients with difficult airways. Local pathology, such as lingual tonsillar hyperplasia, may interfere with visualization of the larynx and passage of the endotracheal tube.

George A. Arndt, Adam J. Cambray, and Jon Tomasson

Intubation Bougie Dissection of Tracheal Mucosa and Intratracheal Airway Obstruction (Case Report)
Anesth Analg 2008 107: 603-604. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Intubation bougies are useful adjuncts for tracheal intubation when laryngoscopic view of the airway is difficult. The use of bougies, however, can lead to significant tracheal injury and morbidity.

CRITICAL CARE AND TRAUMA:

Laurent Muller, Guillaume Louart, Christian Bengler, Pascale Fabbro-Peray, Julie Carr, Jacques Ripart, Jean-Emmanuel de La Coussaye, and Jean-Yves Lefrant

The Intrathoracic Blood Volume Index as an Indicator of Fluid Responsiveness in Critically Ill Patients with Acute Circulatory Failure: A Comparison with Central Venous Pressure
Anesth Analg 2008 107: 607-613. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Intrathoracic blood volume index and central venous pressure, when compared in critically ill patients with acute circulatory failure, have a similar ability to predict fluid responsiveness.

Serdar Celebi, Özge Köner, Ferdi Menda, Oguz Omay, Ilhan Günay, Kaya Suzer, and Nahit Cakar

Pulmonary Effects of Noninvasive Ventilation Combined with the Recruitment Maneuver After Cardiac Surgery
Anesth Analg 2008 107: 614-619. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The combination of recruitment maneuver (RM) and noninvasive ventilation (NIV) and NIV alone resulted in improved postoperative oxygenation, pulmonary function tests, and atelectasis scores compared to the control group. Prophylactic use of NIV, either alone or in combination with RM after open heart surgery, has no effect on the duration of mechanical ventilation, intensive care unit stay, or hospitalization period.

Claudia Schummer, Melanie Wirsing, and Wolfram Schummer

The Pivotal Role of Vasopressin in Refractory Anaphylactic Shock (Case Report)
Anesth Analg 2008 107: 620-624. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Because anaphylaxis is uncommon, unpredictable and may be fatal, a prospective, randomized, controlled trial in humans on the best management is difficult and guidelines are based on theory and anecdotes only. We add six more anecdotes in which the use of vasopressin was successful in the treatment of anaphylactic shock.

OBSTETRIC ANESTHESIOLOGY:

Younès Aissaoui, Rémi Bruyère, Hassan Mustapha, Dominique Bry, Noureddine Drissi Kamili, and Chantal Miller

A Randomized Controlled Trial of Pudendal Nerve Block for Pain Relief After Episiotomy
Anesth Analg 2008 107: 625-629. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Unilateral nerve stimulator-guided pudendal nerve block with ropivacaine is effective in pain relief after mediolateral episiotomy and reduces the need for additional analgesics.

ECONOMICS, EDUCATION, AND POLICY:

Michael G. Fitzsimons, Keith H. Baker, Edward Lowenstein, and Warren M. Zapol

Random Drug Testing to Reduce the Incidence of Addiction in Anesthesia Residents: Preliminary Results from One Program (Special Article)
Anesth Analg 2008 107: 630-635. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Random drug testing of anesthesia residents may reduce the incidence of substance abuse. This article summarizes the initial development and results of a testing program.

NEUROSURGICAL ANESTHESIOLOGY:

Eric J. Heyer, Mark I. Gold, E. Will Kirby, Joseph Zurica, Elizabeth Mitchell, Hadi J. Halazun, Lauren Teverbaugh, Robert R. Sciacca, Robert A. Solomon, Donald O. Quest, Thomas S. Maldonado, Thomas S. Riles, and E. Sander Connolly, Jr

A Study of Cognitive Dysfunction in Patients Having Carotid Endarterectomy Performed with Regional Anesthesia
Anesth Analg 2008 107: 636-642. [Abstract] [Full Text] [PDF] [Data Supplement]   

IMPLICATIONS: About 25% of patients having carotid endarterectomy develop significant cognitive dysfunction with a regional anesthetic 1 day after surgery. This result is similar to previously reported findings when carotid endarterectomy is performed with a general anesthetic and strongly suggests that cognitive dysfunction arises from surgery and not anesthesia.

Motoi Kumagai, Takashi Horiguchi, Toshiaki Nishikawa, Yoko Masaki, and Yoshitugu Tobe

Intravenous Dexmedetomidine Decreases Lung Permeability Induced by Intracranial Hypertension in Rats
Anesth Analg 2008 107: 643-647. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Prophylactic IV dexmedetomidine decreased lung permeability and attenuated hemodynamic changes induced by intracranial hypertension in rats.

GENERAL ARTICLES:

Karen A. Robbins and Elias N. León-ruiz

Anesthetic Management of a Patient with 3-Methylcrotonyl-CoA Carboxylase Deficiency (Case Report)
Anesth Analg 2008 107: 648-650. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We present the first description of anesthetic management of a patient with 3-methylcrotonyl-CoA carboxylase deficiency. Patients with this inherited metabolic defect often have underlying cardiac myopathy and may be profoundly carnitine deficient, placing them at risk for severe metabolic decompensation, acidosis, and hypoglycemia in the perioperative setting.

ANALGESIA:

Eugene R. Viscusi, Joseph S. Gimbel, Andreas M. Halder, Michael Snabes, Mark T. Brown, and Kenneth M. Verburg

A Multiple-Day Regimen of Parecoxib Sodium 20 mg Twice Daily Provides Pain Relief After Total Hip Arthroplasty
Anesth Analg 2008 107: 652-660. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Administration of parecoxib sodium 20 mg once or twice daily provides effective and well-tolerated analgesia over 5 days after total hip arthroplasty.

Young-Chang P. Arai, Takahiro Ushida, Tomoaki Osuga, Takako Matsubara, Kahori Oshima, Kana Kawaguchi, Chiaki Kuwabara, Sigeya Nakao, Atsushi Hara, Chihiro Furuta, Erina Aida, Shugyoku Ra, Yui Takagi, and Kyoko Watakabe

The Effect of Acupressure at the Extra 1 Point on Subjective and Autonomic Responses to Needle Insertion
Anesth Analg 2008 107: 661-664. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Acupressure at the extra 1 point significantly reduced needle insertion pain and autonomic nervous system response.

Jennifer McElwain, Noelle M. Freir, Crina L. Burlacu, Denis C. Moriarty, Daniel I. Sessler, and Donal J. Buggy

The Feasibility of Patient-Controlled Paravertebral Analgesia for Major Breast Cancer Surgery: A Prospective, Randomized, Double-Blind Comparison of Two Regimens (Brief Report)
Anesth Analg 2008 107: 665-668. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We tested two regimens of patient-controlled paravertebral analgesia for postoperative breast cancer surgery patients. Both regimens provided satisfactory analgesia and were well tolerated.

Yatindra Kumar Batra, Rajesh Mahajan, Sushil Kumar, Subramanyam Rajeev, and Mandeep Singh Dhillon

A Dose-Ranging Study of Intraarticular Midazolam for Pain Relief After Knee Arthroscopy (Brief Report)
Anesth Analg 2008 107: 669-672. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Intraarticular midazolam provides pain relief of short duration after arthroscopic knee surgery.

Philipp Lirk, Mark Poroli, Marcel Rigaud, Andreas Fuchs, Patrick Fillip, Chun-Yuan Huang, Marko Ljubkovic, Damir Sapunar, and Quinn Hogan

Modulators of Calcium Influx Regulate Membrane Excitability in Rat Dorsal Root Ganglion Neurons
Anesth Analg 2008 107: 673-685. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Loss of inward Ca2+ current in A-type neurons, such as follows peripheral nerve injury, contributes to increased sensory neuron excitability. Measures that increase inward Ca2+ flux may potentially be therapeutic for painful peripheral neuropathy.

Chen-Fuh Lam, Pei-Jung Chang, Yu-Sheng Huang, Yen-Hui Sung, Chien-Chi Huang, Ming-Wei Lin, Yen-Chin Liu, and Yu-Chuan Tsai

Prolonged Use of High-Dose Morphine Impairs Angiogenesis and Mobilization of Endothelial Progenitor Cells in Mice
Anesth Analg 2008 107: 686-692. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Using a mouse model of excisional wound injury, we demonstrated that high-dose morphine impairs angiogenesis and reduces mobilization of endothelial progenitor cells, leading to delayed wound healing.

Dae-Hyun Roh, Hyun-Woo Kim, Seo-Yeon Yoon, Hyoung-Sig Seo, Young-Bae Kwon, Ho-Jae Han, Alvin J. Beitz, and Jang-Hern Lee

Intrathecal Clonidine Suppresses Phosphorylation of the N-Methyl-D-Aspartate Receptor NR1 Subunit in Spinal Dorsal Horn Neurons of Rats with Neuropathic Pain
Anesth Analg 2008 107: 693-700. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study demonstrated that intrathecal clonidine injection dose-dependently reduces mechanical allodynia and thermal hyperalgesia in neuropathic rats and that this reduction is associated with a significant suppression of the phosphorylation of the N-methyl-D-aspartate (NMDA) receptor NR1 subunit in the dorsal horn. These data suggest that modulation of spinal NMDA receptor activation may be one of mechanisms underlying the antihyperalgesic or antiallodynic effect of intrathecal clonidine treatment in neuropathic patients.

Brian M. Ilfeld, Vanessa J. Loland, J. C. Gerancher, Anupama N. Wadhwa, Elizabeth M. Renehan, Daniel I. Sessler, Jonathan J. Shuster, Douglas W. Theriaque, Rosalita C. Maldonado, Edward R. Mariano For the PAINfRE^TM Investigators

The Effects of Varying Local Anesthetic Concentration and Volume on Continuous Popliteal Sciatic Nerve Blocks: A Dual-Center, Randomized, Controlled Study
Anesth Analg 2008 107: 701-707. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: During continuous popliteal-sciatic perineural infusion, local anesthetic concentration and volume influenced block characteristics. Patients given a 0.2% ropivacaine infusion at 8 mL/h experienced an insensate limb three times more often than those given 0.4% ropivacaine at 4 mL/h. In contrast, analgesia and satisfaction were similar in each group.

W. Anton Visser, Ruben A. Lee, and Mathieu J. M. Gielen

Factors Affecting the Distribution of Neural Blockade by Local Anesthetics in Epidural Anesthesia and a Comparison of Lumbar Versus Thoracic Epidural Anesthesia (Review Article)
Anesth Analg 2008 107: 708-721. [Abstract] [Full Text] [PDF] [CME]  

LETTERS TO THE EDITOR:

Brian M. Ilfeld, Thomas W. Wright, Daniel I. Sessler, and Terese L. Chmielewski

Valid and Relevant Outcome Measures Are Critical for Objective Hypothesis-Testing
Anesth Analg 2008 107: 722. [Full Text] [PDF]  

Klaus F. Hofmann-Kiefer, Tim Eiser, Daniel Chappell, Stephan Leuschner, Peter Conzen, and Dierk Schwender

Valid and Relevant Outcome Measures Are Critical for Objective Hypothesis-Testing
Anesth Analg 2008 107: 722-723. [Full Text] [PDF]  

Edward F. Domino

Dr. Paul: Views Through the Piperidine Ring
Anesth Analg 2008 107: 723-724. [Full Text] [PDF]  

Theodore H. Stanley

Dr. Paul: Views Through the Piperidine Ring
Anesth Analg 2008 107: 724. [Full Text] [PDF]  

Samuel A. Budnyk

Judgment and Risk to Patient in Study Design
Anesth Analg 2008 107: 724-725. [Full Text] [PDF]  

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

Judgment and Risk to Patient in Study Design
Anesth Analg 2008 107: 725-726. [Full Text] [PDF]  

Alan J. R. Macfarlane and Richard Brull

Continuous Interscalene Block for Open Shoulder Surgery
Anesth Analg 2008 107: 726. [Full Text] [PDF]  

Klaus F. Hofmann-Kiefer, Tim Eiser, Daniel Chappell, Stephan Leuschner, Peter Conzen, and Dierk Schwender

Continuous Interscalene Block for Open Shoulder Surgery
Anesth Analg 2008 107: 726-727. [Full Text] [PDF]  

Shaul Cohen and Maria Negron

A Near Total Spinal Anesthetic Following a Test Dose Prior to an Epidural Blood Patch
Anesth Analg 2008 107: 727-728. [Full Text] [PDF]  

Denise Thibaut, Juan Carlos de la Cuadra-Fontaine, María Pía Bravo, and René de la Fuente

Ilioinguinal/Iliohypogastric Blocks: Where Is the Anesthetic Injected?
Anesth Analg 2008 107: 728-729. [Full Text] [PDF]  

Prakash K. Dubey

Gabapentin for the Treatment of Glossodynia due to an Unusual Cause
Anesth Analg 2008 107: 729. [Full Text] [PDF]  

Ki Jinn Chin, Ahtsham Niazi, and Vincent Chan

Anomalous Brachial Plexus Anatomy in the Supraclavicular Region Detected by Ultrasound
Anesth Analg 2008 107: 729-731. [Full Text] [PDF]  

Hemanshu Prabhakar, Zulfiqar Ali, and Manish S. Sharma

Valsalva’s Maneuver to Assist Delivery of a Neurocysticercosis Cyst from the Fourth Ventricle
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