EDITORIALS:

Steven L. Shafer

Let Us Hear From You, Again!
Anesth Analg 2008 107: 1453. [Full Text] [PDF] [Request Permissions]  

Alexander A. Hannenberg and Daniel I. Sessler

Improving Perioperative Temperature Management
Anesth Analg 2008 107: 1454-1457. [Full Text] [PDF] [Request Permissions]  

Dan Benhamou, Yves Auroy, and René Amalberti

Monitoring Quality and Safety in Anesthesia: Are Large Numbers Enough?
Anesth Analg 2008 107: 1458-1460. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIOLOGY:

Malin Rundgren and Martin Engström

A Thromboelastometric Evaluation of the Effects of Hypothermia on the Coagulation System
Anesth Analg 2008 107: 1465-1468. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: According to our ROTEM(R) studies, hypothermia progressively impairs the coagulation system in whole blood. The effects on humoral coagulation factors seem to be more pronounced than the effects on platelet-mediated parts of the clotting.

Wulf Dietrich, Michael Spannagl, Johannes Boehm, Katharina Hauner, Siegmund Braun, Tibor Schuster, and Raimund Busley

Tranexamic Acid and Aprotinin in Primary Cardiac Operations: An Analysis of 220 Cardiac Surgical Patients Treated with Tranexamic Acid or Aprotinin
Anesth Analg 2008 107: 1469-1478. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In cardiac surgical patients with low risk of bleeding, tranexamic acid was slightly less effective compared to aprotinin in reducing the transfusion incidence.

Jean Wong, Hossam El Beheiry, Yoga Raja Rampersaud, Stephen Lewis, Henry Ahn, Yoshani De Silva, Amir Abrishami, Naseer Baig, Robert J. McBroom, and Frances Chung

Tranexamic Acid Reduces Perioperative Blood Loss in Adult Patients Having Spinal Fusion Surgery
Anesth Analg 2008 107: 1479-1486. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Tranexamic acid reduces perioperative estimated and calculated bleeding in adult patients having elective posterior thoracic/lumbar instrumented spinal fusion surgery.

Andrew A. Klein, Samer A. M. Nashef, Linda Sharples, Fiona Bottrill, Matthew Dyer, Johanna Armstrong, and Alain Vuylsteke

A Randomized Controlled Trial of Cell Salvage in Routine Cardiac Surgery
Anesth Analg 2008 107: 1487-1495. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In the setting of a strict transfusion protocol and with the routine use of antifibrinolytic medication, cell salvage does not reduce the proportion of patients exposed to allogeneic blood transfusion during cardiac surgery, but it does lead to a reduced number of units of blood transfused in patients who do not bleed excessively.

Joachim Boldt, Ch Brosch, K. Röhm, A. Lehmann, A. Mengistu, and S. Suttner

Is Albumin Administration in Hypoalbuminemic Elderly Cardiac Surgery Patients of Benefit with Regard to Inflammation, Endothelial Activation, and Long-Term Kidney Function?
Anesth Analg 2008 107: 1496-1503. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intravascular volume replacement using human albumin in hypoalbuminemic elderly cardiac surgery patients aged >80 yr did not improve inflammatory response, endothelial activation, and long-term kidney function compared to a hydroxyethyl starch preparation with a low mean molecular weight and low molar substitution.

Paul S. Myles and Silvana Marasco

Misleading Turbulent Flow Through Pulmonary Venous Anastomoses During Lung Transplantation (Echo Rounds)
Anesth Analg 2008 107: 1504-1505. [Full Text] [PDF] [Echo Loops]  [Request Permissions]  

Michel Rheault, Andrej Alfirevic, and Emad B. Mossad

An Unusual Case of Postoperative Hypoxemia Diagnosed with Transesophageal Echocardiography (Echo Rounds)
Anesth Analg 2008 107: 1506-1508. [Full Text] [PDF] [Echo Loops]  [Request Permissions]  

Thomas M. Burch, K. Annette Mizuguchi, Mark C. Wesley, Tara M. Swanson, and James A. DiNardo

Echocardiographic Features of Pulmonary Atresia with Intact Ventricular Septum (Echo Rounds)
Anesth Analg 2008 107: 1509-1511. [Full Text] [PDF] [Echo Loops]  [Request Permissions]  

PEDIATRIC ANESTHESIOLOGY:

Constantinos Chrysostomou, Lee Beerman, Dana Shiderly, Donald Berry, Victor O. Morell, and Ricardo Munoz

Dexmedetomidine: A Novel Drug for the Treatment of Atrial and Junctional Tachyarrhythmias During the Perioperative Period for Congenital Cardiac Surgery: A Preliminary Study
Anesth Analg 2008 107: 1514-1522. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dexmedetomidine, a primarily sedative drug, seems to be effective for the acute treatment of atrial and junctional tachyarrhythmias. This preliminary finding may have important implications in the intensive care unit, since currently available antiarrhythmic drugs are at times ineffective or associated with significant side effects.

Peter Szmuk, Oscar Ghelber, Maria Matuszczak, Marry F. Rabb, Tiberiu Ezri, and Daniel I. Sessler

A Prospective, Randomized Comparison of Cobra Perilaryngeal Airway and Laryngeal Mask Airway Unique in Pediatric Patients
Anesth Analg 2008 107: 1523-1530. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The Cobra Perilaryngeal Airway performed as well as the Laryngeal Mask Airway Unique Classic during anesthesia in pediatric patients for a large range of outcomes and was superior for some.

Eliahu Simhi, Ludmyla Kachko, Elhanan Bruckheimer, and Jacob Katz

A Vein Entry Indicator Device for Facilitating Peripheral Intravenous Cannulation in Children: A Prospective, Randomized, Controlled Trial
Anesth Analg 2008 107: 1531-1535. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The Vein Entry Indicator Device facilitates the insertion of peripheral venous cannulas in healthy children with intermediate/difficult veins undergoing same-day surgery, reducing both the time and number of attempts required.

Hany A. Mowafi, Samer A. Arab, Salah A. Ismail, Abdulmohsin A. Al-Ghamdi, and Roshdi R. Al-Metwalli

Plethysmographic Pulse Wave Amplitude Is an Effective Indicator for Intravascular Injection of Epinephrine-Containing Epidural Test Dose in Sevoflurane-Anesthetized Pediatric Patients
Anesth Analg 2008 107: 1536-1541. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Plethysmographic pulse wave amplitude is a reliable alternative to changes in heart rate and systolic blood pressure for detecting intravascular injection of an epinephrine-containing simulated epidural test dose during sevoflurane anesthesia in children.

AMBULATORY ANESTHESIOLOGY:

Sharon A. Chung, Hongbo Yuan, and Frances Chung

A Systemic Review of Obstructive Sleep Apnea and Its Implications for Anesthesiologists
Anesth Analg 2008 107: 1543-1563. [Abstract] [Full Text] [PDF] [CME] [Request Permissions]  

IMPLICATIONS: There is a frequent prevalence of undiagnosed obstructive sleep apnea (OSA). Surgical patients with OSA are vulnerable to sedation, anesthesia and analgesia. The perioperative risk of OSA patients may be reduced by the appropriate screening to detect undiagnosed OSA and adoption of a specific perioperative management plan for OSA.

ANESTHETIC PHARMACOLOGY:

Luis I. Cortínez, Iñaki F. Trocóniz, Ricardo Fuentes, Pedro Gambús, Yung-Wei Hsu, Fernando Altermatt, and Hernán R. Muñoz

The Influence of Age on the Dynamic Relationship Between End-Tidal Sevoflurane Concentrations and Bispectral Index
Anesth Analg 2008 107: 1566-1572. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the influence of age on the dynamic relationship between end-tidal sevoflurane concentrations and bispectral index (BIS). Age increases the sensitivity to sevoflurane's effect and decreases the speed of change of this effect as measured by BIS.

Ricardo Fuentes, Luis I. Cortínez, Michel M. R. F. Struys, Alejandro Delfino, and Hernán Muñoz

The Dynamic Relationship Between End-Tidal Sevoflurane Concentrations, Bispectral Index, and Cerebral State Index in Children
Anesth Analg 2008 107: 1573-1578. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effect-site equilibration half-life of sevoflurane and the pharmacodynamic model of sevoflurane estimated with bispectral index and cerebral state index are entirely dependent on the monitor used to measure its hypnotic effect.

Takafumi Horishita, Edmond I. Eger, II, and R. Adron Harris

The Effects of Volatile Aromatic Anesthetics on Voltage-Gated Na⁺ Channels Expressed in Xenopus Oocytes
Anesth Analg 2008 107: 1579-1586. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Aromatic anesthetics can block N-methyl-d-aspartate receptors and enhance {gamma}-aminobutyric acid A receptor responses. The present report finds various effects of these compounds on sodium channels. Although volatile aromatic anesthetics are not used clinically, exploring their effects on ion channels may aid in understanding the mechanisms of clinical inhaled anesthetic actions.

Jin Woo Shin, Carlo Pancaro, Chi Fei Wang, and Peter Gerner

Low-Dose Systemic Bupivacaine Prevents the Development of Allodynia After Thoracotomy in Rats
Anesth Analg 2008 107: 1587-1591. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This article shows that systemic bupivacaine might have a role in preventing and treating neuropathic pain in patients undergoing thoracotomy.

Sukumar P. Desai, Koji Kojima, Charles A. Vacanti, and Shohta Kodama

Lidocaine Inhibits NIH-3T3 Cell Multiplication by Increasing the Expression of Cyclin-Dependent Kinase Inhibitor 1A (p21)
Anesth Analg 2008 107: 1592-1597. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lidocaine inhibits growth of the murine embryonic fibroblast cell line NIH-3T3 by upregulating expression of p21. Such effects could result in impaired wound healing, but may be used with advantage where protection from hyperproliferation of fibroblasts is desirable.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Stanley Muravchick, James E. Caldwell, Richard H. Epstein, Maria Galati, Warren J. Levy, Michael O'Reilly, Jeffrey S. Plagenhoef, Mohamed Rehman, David L. Reich, and Michael M. Vigoda

Anesthesia Information Management System Implementation: A Practical Guide (Special Article)
Anesth Analg 2008 107: 1598-1608. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthesia information management systems (AIMS) generate comprehensive and searchable perioperative clinical documentation. By describing basic concepts and practical approaches for AIMS implementation, this article may facilitate more widespread use of this valuable evolving technology by anesthesiologists in both academic and community practice.

Terence J. Gilhuly, Bernard A. MacLeod, Guy A. Dumont, Alex M. Bouzane, and Stephan K. W. Schwarz

Improved Neuromuscular Blockade Using a Novel Neuromuscular Blockade Advisory System: A Randomized, Controlled, Clinical Trial (Special Article)
Anesth Analg 2008 107: 1609-1617. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this prospective, randomized, controlled clinical trial, rocuronium administration guided by a novel adaptive process control program based on a sixth-order Laguerre model, the Neuromuscular Blockade Advisory System, was associated with improved neuromuscular blockade compared to standard practice.

PATIENT SAFETY:

Jerome H. Modell, Nikolaus Gravenstein, and Timothy E. Morey

Body Temperature Change During Anesthesia for Electroconvulsive Therapy: Implications for Quality Incentives in Anesthesiology
Anesth Analg 2008 107: 1618-1620. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There was no consistent change in temperature during anesthesia among our study patients when anesthesia was administered to facilitate electroconvulsive therapy. There is no basis, at least in this category of patient, to arbitrarily conclude that if the temperature is below 36{degrees}C when the patient arrives in the postanesthesia care unit, the care has not been optimal. Further, anesthesia departments may be financially penalized for failure to accurately measure temperature postoperatively.

Oliver Kimberger, Christine Held, Karin Stadelmann, Nikolaus Mayer, Corinne Hunkeler, Daniel I. Sessler, and Andrea Kurz

Resistive Polymer Versus Forced-Air Warming: Comparable Heat Transfer and Core Rewarming Rates in Volunteers
Anesth Analg 2008 107: 1621-1626. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Heating efficacy and core rewarming rates were similar with full-body forced-air and full-body resistive polymer heating in volunteers.

Ali Dabbagh, Naseraddin Mobasseri, Hedayatollah Elyasi, Babak Gharaei, Mohammadreza Fathololumi, Mahshid Ghasemi, and Iman Bandarchi Chamkhale

A Rapidly Enlarging Neck Mass: The Role of the Sitting Position in Fiberoptic Bronchoscopy for Difficult Intubation (Case Report)
Anesth Analg 2008 107: 1627-1629. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Management of the difficult airway presents a great dilemma for the anesthesiologist. This case report presents the management of a rapidly enlarging neck mass accompanied by respiratory distress. With the patient in the seated position, awake fiberoptic intubation was successful in securing the airway.

Steven R. Clendenen and David A. Kostick

Ocular Globe Luxation Under General Anesthesia (Case Report)
Anesth Analg 2008 107: 1630-1631. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ocular globe luxation is a rare event but it carries the threat of permanent vision loss if appropriate therapy is not initiated in a timely manner.

CRITICAL CARE AND TRAUMA:

Alain Eid, Christian J. Wiedermann, and Gary T. Kinasewitz

Early Administration of High-Dose Antithrombin in Severe Sepsis: Single Center Results from the KyberSept-Trial
Anesth Analg 2008 107: 1633-1638. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The overall finding in the KyberSept trial of no treatment effect of high-dose antithrombin in severe sepsis was inconsistent for the primary outcome: 28-day mortality. This posthoc analysis on the safety and efficacy of antithrombin given within 48 h after onset of organ failure confirms bleeding as an important safety issue and reports on reduced organ dysfunction and 28-day mortality by 21% and 14%, respectively. Even though statistically insignificant, these findings support a relevant role that timing of therapy with endogenous anticoagulants may have in treating severe sepsis.

Stefan Kluge, Hans Jörg Baumann, Claudia Maier, Hans Klose, Andreas Meyer, Axel Nierhaus, and Georg Kreymann

Tracheostomy in the Intensive Care Unit: A Nationwide Survey
Anesth Analg 2008 107: 1639-1643. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Tracheostomy is the most frequent surgical procedure in the intensive care unit, and techniques have changed substantially in the last years. However, the optimal timing of tracheostomy and choice of method remain controversial.

George Vretzakis, Elena Theodorou, and Dimitrios Mikroulis

Endobrochial Blockade Through a Tracheostomy Tube for Lung Isolation (Case Report)
Anesth Analg 2008 107: 1644-1645. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report on the use of a Fogarty catheter as an endobrochial blocker in patients with tracheostomy for providing one-lung ventilation. This could be achieved either with or without a fiberoptic bronchoscope.

OBSTETRIC ANESTHESIOLOGY:

Eric Cappiello, Nollag O'Rourke, Scott Segal, and Lawrence C. Tsen

A Randomized Trial of Dural Puncture Epidural Technique Compared with the Standard Epidural Technique for Labor Analgesia
Anesth Analg 2008 107: 1646-1651. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dural puncture with a 25-gauge Whitacre spinal needle without intrathecal drug administration, immediately before the initiation of epidural analgesia, improves the sacral spread, onset, and bilateral nature of epidural labor analgesia.

Kathleen Sachse and Medhat Hannallah

The Anesthetic Management for Cesarean Delivery in a Patient with Shone's Syndrome (Case Report)
Anesth Analg 2008 107: 1652-1654. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This is a report of a pregnant adolescent with Shone's syndrome, manifested by mitral stenosis and left ventricular outflow tract obstruction, who presented for cesarean delivery. Anesthetic management considerations and options for the peripartum care of these patients are discussed.

ECONOMICS, EDUCATION, AND POLICY:

Jeroen M. van Oostrum, Mark Van Houdenhoven, Manon M. J. Vrielink, Jan Klein, Erwin W. Hans, Markus Klimek, Gerhard Wullink, Ewout W. Steyerberg, and Geert Kazemier

A Simulation Model for Determining the Optimal Size of Emergency Teams on Call in the Operating Room at Night
Anesth Analg 2008 107: 1655-1662. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A discrete simulation that incorporated patient safety intervals was used to determine the optimal composition and size of emergency teams on the operating room from 11:00 pm to 7:30 am A case study showed that this approach can reduce staffing without jeopardizing patient safety.

Zeev Friedman, Kong E. You-Ten, Matthew D. Bould, and Viren Naik

Teaching Lifesaving Procedures: The Impact of Model Fidelity on Acquisition and Transfer of Cricothyrotomy Skills to Performance on Cadavers
Anesth Analg 2008 107: 1663-1669. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A simple model achieved the same effect on objectively rated cricothyrotomy skill acquisition, as did an expensive simulator. The acquired skills could be used successfully in cadavers.

NEUROSURGICAL ANESTHESIOLOGY AND NEUROSCIENCE:

Mark D. Stoneham, Omer Lodi, Thearina C. D. de Beer, and John W. Sear

Increased Oxygen Administration Improves Cerebral Oxygenation in Patients Undergoing Awake Carotid Surgery
Anesth Analg 2008 107: 1670-1675. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During carotid cross-clamping in awake patients, the administration of 100% oxygen improved cerebral oxygenation measured by near-infrared spectroscopy. This may be useful when there is concern about the adequacy of cerebral oxygenation after cross-clamping.

Vincent Cottenceau, Laurent Petit, Françoise Masson, Dominique Guehl, Julien Asselineau, Jean-François Cochard, Catherine Pinaquy, Alain Leger, and François Sztark

The Use of Bispectral Index to Monitor Barbiturate Coma in Severely Brain-Injured Patients with Refractory Intracranial Hypertension
Anesth Analg 2008 107: 1676-1682. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Barbiturate therapy in severely brain-injured patients is usually monitored by an electroencephalogram but its interpretation is not easy. In this study, a Bispectral Index range predictive of optimal level of suppression was determined. This monitoring might be useful for helping clinicians or nurses to adjust barbiturate infusion.

Heleen J. Blussé van Oud-Alblas, Jeroen W. B. Peters, Tom G. de Leeuw, Kris T. A. Vermeylen, Luuk W. L. de Klerk, Dick Tibboel, Jan Klein, and Frank Weber

A Comparison in Adolescents of Composite Auditory Evoked Potential Index and Bispectral Index During Propofol-Remifentanil Anesthesia for Scoliosis Surgery with Intraoperative Wake-Up Test
Anesth Analg 2008 107: 1683-1688. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During propofol-remifentanil anesthesia for adolescent scoliosis surgery, the Bispectral Index performed significantly better during induction than the composite Auditory Evoked Potential Index in distinguishing different levels of hypnosis. During the intraoperative wake-up test and emergence both indices performed equally. Despite increased values of both indices during an intraoperative wake-up test, none of the patients demonstrated explicit recall.

Logan J. Voss, James W. Sleigh, John P. M. Barnard, and Heidi E. Kirsch

The Howling Cortex: Seizures and General Anesthetic Drugs (Review Article)
Anesth Analg 2008 107: 1689-1703. [Abstract] [Full Text] [PDF] [CME] [Request Permissions]  

IMPLICATIONS: While anesthetic-induced generalized tonic-clonic convulsions are rare, electroencephalographic seizure-like activity is common and may not be entirely benign. The mechanisms of general anesthetic-induced seizures are poorly understood, but may help explain other counter-intuitive aspects of seizurogenesis.

Ming-Hui Hung, Shou-Zen Fan, Chun-Po Lin, Yen-Chun Hsu, Po-Yuan Shih, and Tzong-Shiun Lee

Emergency Airway Management with Fiberoptic Intubation in the Prone Position with a Fixed Flexed Neck (Case Report)
Anesth Analg 2008 107: 1704-1706. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We described the use of fiberoptic intubation in emergency airway management in the prone position in a patient with a fixed flexed neck during surgery.

GENERAL ARTICLES:

Jean-Marc Delay, Mustapha Sebbane, Boris Jung, David Nocca, Daniel Verzilli, Yvan Pouzeratte, Moez El Kamel, Jean-Michel Fabre, Jean-Jacques Eledjam, and Samir Jaber

The Effectiveness of Noninvasive Positive Pressure Ventilation to Enhance Preoxygenation in Morbidly Obese Patients: A Randomized Controlled Study
Anesth Analg 2008 107: 1707-1713. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Noninvasive positive pressure ventilation provides a more rapid preoxygenation, achieving a higher end-tidal oxygen concentration, than spontaneous ventilation in morbidly obese patients.

ANALGESIA:

Argyro Fassoulaki, Aikaterini Melemeni, Anteia Paraskeva, Ioanna Siafaka, and Constantine Sarantopoulos

Postoperative Pain and Analgesic Requirements After Anesthesia with Sevoflurane, Desflurane or Propofol
Anesth Analg 2008 107: 1715-1719. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: General anesthetics may have a differential effect on postoperative pain and analgesic requirements. General anesthesia with sevoflurane, desflurane or propofol did not influence the analgesic consumption or pain experienced during the first 24 h postoperatively in women undergoing myectomy or abdominal hysterectomy.

Nicolas Brogly, Jean-Michel Wattier, Grégoire Andrieu, Daliana Peres, Emanuel Robin, Eric Kipnis, Laurent Arnalsteen, Béatrice Thielemans, Bruno Carnaille, François Pattou, Benoît Vallet, and Gilles Lebuffe

Gabapentin Attenuates Late but Not Early Postoperative Pain After Thyroidectomy with Superficial Cervical Plexus Block
Anesth Analg 2008 107: 1720-1725. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Even though the addition of gabapentin to superficial cervical plexus block did not provide additional analgesic benefits after thyroidectomy, it did demonstrate the potential to decrease chronic pain after thyroidectomy, a phenomenon which has not been described before.

Mark P. Yeager, Patricia A. Pioli, Kathleen Wardwell, Michael L. Beach, Peter Martel, Hong K. Lee, Athos J. Rassias, and Paul M. Guyre

In Vivo Exposure to High or Low Cortisol Has Biphasic Effects on Inflammatory Response Pathways of Human Monocytes
Anesth Analg 2008 107: 1726-1734. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study demonstrates that human monocytes alternately increase or decrease mRNA levels of key inflammatory mediators when they are exposed, in vivo, to high or low levels of cortisol. The results do not support a view that glucocorticoids are universally antiinflammatory, but suggest that glucocorticoid effects on human inflammatory responses may be biphasic, depending upon the free cortisol concentration to which they are exposed in vivo.

Somrat Charuluxananan, Somboon Thienthong, Mali Rungreungvanich, Thavat Chanchayanon, Thitima Chinachoti, Oranuch Kyokong, and Yodying Punjasawadwong

Cardiac Arrest After Spinal Anesthesia in Thailand: A Prospective Multicenter Registry of 40,271 Anesthetics
Anesth Analg 2008 107: 1735-1741. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: Cardiac arrest during spinal anesthesia in Thailand occurred at a rate of 2.7 per 10,000 anesthetics and was associated with a mortality rate of 90.9%. All patients who arrested were undergoing cesarean delivery or surgery to the lower extremity. The surgeon administering the spinal anesthetic was identified as a significant factor associated with cardiac arrest during spinal anesthesia. The suggested corrective strategies are to increase the number of anesthesiologists, improving monitoring guidelines, and improve the nurse-anesthetist training program.

Kaan Katircioglu, Levent Hasegeli, H. Fehmi Ibrahimhakkioglu, Berkay Ulusoy, and Huseyin Damar

A Retrospective Review of 34,109 Epidural Anesthetics for Obstetric and Gynecologic Procedures at a Single Private Hospital in Turkey (Brief Report)
Anesth Analg 2008 107: 1742-1745. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We retrospectively reviewed the records of 34,109 epidural blocks in obstetric and gynecologic anesthesia from 35,628 patients. The epidural rate increased from 57% to 96% over a 14-yr period (1993-2006). Permanent neurological sequel, cardiac arrest, or mortality and maternal mortality were not seen during this period.

Soheila Jafari, Allison I. Kalstein, Habib M. Nasrullah, Mehrdad Hedayatnia, Joel M. Yarmush, and Joseph SchianodiCola

A Randomized, Prospective, Double-Blind Trial Comparing 3% Chloroprocaine Followed by 0.5% Bupivacaine to 2% Lidocaine Followed by 0.5% Bupivacaine for Interscalene Brachial Plexus Block
Anesth Analg 2008 107: 1746-1750. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A 2-chloroprocaine/bupivacaine combination provides a faster onset motor and sensory interscalene block than that produced by a lidocaine/bupivacaine combination. Both combinations offer adequate intraoperative anesthesia.

Waleed Riad and Nauman Ahmed

Single Injection Peribulbar Anesthesia with a Short Needle Combined with Digital Compression (Brief Report)
Anesth Analg 2008 107: 1751-1753. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Peribulbar blockade with a 15 mm needle combined with digital compression is equally effective compared to a 25 mm needle length without digital compression.

Christopher Robards, Steven Clendenen, and Roy Greengrass

Intravascular Injection During Ultrasound-Guided Axillary Block: Negative Aspiration Can Be Misleading (Case Report)
Anesth Analg 2008 107: 1754-1755. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Visualization of local anesthetic spread is more important than negative aspiration or needle tip visualization during ultrasound-guided axillary block in the detection of inadvertent intravascular needle placement and local anesthetic injection.

LETTERS TO THE EDITOR:

Aaron F. Kopman

Residual Neuromuscular Block and Adverse Respiratory Events
Anesth Analg 2008 107: 1756. [Full Text] [PDF] [Request Permissions]  

Glenn S. Murphy, Joseph W. Szokol, Jesse H. Marymont, Steven B. Greenberg, Michael J. Avram, and Jeffery S. Vender

Residual Neuromuscular Block and Adverse Respiratory Events
Anesth Analg 2008 107: 1756. [Full Text] [PDF] [Request Permissions]  

Adam Hassani and Gareth Kessell

Neck Circumference and Difficult Intubation
Anesth Analg 2008 107: 1756-1757. [Full Text] [PDF] [Request Permissions]  

Vincent Minville, Hélène Gonzalez, and Olivier Fourcade

Neck Circumference and Difficult Intubation
Anesth Analg 2008 107: 1757. [Full Text] [PDF] [Request Permissions]  

Cheri Landers, Dawn Turner, Carrie Makin, Horacio Zaglul, and Rae Brown

Propofol Associated Hiccups and Treatment with Lidocaine
Anesth Analg 2008 107: 1757-1758. [Full Text] [PDF] [Request Permissions]  

Zorica Jankovic, Niaz Ahmad, Nagaraja Ravishankar, and Frances Archer

Transversus Abdominis Plane Block: How Safe is it?
Anesth Analg 2008 107: 1758-1759. [Full Text] [PDF] [Request Permissions]  

Sriganesh Kamath, Suparna Balethbail, and Gayatri Parthasarathi

Pseudo-Pneumothorax: Look Before You Leap!
Anesth Analg 2008 107: 1759. [Full Text] [PDF] [Request Permissions]  

Deepak Thapa, Lakshmi Mahajan, and Lalit Gupat

Displacement of Double Lumen Tube After the Rupture of a Giant Lung Bulla During Bullectomy
Anesth Analg 2008 107: 1759-1760. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Katherine Grichnik and Susan Martinelli

Web Bronchoscopy
Anesth Analg 2008 107: 1761-1762. [Full Text] [PDF] [Request Permissions]  

Regina Fragneto

Procedures Consult: Anesthesia
Anesth Analg 2008 107: 1762-1763. [Full Text] [PDF] [Request Permissions]  

Michael S. Boger and David A. Nakata

The Oxford American Handbook of Anesthesiology
Anesth Analg 2008 107: 1763-1764. [Full Text] [PDF] [Request Permissions]  

Pamela Flood

Obstetric Anesthesia
Anesth Analg 2008 107: 1764. [Full Text] [PDF] [Request Permissions]  

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