EDITORIALS:

Martin Smith and Clare Elwell

Near-Infrared Spectroscopy: Shedding Light on the Injured Brain
Anesth Analg 2009 108: 1055-1057. [Full Text] [PDF] [Request Permissions]  

Mohamed Naguib and Peter A. Goldstein

All Results Count
Anesth Analg 2009 108: 1058-1061. [Full Text] [PDF] [Request Permissions]  

Guy L. Weinberg

Limits to Lipid in the Literature and Lab: What We Know, What We Don’t Know
Anesth Analg 2009 108: 1062-1064. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIOLOGY:

Daniel Bolliger, Manfred D. Seeberger, Giovanna A. L. Lurati Buse, Peter Christen, Brian Rupinski, Lorenz Gürke, and Miodrag Filipovic

A Preliminary Report on the Prognostic Significance of Preoperative Brain Natriuretic Peptide and Postoperative Cardiac Troponin in Patients Undergoing Major Vascular Surgery
Anesth Analg 2009 108: 1069-1075. [Abstract] [Full Text] [PDF] [CME] [Request Permissions]  

IMPLICATIONS: In this prospective study of 133 patients, we found an additive effect of preoperative elevation of brain natriuretic peptide, and postoperative elevation of cardiac troponin for identifying patients at risk for major adverse cardiac events and all-cause mortality within 1 yr after major vascular surgery.

Paul S. Pagel and John G. Krolikowski

Transient Metabolic Alkalosis During Early Reperfusion Abolishes Helium Preconditioning Against Myocardial Infarction: Restoration of Cardioprotection by Cyclosporin A in Rabbits
Anesth Analg 2009 108: 1076-1082. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cardioprotection produced by brief, repetitive administration of helium before myocardial ischemia and reperfusion was abolished by transient metabolic alkalosis during early reperfusion and restored by administration of the mitochondrial permeability transition pore inhibitor cyclosporin A in rabbits. The results suggest that helium protects against myocardial infarction by sustaining intracellular acidosis during early reperfusion.

Ilona T. A. Pereboom, Marieke T. de Boer, Elizabeth B. Haagsma, Herman G. D. Hendriks, Ton Lisman, and Robert J. Porte

Platelet Transfusion During Liver Transplantation Is Associated with Increased Postoperative Mortality Due to Acute Lung Injury
Anesth Analg 2009 108: 1083-1091. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Platelet transfusion during liver transplantation is associated with an increased postoperative mortality because of acute lung injury. These findings call for cautious use of platelet transfusions in patients undergoing liver transplantation.

Raynauld Ko, Karen McRae, Gail Darling, Thomas K. Waddell, Desmond McGlade, Ken Cheung, Joel Katz, and Peter Slinger

The Use of Air in the Inspired Gas Mixture During Two-Lung Ventilation Delays Lung Collapse During One-Lung Ventilation
Anesth Analg 2009 108: 1092-1096. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In thoracic anesthesia, the use of air/oxygen mixtures during two-lung ventilation causes a delay in the collapse of the nonventilated lung during subsequent one-lung ventilation, and this interferes with surgical exposure in the chest.

Manu Narayanaswamy, Karen McRae, Peter Slinger, Geoffrey Dugas, George W. Kanellakos, Andy Roscoe, and Melanie Lacroix

Choosing a Lung Isolation Device for Thoracic Surgery: A Randomized Trial of Three Bronchial Blockers Versus Double-Lumen Tubes
Anesth Analg 2009 108: 1097-1101. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study compared the clinical performance of three bronchial blockers (BBs) with left-sided double-lumen endobronchial tubes in patients undergoing left-sided thoracotomy or video-assisted thoracoscopic surgery. We found that the surgical exposure was similar among the BBs and double-lumen endobronchial tubes but BBs required longer to position and required more intraoperative repositionings.

Ronald A. Kahn, Alexander J. C. Mittnacht, and Anelechi C. Anyanwu

Systolic Anterior Motion as a Result of Relative "Undersizing" of a Mitral Valve Annulus in a Patient with Barlow’s Disease (Echo Rounds)
Anesth Analg 2009 108: 1102-1104. [Full Text] [PDF] [Video Clip]  [Request Permissions]  

Nathaen Weitzel, Ferenc Puskas, Vicki Callahan, and Tamas Seres

A Case of Left Ventricular Noncompaction (Echo Rounds)
Anesth Analg 2009 108: 1105-1106. [Full Text] [PDF] [CME] [Video Clip]  [Request Permissions]  

Audrey Leverich, Christine Johnston, Brendon Stiles, Leonard Girardi, Gregg Hartman, and Nikolaos J. Skubas

Cabrol Composite Graft for Aortic Root Replacement: Echocardiographic Imaging (Echo Rounds)
Anesth Analg 2009 108: 1107-1109. [Full Text] [PDF] [CME] [Video Clip]  [Request Permissions]  

Usha Vellayappan, Miguel D. Attias, and Mark S. Shulman

Paradoxical Embolization by Amniotic Fluid Seen on the Transesophageal Echocardiography (Echo Rounds)
Anesth Analg 2009 108: 1110-1112. [Full Text] [PDF] [CME] [Video Clips]  [Request Permissions]  

Edwin G. Avery, Alan D. Hilgenberg, Richard P. Cambria, Rena Beckerly, Anne M. Donnelly, and Michael Laposata

Successful Use of Bivalirudin for Combined Carotid Endarterectomy and Coronary Revascularization with the Use of Cardiopulmonary Bypass in a Patient with an Elevated Heparin-Platelet Factor 4 Antibody Titer (Case Report)
Anesth Analg 2009 108: 1113-1115. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We present the first report of the successful use of the direct thrombin inhibitor, bivalirudin, as the anticoagulant in a patient undergoing combined carotid endarterectomy surgery with coronary revascularization on cardiopulmonary bypass. Bivalirudin was used to avoid potential thromboembolic complications related to his positive heparin-platelet factor 4 antibody titer.

Karinne Jervis, Venkatachalam Senthilnathan, and Adam B. Lerner

Management of a Patient with Lupus Anticoagulant and Antiphospholipid Syndrome for Off-Pump Coronary Artery Bypass Grafting Using the Hepcon® System (Case Report)
Anesth Analg 2009 108: 1116-1119. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report discusses the intraoperative management of anticoagulation for a patient with lupus anticoagulant and antiphospholipid syndrome presenting for off-pump coronary artery bypass grafting. We provide a review of the pathophysiology of the disease, review prior published clinical experience, and provide a management plan for intraoperative anticoagulation for this unique patient population.

PEDIATRIC ANESTHESIOLOGY:

Barry D. Kussman, David Wypij, James A. DiNardo, Jane W. Newburger, John E. Mayer, Jr, Pedro J. del Nido, Emile A. Bacha, Frank Pigula, Ellen McGrath, Peter C. Laussen, and Peter J. Davis

Cerebral Oximetry During Infant Cardiac Surgery: Evaluation and Relationship to Early Postoperative Outcome
Anesth Analg 2009 108: 1122-1131. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated changes in cerebral oxygen saturation during reparative infant heart surgery. Intraoperative cerebral oxygen saturation varies according to anatomic diagnosis but accounts for very little of the variance in early hemodynamic and clinical outcome after biventricular repair.

Babita Ghai, Jagat Ram, Jeetinder Kaur Makkar, Jyotsna Wig, and Sushmita Kaushik

Subtenon Block Compared to Intravenous Fentanyl for Perioperative Analgesia in Pediatric Cataract Surgery
Anesth Analg 2009 108: 1132-1138. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The efficacy and safety of subtenon block was compared with IV fentanyl for perioperative analgesia in pediatric cataract surgery. The results suggest that subtenon block is a safe and superior alternative to fentanyl.

AMBULATORY ANESTHESIOLOGY:

Paul F. White, Burcu Tufanogullari, Jimmie Taylor, and Kevin Klein

The Effect of Pregabalin on Preoperative Anxiety and Sedation Levels: A Dose-Ranging Study
Anesth Analg 2009 108: 1140-1145. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This dose-ranging study evaluated the sedative and anxiolytic effects of premedication with pregabalin 75-300 mg po. Pregabalin failed to produce an acute anxiolytic effect in this diverse surgical population. Moreover, pregabalin 300 mg po significantly increased the level of sedation immediately before and after surgery. Finally, a single preoperative dose of pregabalin failed to improve postoperative pain management.

Salah A. Ismail and Hany A. Mowafi

Melatonin Provides Anxiolysis, Enhances Analgesia, Decreases Intraocular Pressure, and Promotes Better Operating Conditions During Cataract Surgery Under Topical Anesthesia
Anesth Analg 2009 108: 1146-1151. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study examines the effects of oral melatonin premedication in patients undergoing cataract surgery under topical anesthesia. Melatonin provided anxiolysis, enhanced analgesia, and decreased intraocular pressure resulting in better operating conditions.

Ismail Gögenur, Bülent Kücükakin, Thue Bisgaard, Viggo Kristiansen, Niels-Christian Hjortsø, Debra J. Skene, and Jacob Rosenberg

The Effect of Melatonin on Sleep Quality After Laparoscopic Cholecystectomy: A Randomized, Placebo-Controlled Trial (Brief Report)
Anesth Analg 2009 108: 1152-1156. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oral melatonin treatment for 3 nights after laparoscopic cholecystectomy is overall not superior to placebo in improving sleep quality or reducing subjective discomfort.

Marie T. Aouad, Achir A. Al-Alami, Viviane G. Nasr, Fouad G. Souki, Reine A. Zbeidy, and Sahar M. Siddik-Sayyid

The Effect of Low-Dose Remifentanil on Responses to the Endotracheal Tube During Emergence from General Anesthesia (Brief Report)
Anesth Analg 2009 108: 1157-1160. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This prospective, randomized, double-blind study evaluated the effect of low-dose remifentanil on responses to the endotracheal tube during emergence from general anesthesia. Patients who received low-dose remifentanil during emergence had a lower incidence of cough, nonpurposeful movement, and tachycardia compared with patients who had remifentanil stopped during emergence.

ANESTHETIC PHARMACOLOGY:

Martyn Harvey, Grant Cave, and Alex Kazemi

Intralipid Infusion Diminishes Return of Spontaneous Circulation After Hypoxic Cardiac Arrest in Rabbits
Anesth Analg 2009 108: 1163-1168. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this intact rabbit model of hypoxic pulseless electrical activity, infusion of lipid emulsion in addition to standard resuscitative measures resulted in lesser developed coronary perfusion pressure and diminished return of spontaneous circulation. Clinicians considering lipid in the clinical scenario of cardiovascular collapse attributable to a cardiotoxic drug of high lipophilicity should consider optimization of oxygenation, ventilation, and coronary perfusion prerequisite. Consideration for lipid when lipophilic drug cardiac toxicity is suspected, but unproven, must be approached with some caution.

Ulf Guenther, Till Manzke, Hermann Wrigge, Matthias Dutschmann, Joerg Zinserling, Christian Putensen, and Andreas Hoeft

The Counteraction of Opioid-Induced Ventilatory Depression by the Serotonin 1A-Agonist 8-OH-DPAT Does Not Antagonize Antinociception in Rats In Situ and In Vivo
Anesth Analg 2009 108: 1169-1176. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The serotonin 1A-receptor agonist 8-OH-DPAT, at a dose sufficient to stimulate spontaneous breathing, does not activate nociceptive reflexes, and it counteracts opioid-induced ventilatory depression without diminishing antinociception in rats.

Yoko Kawaguchi, Tomoko Ono, Mihoko Kudo, Tetsuya Kushikata, Eiji Hashiba, Hitoshi Yoshida, Tsuyoshi Kudo, Kenichi Furukawa, Stephen A. Douglas, and Kazuyoshi Hirota

The Effects of Benzodiazepines on Urotensin II-Stimulated Norepinephrine Release from Rat Cerebrocortical Slices
Anesth Analg 2009 108: 1177-1181. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Urotensin II (UII) induces anxiogenic-like behaviors with an increase in norepinephrine release. In contrast, midazolam produces anxiolysis with a decrease in norepinephrine release. As clinically relevant concentrations of midazolam inhibited UII-increased norepinephrine release and this inhibition was partially reversed by flumazenil, there may be an interaction between the UII system and central benzodiazepine receptors in the cerebral cortex.

Robert R. Kirby, James M. Colaw, and Michael M. Douglas

Death from Propofol: Accident, Suicide, or Murder? (Case Report)
Anesth Analg 2009 108: 1182-1184. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Propofol was introduced clinically in 1986 and is widely used for sedation/analgesia and anesthesia in operating rooms, endoscopy centers, intensive care units, and numerous other settings. Not widely recognized is its potential for abuse, psychological dependency, suicide, and perhaps homicide, all of which are of concern to anesthesia providers.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Jonathan K. Ho, Oliver J. Liakopoulos, Ryan Crowley, Aaron B. Yezbick, Elizabeth Sanchez, Kalyanam Shivkumar, and Aman Mahajan

In Vivo Detection of Myocardial Ischemia in Pigs Using Visible Light Spectroscopy
Anesth Analg 2009 108: 1185-1192. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our study demonstrates the use of visible light spectroscopy tissue saturation measurements for reliably detecting alterations in myocardial perfusion in porcine models of regional and global ischemia.

Michael P. Dosch, Robert G. Loeb, Tiffany L. Brainerd, John F. Stallwood, and Steven Lechner

Time to a 90% Change in Gas Concentration: A Comparison of Three Semi-Closed Anesthesia Breathing Systems
Anesth Analg 2009 108: 1193-1197. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: At low fresh gas flows, gas concentration changes faster in the low volume ADU anesthesia machine breathing system than it does in the higher volume Fabius or Aestiva breathing systems. However, at fresh gas flows above 6 L/min, gas concentration changed just as quickly in all three breathing systems. Clinically important differences in speed of inhaled induction, emergence and denitrogenation should be independent of which of these machines is used, provided that high fresh gas flows are used.

Duncan McPherson, Olukorede Adekanye, Antony R. Wilkes, and Judith E. Hall

Fluid Flow Through Intravenous Cannulae in a Clinical Model
Anesth Analg 2009 108: 1198-1202. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Flow through a cannula is not laminar at clinically used rates and not simply related to the quoted maximum. Neither Poiseuille's law nor the quoted values can be used to predict the actual flow of IV fluid through an IV cannula.

Arieh Eden, Reuven Pizov, Liat Toderis, Gareth Kantor, and Azriel Perel

The Impact of an Electronic Reminder on the Use of Alarms After Separation from Cardiopulmonary Bypass
Anesth Analg 2009 108: 1203-1208. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We developed a computerized algorithm that detects separation from cardiopulmonary bypass based on physiological variables and prompts for alarm reactivation. The introduction of this electronic reminder led to a significant increase in alarm reactivation by anesthesiologists during cardiac surgery.

Katie K. Figg and Edward C. Nemergut

Error in Central Venous Pressure Measurement (Brief Report)
Anesth Analg 2009 108: 1209-1211. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There is significant variation in transducer placement among health care providers, which is not reduced or eliminated by using a laser level and should be considered when interpreting CVP data.

John Fiadjoe, Harshad Gurnaney, Kanchi Muralidhar, Surya Mohanty, John Kumar, Raja Viswanath, Srinivas Sonar, Stephen Dunn, and Mohamed Rehman

Telemedicine Consultation and Monitoring for Pediatric Liver Transplant (Case Report)
Anesth Analg 2009 108: 1212-1214. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Telemedicine was used in the setting of liver transplantation to provide expert advice to the anesthesia team at the point of care and potentially improve outcome.

PATIENT SAFETY:

Ka-young Rhee, Jeong-rim Lee, Jinhee Kim, Sanghyon Park, Won-Kyong Kwon, and SungHee Han

A Comparison of Lighted Stylet (Surch-Lite^TM) and Direct Laryngoscopic Intubation in Patients with High Mallampati Scores
Anesth Analg 2009 108: 1215-1219. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared a lighted stylet (Surch-LiteTM) and direct laryngoscopy for tracheal intubation in patients with a high Mallampati score. Surch-Lite had a higher success rate and produced fewer hemodynamic disturbances. Thus, the lighted stylet is an effective alternative to direct laryngoscopy in these patients.

Omar M. Khawaja, J. Taylor Reed, Shahzad Shaefi, Hovig V. Chitilian, and Warren S. Sandberg

Crisis Resource Management of the Airway in a Patient with Klippel-Feil Syndrome, Congenital Deafness, and Aortic Dissection (Case Report)
Anesth Analg 2009 108: 1220-1225. [Abstract] [Full Text] [PDF] [Video Clip]  [Request Permissions]  

IMPLICATIONS: Klippel-Feil syndrome is a rare congenital disorder affecting cervical mobility, such that awake fiberoptic intubation is the preferred elective airway technique. We applied crisis resource management in a case of urgent surgery in which patient and surgical factors required a different approach.

CRITICAL CARE AND TRAUMA:

Thomas C. Mort

Tracheal Tube Exchange: Feasibility of Continuous Glottic Viewing with Advanced Laryngoscopy Assistance (Brief Report)
Anesth Analg 2009 108: 1228-1231. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Exchanging an endotracheal tube in the difficult airway patient with the adjunct use of advanced laryngoscopy appears feasible, offering improved visualization of the glottic structures when compared with conventional laryngoscopy.

OBSTETRIC ANESTHESIOLOGY:

Jill M. Mhyre, Mary Lou V. H. Greenfield, Lawrence C. Tsen, and Linda S. Polley

A Systematic Review of Randomized Controlled Trials That Evaluate Strategies to Avoid Epidural Vein Cannulation During Obstetric Epidural Catheter Placement
Anesth Analg 2009 108: 1232-1242. [Abstract] [Full Text] [PDF] [Data Supplement]  [Request Permissions]  

IMPLICATIONS: A systematic review of literature suggests that the risk of intravascular placement of a lumbar epidural catheter in pregnancy may be reduced with the lateral as opposed to sitting patient position, fluid predistension of the epidural space, the use of single- instead of multiorifice catheters, the use of wire-embedded polyurethane rather than standard nylon catheters and by limiting the depth of catheter insertion to 6 cm or less.

Kyle G. Wojciechowski, Michael J. Avram, Kiril Raikoff, Robert J. McCarthy, and Cynthia A. Wong

A Comparison of Epinephrine Concentrations in Local Anesthetic Solutions Using a "Wash" Versus Measured Technique (Brief Report)
Anesth Analg 2009 108: 1243-1245. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The addition of epinephrine to local anesthetic solutions using a small syringe was less accurate than using an epinephrine "wash" technique. Regardless of technique, there is greater variability in concentration among individual anesthesiologists than there is among samples prepared by a single individual.

Bernard Wittels, Tamer A. Attia, Abbas Al-Qamari, and Matthew P. Jaycox

Repeated Episodes of Respiratory Distress in an Obese Parturient After Cesarean Delivery (Case Report)
Anesth Analg 2009 108: 1246-1248. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report an unusual case of an obese patient with repeated episodes of postcesarean respiratory distress and hypothesize that these were due to airway obstruction from an undiagnosed multinodular goiter that expanded in size in the postpartum period.

ECONOMICS, EDUCATION, AND POLICY:

Pieter S. Stepaniak, Guido H. H. Mannaerts, Marcel de Quelerij, and Guus de Vries

The Effect of the Operating Room Coordinator's Risk Appreciation on Operating Room Efficiency
Anesth Analg 2009 108: 1249-1256. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this study, we show that a nonrisk-averse operating room (OR)coordinator creates significantly less unused ORs capacity without a great chance of running ORs after regular working hours or canceling elective cases scheduled for surgery. This is an important fact since it contributes to increased efficiency in the OR.

Elisabeth U. Dexter, Franklin Dexter, Danielle Masursky, Michael P. Garver, and Nancy A. Nussmeier

Both Bias and Lack of Knowledge Influence Organizational Focus on First Case of the Day Starts
Anesth Analg 2009 108: 1257-1261. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: An online, anonymous, 27 question survey of operating room personnel at a United States teaching hospital included three questions regarding operations research. There was a strong bias that cases start later than scheduled, explaining why people perceive that they are always running behind. There was a lack of knowledge of the science of operating room efficiency, such that education may be able to influence behavior.

Franklin Dexter and Richard H. Epstein

Typical Savings from Each Minute Reduction in Tardy First Case of the Day Starts
Anesth Analg 2009 108: 1262-1267. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Each 1.0 min reduction in the tardiness of the first cases of the day in operating rooms with more than 8 h of cases typically results in 1.1 {+/-} 0.1 min reduction in regularly scheduled labor costs. This result is close to the 1.2 min obtained using an entirely different (simulation) method performed previously for reductions in operating room time.

NEUROSURGICAL ANESTHESIOLOGY AND NEUROSCIENCE:

C. Dean Kurth, John C. McCann, Jun Wu, Lili Miles, and Andreas W. Loepke

Cerebral Oxygen Saturation-Time Threshold for Hypoxic-Ischemic Injury in Piglets
Anesth Analg 2009 108: 1268-1277. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Near-infrared spectroscopy, electrocortical activity and neurological outcome were monitored in piglets subjected to mild hypoxia-ischemia from 1 to 8 h. Neurological injury began to occur after 2 h of hypoxia-ischemia and was heralded by abnormalities in near-infrared spectroscopy and electrocortical activity during reperfusion, suggesting that there is a time window to prevent neurological injury and that these monitors might be used together to predict outcome.

Ken M. Brady, Jennifer K. Lee, Kathleen K. Kibler, Ronald B. Easley, Raymond C. Koehler, Marek Czosnyka, Peter Smielewski, and Donald H. Shaffner

The Lower Limit of Cerebral Blood Flow Autoregulation Is Increased with Elevated Intracranial Pressure
Anesth Analg 2009 108: 1278-1283. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The present study shows that the lower limit of autoregulation in piglets is affected by increased intracranial pressure so that monitoring autoregulation may be as or more important than monitoring cerebral perfusion pressure.

Timothy J. McCulloch and Martin J. Turner

The Effects of Hypocapnia and the Cerebral Autoregulatory Response on Cerebrovascular Resistance and Apparent Zero Flow Pressure During Isoflurane Anesthesia
Anesth Analg 2009 108: 1284-1290. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Variations in cerebral arteriolar were induced by hyperventilation and by increasing blood pressure to stimulate the cerebral autoregulatory response. The apparent zero flow pressure and the resistance area product both increased when arteriolar tone was expected to increase. These results imply that variations in arteriolar tone control cerebral blood flow by altering both effective downstream pressure and vascular resistance. The changes in resistance appeared to have a greater influence on cerebral blood flow than the changes in effective downstream pressure.

Vincent Minville, Karim Asehnoune, Sabrina Salau, Benoît Bourdet, Bernard Tissot, Vincent Lubrano, and Olivier Fourcade

The Effects of Spinal Anesthesia on Cerebral Blood Flow in the Very Elderly
Anesth Analg 2009 108: 1291-1294. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The aim of this study was to assess the effects of spinal anesthesia on cerebral blood flow in very elderly patients.

ANALGESIA:

Brian A. Williams, Qainyu Dang, James E. Bost, James J. Irrgang, Steven L. Orebaugh, Matthew T. Bottegal, and Michael L. Kentor

General Health and Knee Function Outcomes from 7 Days to 12 Weeks After Spinal Anesthesia and Multimodal Analgesia for Anterior Cruciate Ligament Reconstruction
Anesth Analg 2009 108: 1296-1302. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: After anterior cruciate ligament reconstruction with spinal anesthesia and multimodal analgesia, patients were evaluated three times from 7 days to 12 wk after surgery with (1) the SF-36 and (2) the Knee Outcome Survey-Activities of Daily Living Scale (KOS-ADLS). There were no differences in general health or knee function based on nerve block treatment group; continuous femoral nerve block analgesia was not associated with any adverse effects on patient-reported general health or knee function in the 7-day to 12-wk period after anterior cruciate ligament reconstruction.

Chao-Ming Shih, Shin-Nan Cheng, Chih-Shung Wong, Yu-Ling Kuo, and Tz-Chong Chou

Antiinflammatory and Antihyperalgesic Activity of C-Phycocyanin
Anesth Analg 2009 108: 1303-1310. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We first demonstrated that c-phycocyanin attenuates carrageenan-induced inflammatory nociception, which may be associated with the inhibition of nitric oxide and prostaglandin E2 over-production (through suppressing inducible nitric oxide synthase), cyclooxygeanase-2 induction, attenuation of tumor necrosis factor-{alpha} formation and neutrophil infiltration into inflammatory sites. These findings suggest that c-phycocyanin may be a potential therapeutic drug for reducing inflammatory nociception.

Lise Gormsen, Nanna B. Finnerup, Per M. Almqvist, and Troels S. Jensen

The Efficacy of the AMPA Receptor Antagonist NS1209 and Lidocaine in Nerve Injury Pain: A Randomized, Double-Blind, Placebo-Controlled, Three-Way Crossover Study
Anesth Analg 2009 108: 1311-1319. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This pilot study suggests that NS1209, a novel, selective, competitive and potent AMPA/GluR5 receptor antagonist, alleviates certain signs and symptoms of neuropathic pain with an effect profile similar to the sodium channel blocker lidocaine. The findings suggest a role for AMPA-receptor involvement in neuropathic pain in humans, but studies in a larger population are needed.

Brian M. Ilfeld, R. Scott Meyer, Linda T. Le, Edward R. Mariano, Brian A. Williams, Krista Vandenborne, Pamela W. Duncan, Daniel I. Sessler, F. Kayser Enneking, Jonathan J. Shuster, Rosalita C. Maldonado, and Peter F. Gearen

Health-Related Quality of Life After Tricompartment Knee Arthroplasty With and Without an Extended-Duration Continuous Femoral Nerve Block: A Prospective, 1-Year Follow-Up of a Randomized, Triple-Masked, Placebo-Controlled Study
Anesth Analg 2009 108: 1320-1325. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Previously, we provided evidence that extending an overnight continuous femoral nerve block to 4 days after tricompartment knee arthroplasty provides clear benefits in the immediate postoperative period. But, in this investigation, we found no evidence that the extended perineural infusion improves subsequent health-related quality of life between 7 days and 12 mo.

Vincent Compère, J. F. Legrand, P. G. Guitard, K. Azougagh, O. Baert, A. Ouennich, V. Fourdrinier, N. Frebourg, and B. Dureuil

Bacterial Colonization After Tunneling in 402 Perineural Catheters: A Prospective Study
Anesth Analg 2009 108: 1326-1330. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bacterial colonization of peripheral nerve catheters is frequent, although infection is relatively rare. Catheter tunneling may reduce the incidence of perineural catheter colonization.

Rainer Meierhenrich, Florian Wagner, Wolfram Schütz, Michael Rockemann, Peter Steffen, Uwe Senftleben, and Albrecht Gauss

The Effects of Thoracic Epidural Anesthesia on Hepatic Blood Flow in Patients Under General Anesthesia
Anesth Analg 2009 108: 1331-1337. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In 20 patients, thoracic epidural anesthesia was associated with a significant decrease in hepatic blood flow. This may have implications for patients with preexisting liver disease or those undergoing hepatic surgery.

Axel R. Sauter, Michael S. Dodgson, Håvard Kalvøy, Sverre Grimnes, Audun Stubhaug, and Øivind Klaastad

Current Threshold for Nerve Stimulation Depends on Electrical Impedance of the Tissue: A Study of Ultrasound-Guided Electrical Nerve Stimulation of the Median Nerve
Anesth Analg 2009 108: 1338-1343. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Electrical impedance measurements were performed to investigate the conductive properties of the tissue surrounding the median nerve and to determine its effect on peripheral nerve stimulation. We determined an inverse relationship between impedance and current thresholds for nerve stimulation.

Peter C. Marwick, Andrew I. Levin, and Andre R. Coetzee

Recurrence of Cardiotoxicity After Lipid Rescue from Bupivacaine-Induced Cardiac Arrest (Case Report)
Anesth Analg 2009 108: 1344-1346. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Systemic local anesthetic toxicity may recur after initial lipid rescue, necessitating administration of additional doses of IV lipid emulsion. This further underscores the importance of the availability of a sufficient quantity of lipid emulsion when regional anesthesia is performed.

Steven R. Clendenen, Kevin Riutort, Beth L. Ladlie, Christopher Robards, Carlo D. Franco, and Roy A. Greengrass

Real-Time Three-Dimensional Ultrasound-Assisted Axillary Plexus Block Defines Soft Tissue Planes (Case Report)
Anesth Analg 2009 108: 1347-1350. [Abstract] [Full Text] [PDF] [Video Clips]  [Request Permissions]  

IMPLICATIONS: Real-time three-dimensional ultrasound-guided axillary block provides insight into the functional anatomy of the brachial sheath and allows for visualization of the plexus in multiple planes with real-time manipulation of the image without movement of the probe.

ERRATA-RETRACTION:

Steven L. Shafer

NOTICE OF RETRACTION
Anesth Analg 2009 108: 1350. [Full Text] [PDF] [Request Permissions]  

LETTERS TO THE EDITOR:

Steven L. Shafer

Retraction Notice
Anesth Analg 2009 108: 1351. [Full Text] [PDF] [Request Permissions]  

Oliver W. Masters and Jeffrey L. Tong

The Assessment of Sore Throat Following Nasotracheal Intubation
Anesth Analg 2009 108: 1351. [Full Text] [PDF] [Request Permissions]  

Philip M. Jones and Timothy P. Turkstra

The Assessment of Sore Throat Following Nasotracheal Intubation
Anesth Analg 2009 108: 1351-1352. [Full Text] [PDF] [Request Permissions]  

Jonathan V. Roth

Forced-Air Warming May Have Benefits Even in Short Cases
Anesth Analg 2009 108: 1352. [Full Text] [PDF] [Request Permissions]  

Bruce Ben-David and Jacques E. Chelly

Propofol Alters Ketamine Effect on Opiate-Induced Hyperalgesia
Anesth Analg 2009 108: 1353. [Full Text] [PDF] [Request Permissions]  

Thomas Engelhardt and Mark W. Crawford

Propofol Alters Ketamine Effect on Opiate-Induced Hyperalgesia
Anesth Analg 2009 108: 1353-1354. [Full Text] [PDF] [Request Permissions]  

Chris Nixon, Kerry Gunn, Tom Main, Yatin Young, and John McCall

Platelets and Survival After Liver Transplantation
Anesth Analg 2009 108: 1354-1355. [Full Text] [PDF] [Request Permissions]  

Marieke T. de Boer and Robert J. Porte

Platelets and Survival After Liver Transplantation
Anesth Analg 2009 108: 1355. [Full Text] [PDF] [Request Permissions]  

Olga I. Lyuksyutova, Karoly Varga, Charles T. Van Buren, and Evan G. Pivalizza

Thrombelastography in a Patient with Prolonged Partial Thromboplastin Time Undergoing a Kidney Transplant
Anesth Analg 2009 108: 1355-1356. [Full Text] [PDF] [Request Permissions]  

Steven M. Neustein

Achieving Lung Isolation Via a Tracheostomy
Anesth Analg 2009 108: 1356. [Full Text] [PDF] [Request Permissions]  

Miguel Paciuc

Deep Neck Abscess and Mediastinitis After Laryngeal Mask Anesthesia
Anesth Analg 2009 108: 1356-1357. [Full Text] [PDF] [Request Permissions]  

Sriganesh Kamath, Nilay Chatterjee, Suparna Acharya, and Subrata Kumar Singha

Transesophageal Echocardiography Induced Airway Obstruction in a Patient in Whom the Trachea Had Been Intubated via a LMA CTrach^TM
Anesth Analg 2009 108: 1357. [Full Text] [PDF] [Request Permissions]  

Jeffrey Huang and Charles Majetich

Team Approach for Laryngeal Mask Insertion
Anesth Analg 2009 108: 1357-1358. [Full Text] [PDF] [Request Permissions]  

Robert P. S. Introna, John R. Blair, and John B. Neeld

Epidural Anesthesia for Cesarean Delivery: Failure Rates
Anesth Analg 2009 108: 1358. [Full Text] [PDF] [Request Permissions]  

Kazuna Sugiyama, Naoki Takahashi, and Atsushi Kohjitani

The EndoFlex® Tube Enhances Navigability Through the Nasal Cavity During Nasotracheal Intubation
Anesth Analg 2009 108: 1358-1359. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Vivek K. Moitra

Best Practice & Research: Clinical Anaesthesiology - Perioperative Organ Protection. Vol 22, No. 1, 2008.
Anesth Analg 2009 108: 1360. [Full Text] [PDF] [Request Permissions]  

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