CARDIOVASCULAR ANESTHESIA:

Heinz Michael Loick, Christoph Schmidt, Hugo Van Aken, Ralf Junker, Michael Erren, Elmar Berendes, Norbert Rolf, Andreas Meißner, Christoph Schmid, Hans Heinrich Scheld, and Thomas Möllhoff

High Thoracic Epidural Anesthesia, but Not Clonidine, Attenuates the Perioperative Stress Response Via Sympatholysis and Reduces the Release of Troponin T in Patients Undergoing Coronary Artery Bypass Grafting
Anesth Analg 1999 88: 701. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Thoracic epidural anesthesia combined with general anesthesia attenuates the myocardial sympathetic response to cardiopulmonary bypass and cardiac surgery. This is associated with decreased myocardial ischemia as determined by less release of troponin T. These findings may have an impact on the anesthetic management for coronary artery bypass grafting.

Edith Hochhauser, Pinchas Halpern, Victor Zolotarsky, Tatyana Krasnov, Jaqueline Sulkes, and Bernardo Vidne

Isoflurane and Sodium Nitroprusside Reduce the Depressant Effects of Protamine Sulfate on Isolated Ischemic Rat Hearts
Anesth Analg 1999 88: 710. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We examined the interactions of isoflurane, sodium nitroprusside, and protamine in a rat heart model and found that both isoflurane and sodium nitroprusside partially protect the heart from the depressant effects of protamine. This finding is significant, as these drugs are often used in heart surgery.

James E. Heavner, Bing Shi, and Mikko Pitkänen

Nitric Oxide Synthesis Inhibition Modifies the Cardiotoxicity of Tetracaine and Lidocaine
Anesth Analg 1999 88: 717. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Inhibition of nitric oxide production in rats markedly enhances the cardiovascular toxicity of lidocaine and tetracaine. Altered drug clearance by N-nitro-L-arginine methyl ester was insufficient to explain these findings because N-nitro-L-arginine methyl ester pretreatment increased the plasma levels of only lidocaine, not tetracaine.

ERRATUM:

Anesth Analg 1999 88: 722. [Full Text] [Request Permissions]  

AMBULATORY ANESTHESIA:

Mônica M. Sá Rêgo, Yoshimi Inagaki, and Paul F. White

The Cost-Effectiveness of Methohexital Versus Propofol for Sedation During Monitored Anesthesia Care
Anesth Analg 1999 88: 723. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: When administered to maintain a stable level of sedation during local anesthesia, methohexital is an acceptable alternative to propofol. However, the overall drug costs were similar with the two drugs.

Scott S. Reuben and Neil Roy Connelly

Postoperative Analgesia for Outpatient Arthroscopic Knee Surgery with Intraarticular Clonidine
Anesth Analg 1999 88: 729. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The intraarticular administration of clonidine along with bupivacaine results in a significant improvement in analgesia compared with either drug alone. There was an increased time to first analgesic request and a decreased need for postoperative analgesics.

Dajun Song, Charles W. Whitten, and Paul F. White

Use of Remifentanil During Anesthetic Induction: A Comparison With Fentanyl in the Ambulatory Setting (Brief Report)
Anesth Analg 1999 88: 734. [Full Text] [PDF] [Request Permissions]  

PEDIATRIC ANESTHESIA:

George D. Politis, Joseph R. Tobin, Robert C. Morell, Robert L. James, and Michael F. Cantwell

Tracheal Intubation of Healthy Pediatric Patients Without Muscle Relaxant: A Survey of Technique Utilization and Perceptions of Safety
Anesth Analg 1999 88: 737. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: Inhaled anesthetic without muscle relaxation is the most often used method of intubation for more than one third of Society for Pediatric Anesthesia anesthesiologists when tracheally intubating healthy, fasted pediatric patients undergoing elective procedures. The frequency of this practice seems to be highest in nonacademic practices.

Robert D. Valley, Justin T. Ramza, Pauletta Calhoun, Eugene B. Freid, Ann G. Bailey, Vincent J. Kopp, and Linda S. Georges

Tracheal Extubation of Deeply Anesthetized Pediatric Patients: A Comparison of Isoflurane and Sevoflurane
Anesth Analg 1999 88: 742. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Deep extubation of children can be safely performed with either isoflurane or sevoflurane. After deep tracheal extubation, airway problems occur but are easily managed. Return to an arousable state occurred more quickly with sevoflurane, although time to meeting discharge criteria was not different between the two groups. Emergence delirium occurs frequently with either technique.

Yuri Shevchenko, Judith C. Jocson, Valerie A. McRae, Stephen A. Stayer, Roy E. Schwartz, Mohamed Rehman, and Dinesh K. Choudhry

The Use of Lidocaine for Preventing the Withdrawal Associated with the Injection of Rocuronium in Children and Adolescents
Anesth Analg 1999 88: 746. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Pain on injection of rocuronium in pediatric patients can be alleviated by pretreatment with IV lidocaine.

John B. Rose, Romulo Cuy, David E. Cohen, and Mark S. Schreiner

Preoperative Oral Dextromethorphan Does Not Reduce Pain or Analgesic Consumption in Children After Adenotonsillectomy
Anesth Analg 1999 88: 749. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Premedication with dextromethorphan 0.5 or 1.0 mg/kg PO does not improve postoperative analgesia in school-aged children who receive preemptive morphine 0.075 mg/kg IV and acetaminophen 25–35 mg/kg PR during nitrous oxide and desflurane anesthesia for adenotonsillectomy.

Makoto Tanaka and Toshiaki Nishikawa

Evaluating T-Wave Amplitude as a Guide for Detecting Intravascular Injection of a Test Dose in Anesthetized Children
Anesth Analg 1999 88: 754. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: To determine whether an epidurally administered local anesthetic is unintentionally injected into a blood vessel, a small dose of epinephrine is often added to a local anesthetic. We found that increases in T-wave amplitude by 25% in lead II monitor electrocardiography are as effective as a heart rate increase 10 bpm for detecting intravascular injection in sevoflurane-anesthetized children.

John H. Huntington, Shobha Malviya, Terri Voepel-Lewis, Thomas R. Lloyd, and Kenneth D. Massey

The Effect of a Right-to-Left Intracardiac Shunt on the Rate of Rise of Arterial and End-Tidal Halothane in Children
Anesth Analg 1999 88: 759. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In this prospective study, we found a slower rate of rise of halothane in arterial blood in children with right-to-left intracardiac shunting. Induction of anesthesia by inhalation of volatile anesthetics may therefore be slower in these children.

M. Booke, O. Hagemann, H. Van Aken, M. Erren, J. Wüllenweber, and H. G. Bone

Intraoperative Autotransfusion in Small Children: An In Vitro Investigation to Study Its Feasability (Brief Report)
Anesth Analg 1999 88: 763. [Full Text] [PDF] [Request Permissions]  

CRITICAL CARE AND TRAUMA:

Sylvia Knapp, Julia Kofler, Brigitte Stoiser, Florian Thalhammer, Heinz Burgmann, Martin Posch, Roland Hofbauer, Margit Stanzel, and Michael Frass

The Assessment of Four Different Methods to Verify Tracheal Tube Placement in the Critical Care Setting
Anesth Analg 1999 88: 766. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: To prevent unidentified esophageal intubation, a serious complication in the critical care setting, four methods for detecting tube position were tested by two examiners (one experienced, the other inexperienced) in endotracheally intubated patients after insertion of a second tube into the esophagus.

Megumi Sumida, Hideo Inaba, Eiji Isawa, Shigeru Fujimoto, Toshihiko Satoh, and Miwako Kawamata

Prevention by Methylprednisolone of Increased Circulating Tumor Necrosis Factor- Levels and Lung Injury Associated with Systemic Inflammatory Response Syndrome due to Intraperitoneal Hyperthermia
Anesth Analg 1999 88: 771. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Pretreatment with methylprednisolone attenuates the increase in circulating tumor necrosis factor- and prevents lung injury in this systemic inflammatory syndrome due to intraperitoneal hyperthermic perfusion.

Leonardo Kapural, Juraj Sprung, Ivo Gluncic, Miranda Kapural, Simon Andelinovic, Dragan Primorac, and Peter K. Schoenwald

Tracheo-Innominate Artery Fistula After Tracheostomy (Case Report)
Anesth Analg 1999 88: 777. [Full Text] [PDF] [Request Permissions]  

NEUROSURGICAL ANESTHESIA:

Alan A. Artru and Yoshihiro Momota

Trabecular Outflow Facility and Formation Rate of Aqueous Humor During Anesthesia with Sevoflurane-Nitrous Oxide or Sevoflurane-Remifentanil in Rabbits
Anesth Analg 1999 88: 781. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The dose-related effects of sevoflurane on intraocular compliance did not produce significant intraocular pressure differences. Adding remifentanil to sevoflurane increased intraocular compliance. Sevoflurane or sevoflurane + remifentanil causes a decrease in intraocular pressure compared with the average of previously reported values in awake rabbits, and the magnitude of the decrease is similar to that previously reported in rabbits anesthetized with ethyl urethane, pentobarbital, or halothane alone or in combination with propofol, cocaine, or lidocaine.

Yoshihide Miura, G. Burkhard Mackensen, Bengt Nellgård, Robert D. Pearlstein, Robert D. Bart, Franklin Dexter, and David S. Warner

Effects of Isoflurane, Ketamine, and Fentanyl/N₂O on Concentrations of Brain and Plasma Catecholamines During Near-Complete Cerebral Ischemia in the Rat
Anesth Analg 1999 88: 787. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: It has been proposed that anesthetics modulate cerebral ischemic outcome by influencing peripheral adrenergic responses to ischemia. This experiment demonstrates that anesthetics differentially modulate adrenergic responses to ischemia but that effects in plasma and brain are independent. This suggests that events detected in the peripheral circulation do not implicate direct mechanisms of action of catecholamines at the neuronal/glial level.

Soraya Suarez, Isabel Ornaque, Neus Fábregas, Ricard Valero, and Enrique Carrero

Venous Air Embolism During Parkinson Surgery in Patients with Spontaneous Ventilation (Case Report)
Anesth Analg 1999 88: 793. [Full Text] [PDF] [Request Permissions]  

OBSTETRIC ANESTHESIA:

Lawrence C. Tsen and Sanjay Datta

Panic Attacks and Lactated Ringer’s Solution: Is There a Relationship? (Case Report)
Anesth Analg 1999 88: 795. [Full Text] [PDF] [Request Permissions]  

REGIONAL ANESTHESIA AND PAIN MANAGEMENT:

Peter S. Hodgson, Joseph M. Neal, Julia E. Pollock, and Spencer S. Liu

The Neurotoxicity of Drugs Given Intrathecally (Spinal) (Review Article)
Anesth Analg 1999 88: 797. [Full Text] [PDF] [Request Permissions]  

Rudolf Stienstra, Ban Z. R. Dilrosun-Alhadi, Albert Dahan, Jack W. van Kleef, Bernadette Th Veering, and Anton G. L. Burm

The Epidural "Top-Up" in Combined Spinal-Epidural Anesthesia: The Effect of Volume Versus Dose
Anesth Analg 1999 88: 810. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In combined spinal-epidural anesthesia, an epidural "top-up" may increase the maximal level of sensory blockade by means of a volume effect and a local anesthetic effect. In this study, volumes of 5 and 10 mL produced a similar increase, and 25 mg of bupivacaine was insufficient to produce an additional local anesthetic effect.

Michael F. Mulroy, Roy Greengrass, Sugantha Ganapathy, Vincent Chan, and Agneta Heierson

Sameridine Is Safe and Effective for Spinal Anesthesia: A Comparative Dose-Ranging Study with Lidocaine for Inguinal Hernia Repair
Anesth Analg 1999 88: 815. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In this clinical trial, we show the potential efficacy of a class of drugs that can produce both spinal anesthesia and postoperative analgesia when used for hernia repair.

Robert Slappendel, Eric W. G. Weber, Ris Dirksen, Mathieu J. M. Gielen, and Jacques van Limbeek

Optimization of the Dose of Intrathecal Morphine in Total Hip Surgery: A Dose-Finding Study
Anesth Analg 1999 88: 822. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Earlier studies showed excellent postoperative pain relief after intrathecal morphine. However, the severity of side effects resulted in decreased enthusiasm for this anesthesia technique. In the present study, we show that an intrathecal dose of 0.1 mg of morphine can be used safely in total hip surgery with excellent postoperative pain relief.

Diethelm Hansen and Stefanie Hansen

The Effects of Three Graded Doses of Meperidine for Spinal Anesthesia in African Men
Anesth Analg 1999 88: 827. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Intrathecal meperidine 1 mg/kg provides surgical anesthesia for only 40–90 min. We investigated the effects of three larger doses of meperidine in 45 African men. The 1.5 and 1.8 mg/kg doses provide a longer duration of anesthesia compared with 1.2 mg/kg. Nausea, pruritus, and respiratory depression were common in all dose groups. We conclude that increasing the dose of meperidine from 1.2 to 1.5 mg/kg increased the duration, but not the level, of sensory block without an increase in side effects.

Scott S. Reuben, Robert B. Steinberg, Shari D. Lurie, and Charles S. Gibson

A Dose-Response Study of Intravenous Regional Anesthesia with Meperidine
Anesth Analg 1999 88: 831. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Meperidine may be a useful addition to 0.5% lidocaine for IV regional anesthesia. We showed that 30 mg is the optimal dose of meperidine with respect to postoperative analgesia. However, this dose caused a significant incidence of sedation, dizziness, and postoperative nausea and vomiting.

Alexander A. Radzievsky, Mikhail A. Rojavin, Alan Cowan, and Marvin C. Ziskin

Suppression of Pain Sensation Caused by Millimeter Waves: A Double-Blinded, Cross-Over, Prospective Human Volunteer Study
Anesth Analg 1999 88: 836. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Pain management is still a significant medical problem. In a double-blinded, experimental setting, we confirmed that low-intensity millimeter wave therapy can reduce pain sensitivity in healthy human volunteers and can potentially be used as a supplementary or alternative treatment for pain relief.

El-sayed A. Ghoname, William F. Craig, Paul F. White, Hesham E. Ahmed, Mohamed A. Hamza, Noor M. Gajraj, Akshay S. Vakharia, and Carl E. Noe

The Effect of Stimulus Frequency on the Analgesic Response to Percutaneous Electrical Nerve Stimulation in Patients with Chronic Low Back Pain
Anesth Analg 1999 88: 841. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The frequency of electrical stimulation seems to be an important determinant of the analgesic efficacy of percutaneous electrical nerve stimulation. Mixed low- and high-frequency stimulation was more effective than either low or high frequencies alone in the treatment of patients with low back pain.

G. Fanelli, A. Casati, P. Garancini, and G. Torri

Nerve Stimulator and Multiple Injection Technique for Upper and Lower Limb Blockade: Failure Rate, Patient Acceptance, and Neurologic Complications
Anesth Analg 1999 88: 847. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Based on a prospective evaluation of 3996 consecutive peripheral nerve blocks, the multiple injection technique with nerve stimulator allows for up to 94% successful nerve block with <30 mL of local anesthetic solution. Although the data collection regarding neurologic dysfunction was limited, the withdrawal and redirection of the stimulating needle was not associated with an increased incidence of neurologic complications. Sedation/analgesia should be advocated during block placement to improve patient acceptance.

Stephan Kapral, Gabriele Gollmann, Barbara Waltl, Rudolf Likar, Robert N. Sladen, Christian Weinstabl, and Franz Lehofer

Tramadol Added to Mepivacaine Prolongs the Duration of an Axillary Brachial Plexus Blockade
Anesth Analg 1999 88: 853. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: This study demonstrates that the admixture of 100 mg of tramadol with mepivacaine 1% for brachial plexus block provides a pronounced prolongation of blockade without side effects. Our data support a specific analgesic effect of tramadol on peripheral nerves.

David A. Scott, Duncan Blake, Mark Buckland, Richard Etches, Richard Halliwell, Colin Marsland, George Merridew, Dermot Murphy, Michael Paech, Stephan A. Schug, Grant Turner, Stuart Walker, Karin Huizar, and Urban Gustafsson

A Comparison of Epidural Ropivacaine Infusion Alone and in Combination with 1, 2, and 4 µg/mL Fentanyl for Seventy-Two Hours of Postoperative Analgesia After Major Abdominal Surgery
Anesth Analg 1999 88: 857. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Postoperative epidural analgesic infusions are widely used, but there is little information regarding optimal strengths of opioid with local anesthetic. In this blinded, prospective study, we compared four different epidural infusion solutions for efficacy and side effects over a clinically useful postoperative period and conclude that an epidural infusion of ropivacaine 2 mg/mL with fentanyl 4 µg/mL was most effective.

Toshiya Shiga, Atsuhiro Sakamoto, Kiyoshi Koizumi, and Ryo Ogawa

Endoscopic Thoracic Sympathectomy for Primary Erythromelalgia in the Upper Extremities (Case Report)
Anesth Analg 1999 88: 865. [Full Text] [PDF] [Request Permissions]  

GENERAL ARTICLES:

Edmond I Eger, II, Pompiliu Ionescu, Michael J. Laster, Diane Gong, Tomas Hudlicky, Joan J. Kendig, R. Adron Harris, James R. Trudell, and Andrew Pohorille

Minimum Alveolar Anesthetic Concentration of Fluorinated Alkanols in Rats: Relevance to Theories of Narcosis
Anesth Analg 1999 88: 867. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Inhaled anesthetic potency correlates with lipophilicity, but potency of common alkanols is greater than their lipophilicity indicates, in part because alkanols have a greater hydrophilicity—i.e., a greater polarity.

Susumu Ueno, James R. Trudell, Edmond I Eger, II, and R. Adron Harris

Actions of Fluorinated Alkanols on GABA_A Receptors: Relevance to Theories of Narcosis
Anesth Analg 1999 88: 877. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We find a consistent parallel between the immobilization produced by fluorinated alkanols and their actions on N-methyl-D-aspartate receptors but do not find a consistent parallel between immobilization and effects on -aminobutyric acid type A receptors. Thus, we suggest that N-methyl-D-aspartate, but not -aminobutyric acid type A, receptors may mediate the capacity of anesthetics to produce immobilization.

Edmond I Eger, II, Donald D. Koblin, James Sonner, Diane Gong, Michael J. Laster, Pompiliu Ionescu, Michael J. Halsey, and Tomas Hudlicky

Nonimmobilizers and Transitional Compounds May Produce Convulsions by Two Mechanisms
Anesth Analg 1999 88: 884. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Nonimmobilizers and transitional compounds may produce convulsions by two mechanisms. One correlates with lipophilicity (nonpolarity), and the other correlates with an action on GABA_A receptors.

Yoshiya Miyazaki, Takehiko Adachi, Jun Utsumi, Tsutomu Shichino, and Hajime Segawa

Xenon Has Greater Inhibitory Effects on Spinal Dorsal Horn Neurons than Nitrous Oxide in Spinal Cord Transected Cats
Anesth Analg 1999 88: 893. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Xenon (Xe) is an inert gas with anesthetic properties. We examined the antinociceptive effects of Xe and nitrous oxide (N₂O) in spinal cord-transected cats. Our studies indicate that Xe has a direct antinociceptive action on the spinal cord that is greater than that of N₂O.

Joel B. Nelson, Terry J. Opgenorth, Lee A. Fleisher, and Steven M. Frank

Perioperative Plasma Endothelin-1 and Big Endothelin-1 Concentrations in Elderly Patients Undergoing Major Surgical Procedures
Anesth Analg 1999 88: 898. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The endothelin response seems to be significantly associated with perioperative hemodynamic aberrations. The endothelin-1 (ET-1) precursor Big ET-1 is a more sensitive measure of the endothelin system activation in response to surgical stress than ET-1 alone. Thermoregulatory vasoconstriction in response to mild perioperative hypothermia occurs independently of the endothelin system.

C. Keller, J. Brimacombe, C. Rädler, and F. Pühringer

Do Laryngeal Mask Airway Devices Attenuate Liquid Flow Between the Esophagus and Pharynx? A Randomized, Controlled Cadaver Study
Anesth Analg 1999 88: 904. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We have shown, in cadavers, that the correctly placed standard and flexible laryngeal mask airways attenuate liquid flow between the pharynx and esophagus.

Lian Kah Ti, Mark Y. H. Chow, and Tat Leang Lee

Comparison of Sevoflurane with Propofol for Laryngeal Mask Airway Insertion in Adults
Anesth Analg 1999 88: 908. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: In this randomized, controlled trial, we compared the ease of insertion of the laryngeal mask airway in adults after induction of anesthesia with either a sevoflurane vital capacity breath technique or propofol IV. We conclude that sevoflurane compares favorably with propofol, although prolonged jaw tightness may delay laryngeal mask airway insertion.

C. Keller and J. Brimacombe

The Influence of Head and Neck Position on Oropharyngeal Leak Pressure and Cuff Position with the Flexible and the Standard Laryngeal Mask Airway
Anesth Analg 1999 88: 913. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: There are small changes in oropharyngeal leak pressure but no changes in cuff position in different head and neck positions for the flexible and standard laryngeal mask airways. Oropharyngeal leak pressure may be improved by head and neck flexion and by avoiding extension.

Andrea Casati, Guido Fanelli, Elisabetta Casaletti, Valeria Cedrati, Fabrizio Veglia, and Giorgio Torri

The Target Plasma Concentration of Propofol Required to Place Laryngeal Mask Versus Cuffed Oropharyngeal Airway
Anesth Analg 1999 88: 917. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: We evaluated the use of target-controlled infusion of propofol to place extratracheal airways in this prospective, randomized study and demonstrated that the target plasma concentration of propofol required to successfully place a laryngeal mask in >95% of healthy, unpremedicated patients is 6 µg/mL, compared with 4 µg/mL to place a cuffed oropharyngeal airway.

Takehiko Ikeda, Daniel I. Sessler, Mutsuhito Kikura, Tomiei Kazama, Kazuyuki Ikeda, and Shigehito Sato

Less Core Hypothermia when Anesthesia Is Induced with Inhaled Sevoflurane Than with Intravenous Propofol
Anesth Analg 1999 88: 921. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Core temperatures in patients who received IV propofol were consistently lower than those in patients who received inhaled sevoflurane, although anesthesia was subsequently maintained with sevoflurane in nitrous oxide in both groups. This suggests that even a brief period of propofol-induced vasodilation during anesthetic induction causes substantial redistribution hypothermia that persists throughout surgery.

Klaus H. Hoerauf, Thomas Wallner, Ozan Akça, Reza Taslimi, and Daniel I. Sessler

Exposure to Sevoflurane and Nitrous Oxide During Four Different Methods of Anesthetic Induction
Anesth Analg 1999 88: 925. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We compared waste gas concentrations to sevoflurane and nitrous oxide during four different induction methods. During inhaled induction with a rebreathing bag or a circle circuit system, waste gas concentrations frequently exceed National Institute for Occupational Safety and Health limits of 2 ppm sevoflurane and 50 ppm nitrous oxide. Therefore, we recommend that people at risk (e.g., women of child-bearing age) should pay great attention when using this technique.

Edith Fleischmann, Ozan Akça, Thomas Wallner, Cem F. Arkiliç, Andrea Kurz, Randy S. Hickle, Michael Zimpfer, and Daniel I. Sessler

Onset Time, Recovery Duration, and Drug Cost with Four Different Methods of Inducing General Anesthesia
Anesth Analg 1999 88: 930. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Anesthetic induction techniques influence awakening time, recovery duration, and drug costs. We tested two IV methods and two inhaled techniques. However, none of the four tested methods was clearly superior to the others.

Mladen I. Vidovich, Lance R. Peterson, and Hak Y. Wong

The Effect of Lidocaine on Bacterial Growth in Propofol
Anesth Analg 1999 88: 936. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The addition of lidocaine to propofol in concentrations clinically effective in reducing pain on injection had no effect on microbial growth. Adherence to strict aseptic technique is further emphasized.

Bilge Celebioglu, Nima Ramzi Eslambouli, Ekmel Olcay, and Safak Atakan

The Effect of Tenoxicam on Intraperitoneal Adhesions and Prostaglandin E₂ Levels in Mice
Anesth Analg 1999 88: 939. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Postoperative intraabdominal adhesions can cause intestinal obstruction, pelvic pain, or infertility. In this study, we showed that intraperitoneally administered tenoxicam decreases tissue prostaglandin E₂ levels and intraabdominal adhesions in mice.

BRIEF COMMUNICATION:

Denis L. Bourke and Jerry Biehl

The Laryngotracheal Topical Anesthesia Kit with Capnography for Difficult Endotracheal Intubation
Anesth Analg 1999 88: 943. [Full Text] [PDF] [Request Permissions]  

REVIEW ARTICLES:

Claudia D. Spies and Hans Rommelspacher

Alcohol Withdrawal in the Surgical Patient: Prevention and Treatment
Anesth Analg 1999 88: 946. [Full Text] [PDF] [Request Permissions]  

MEETING REPORT:

Randall Flick and Lynn D. Martin

Twelfth Annual Meeting of the Society for Pediatric Anesthesia, Orlando, Florida, October 16, 1998
Anesth Analg 1999 88: 955. [Full Text] [PDF] [Request Permissions]  

LETTERS TO THE EDITOR:

Elizabeth C. Behringer, J. R. Brimacombe, J. C. Brimacombe, and A. M. Berry

Comparison of the Laryngeal Mask Airway and Cuffed Oropharyngeal Airway: Alternative Hypotheses • Response
Anesth Analg 1999 88: 961. [Full Text] [PDF] [Request Permissions]  

M. Th. Rennotte, Ph. Baele, G. Aubert, and D. O. Rodenstein

Epidural Opioids and Respiratory Arrests
Anesth Analg 1999 88: 962. [Full Text] [PDF] [Request Permissions]  

Philip R. Bromage, Suzanne Huffnagle, and Mark C. Norris

The Influence of Epidural Needle Bevel on Spread of Sensory Blockade in the Laboring Parturient • Response
Anesth Analg 1999 88: 962. [Full Text] [PDF] [Request Permissions]  

Charles Beattie and Frank J. Overdyk

Successful Strategies for Improving Operating Room Efficiency at Academic Institutions • Response
Anesth Analg 1999 88: 963. [Full Text] [PDF] [Request Permissions]  

Jordan Tarshis, Steven T. Fogel, and Barbara L. Leighton

Epidural Analgesia and Cesarean Delivery: What is the Relationship? • Response
Anesth Analg 1999 88: 963. [Full Text] [PDF] [Request Permissions]  

J. C. Gerancher and David A. Lubarsky

Valuing the Work Performed by Anesthesiology Residents • Response
Anesth Analg 1999 88: 964. [Full Text] [PDF] [Request Permissions]  

Marc A. Rozner and Richard J. Nishman

Pacemaker-Driven Tachycardia Revisited
Anesth Analg 1999 88: 965. [Full Text] [PDF] [Request Permissions]  

Thaddeus J. Krensavage

Saline Solution as Lubrication to Manipulate a Stuck Fiberoptic Bronchoscope
Anesth Analg 1999 88: 965. [Full Text] [PDF] [Request Permissions]  

Serge M. Broka, Stewart J. Lustik, James P. Eichelberger, Ashwani K. Chhibber, and Oscar Bronsther

Perioperative Torsade de Pointes Ventricular Tachycardia • Response
Anesth Analg 1999 88: 966. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Nagy A. Mekhail, Peter M Suter, Jürgen Link, and P. Sebastian Thomas

Management of Acute and Chronic Pain • Principles and Practice of Intensive Care Monitoring • Principles of Anesthetic Techniques and Anesthetic Emergencies. Atlas of Anesthesia Series. Vol. 4 • Churchill’s Pocketbook of Pain Management • Books and Multimedia Received
Anesth Analg 1999 88: 967. [Full Text] [PDF] [Request Permissions]  

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