EDITORIALS:

David J. Birnbach and David H. Chestnut

The Epidural Test Dose in Obstetric Patients: Has It Outlived Its Usefulness?
Anesth Analg 1999 88: 971-972. [Full Text] En Espanol  

CARDIOVASCULAR ANESTHESIA:

Giora Landesburg, Wei Zhou, and Thomas Aversano

Tachycardia-Induced Subendocardial Necrosis in Acutely Instrumented Dogs with Fixed Coronary Stenosis
Anesth Analg 1999 88: 973-979. [Abstract] [Full Text]  

Implications: Prolonged tachycardia-induced ischemia, in the face of fixed coronary stenosis causing no ischemia at the resting heart rate, leads to subendocardial infarction in dogs. These findings suggest a possible mechanism for postoperative myocardial infarction.

Daniel Eyraud, Steven Brabant, Dieudonne Nathalie, Marie-Hélène Fléron, Godet Gilles, Michèle Bertrand, and Peirre Coriat

Treatment of Intraoperative Refractory Hypotension with Terlipressin in Patients Chronically Treated with an Antagonist of the Renin-Angiotensin System
Anesth Analg 1999 88: 980-984. [Abstract] [Full Text]  

Implications: Terlipressin is effective to rapidly correct refractory hypotension in patients chronically treated with antagonists of the renin-angiotensin system without impairing left ventricular function.

Cornelius Keyl, Peter Lemberger, Klaus-Dieter Palitzsch, Karin Hochmuth, Andreas Liebold, and Jonny Hobbhahn

Cardiovascular Autonomic Dysfunction and Hemodynamic Response to Anesthetic Induction in Patients with Coronary Artery Disease and Diabetes Mellitus
Anesth Analg 1999 88: 985-991. [Abstract] [Full Text]  

Implications: This study indicates that increased hemodynamic instability during anesthetic induction is not obligatory in patients with coronary artery disease and autonomic dysfunction.

T. J. Gan, E. Bennett-Guerrero, B. Phillips-Bute, H. Wakeling, D. M. Moskowitz, Y. Olufolabi, S. N. Konstadt, C. Bradford, P. S. A. Glass, S. J. Machin, and M. G. Mythen

Hextend®, a Physiologically Balanced Plasma Expander for Large Volume Use in Major Surgery: A Randomized Phase III Clinical Trial
Anesth Analg 1999 88: 992-998. [Abstract] [Full Text]  

Implications: Hextend® (BioTime, Inc., Berkeley, CA) is a new plasma volume expander containing 6% hetastarch, balanced electrolytes, a lactate buffer, and a physiological level of glucose. It is as effective as 6% hetastarch in saline for the treatment of hypovolemia but has a more favorable side effects profile in volumes of up to 5 L compared with 6% hetastarch in saline.

E. Lynne Williams, Kathy L. Hildebrand, Shelley A. McCormick, and M. Jay Bedel

The Effect of Intravenous Lactated Ringer's Solution Versus 0.9% Sodium Chloride Solution on Serum Osmolality in Human Volunteers
Anesth Analg 1999 88: 999-1003. [Abstract] [Full Text]  

Implications: Large volumes of lactated Ringer's solution administered to healthy humans produced small transient changes in serum osmolality. Large volumes of sodium chloride did not change osmolality but resulted in lower pH.

Kota Soga, Hisae Fujita, Tomio Andoh, and Fukuichiro Okumura

Retinal Artery Air Embolism in Dogs: Fluorescein Angiographic Evaluation of Effects of Hypotension and Hemodilution
Anesth Analg 1999 88: 1004-1010. [Abstract] [Full Text]  

Implications: We evaluated the effects of blood pressure and hemodilution on the duration of retinal artery occlusion caused by air embolism by retinal fluorescein angiography. Hypotension prolonged and hemodilution shortened the duration of retinal artery occlusion caused by air embolism.

Athos J. Rassias, Charles A. S. Marrin, Janice Arruda, Patricia Kate Whalen, Michael Beach, and Mark P. Yeager

Insulin Infusion Improves Neutrophil Function in Diabetic Cardiac Surgery Patients
Anesth Analg 1999 88: 1011-1016. [Abstract] [Full Text]  

Implications: A continuous insulin infusion and glucose control during surgery improves white cell function in diabetic patients and may increase resistance to infection after surgery.

Andrea Szekely, Bernhard Heindl, Stefan Zahler, Peter F. Conzen, and Bernhard F. Becker

S(+)-Ketamine, but Not R(-)-Ketamine, Reduces Postischemic Adherence of Neutrophils in the Coronary System of Isolated Guinea Pig Hearts
Anesth Analg 1999 88: 1017-1024. [Abstract] [Full Text]  

Implications: In this study, we demonstrated stereoselective differences in the biologic action of the two ketamine isomers in an animal model of myocardial ischemia. Polymorphonuclear neutrophil adherence to the coronary vasculature after ischemia was inhibited by S(+)-ketamine, whereas R(-)-ketamine increased coronary vascular fluid leak.

Jose Eduardo Tanus-Santos, Heitor Moreno, Jr., Aldete Zappellini, and Gilberto de Nucci

Small-Dose Inhaled Nitric Oxide Attenuates Hemodynamic Changes After Pulmonary Air Embolism in Dogs
Anesth Analg 1999 88: 1025-1029. [Abstract] [Full Text]  

Implications: In this study, we evaluated the protective effects of inhaled nitric oxide in a pulmonary air embolism setting. Nitric oxide attenuated the hemodynamic changes induced by pulmonary air embolism without improving pulmonary oxygenation.

Satoki Inoue, Yukio Hayashi, Yoshihiko Ohnishi, Katsuro Kikumoto, Naoto Minamino, Kenji Kangawa, Hisayuki Matsuo, Hitoshi Furuya, and Masakazu Kuro

Cerebral Production of Adrenomedullin After Hypothermic Cardiopulmonary Bypass in Adult Cardiac Surgical Patients
Anesth Analg 1999 88: 1030-1035. [Abstract] [Full Text]  

Implications: Plasma adrenomedullin has been reported to increase in humans after cardiac surgery involving cardiopulmonary bypass. In this study, we demonstrated that cerebral adrenomedullin production may contribute to the increased plasma level of adrenomedullin after cardiopulmonary bypass.

PEDIATRIC ANESTHESIA:

Hannu Kokki, Kati Tuovinen, and Heikki Hendolin

The Effect of Intravenous Ketoprofen on Postoperative Epidural Sufentanil Analgesia in Children
Anesth Analg 1999 88: 1036-1041. [Abstract] [Full Text]  

Implications: We compared the effect of the IV nonsteroidal antiinflammatory drug ketoprofen versus placebo as adjuvants to epidural opioid analgesia with sufentanil. The continuous IV nonsteroidal antiinflammatory drug improved pain after major surgery in children receiving an epidural opioid. Although ketoprofen reduced epidural sufentanil requirements, the incidence of opioid-related adverse effects was not changed.

Zeev N. Kain, Shu Ming Wang, Linda C. Mayes, Lisa A. Caramico, and Maura B. Hofstadter

Distress During the Induction of Anesthesia and Postoperative Behavioral Outcomes
Anesth Analg 1999 88: 1042-1047. [Abstract] [Full Text]  

Implications: Anesthesiologists who care for children who are anxious during the induction of anesthesia should inform parents that these children have an increased likelihood of developing postoperative negative behavioral changes.

Shinji Kawahito, Hiroshi Kitahata, Katsuya Tanaka, Yukiko Ikeuchi, Hideyuki Kimura, Yoshiaki Hirose, and Shuzo Oshita

Intraoperative Management of a Pediatric Patient Undergoing Cardiac Tumor Resection with the Aid of Transesophageal and Epicardial Echocardiography (Case Report)
Anesth Analg 1999 88: 1048-1050. [Full Text]  

Martin Jöhr and Roberto Sossai

Colonic Puncture During Ilioinguinal Nerve Block in a Child (Case Report)
Anesth Analg 1999 88: 1051-1052. [Full Text]  

AMBULATORY ANESTHESIA:

Franklin Dexter, Alex Macario, Paul J. Manberg, and David A. Lubarsky

Computer Simulation to Determine How Rapid Anesthetic Recovery Protocols to Decrease the Time for Emergence or Increase the Phase I Postanesthesia Care Unit Bypass Rate Affect Staffing of an Ambulatory Surgery Center
Anesth Analg 1999 88: 1053-1063. [Abstract] [Full Text]  

Implications: Decreases in operating room and postanesthesia care unit labor costs resulting from faster emergence and phase I postanesthesia care unit bypass vary depending on the amount of routine overtime, how the staff are compensated, and how many patients are routinely anesthetized each day.

Dermot J. Kelly, Fergus Walsh, Gary S. Norman, and Anthony J. Cunningham

The Effects of Midazolam on Pure Tone Audiometry, Speech Audiometry, and Audiological Reaction Times in Human Volunteers
Anesth Analg 1999 88: 1064-1068. [Abstract] [Full Text]  

Implications: In this study, we demonstrate that sedation of healthy volunteers with the benzodiazepine midazolam, in the common clinical dosage, does not affect their hearing capability as measured by pure tone and speech audiometry. However, one's ability to react to auditory signals is impaired after midazolam, which may have implications for patients after day-case procedures.

Paul F. White and Dajun Song

New Criteria for Fast-Tracking After Outpatient Anesthesia: A Comparison with the Modified Aldrete's Scoring System (Brief Report)
Anesth Analg 1999 88: 1069-1072. [Full Text] En Espanol  

OBSTETRIC ANESTHESIA:

Mark C. Norris, Denise Ferrenbach, Hiroko Dalman, Steven T. Fogel, Susan Borrenpohl, William Hoppe, and Alicia Riley

Does Epinephrine Improve the Diagnostic Accuracy of Aspiration During Labor Epidural Analgesia?
Anesth Analg 1999 88: 1073-1076. [Abstract] [Full Text] En Espanol  

Implications: Epidural catheters may enter a blood vessel. Many clinicians use epinephrine to detect these catheters. Because aspiration alone detects almost all IV multiorifice catheters in laboring women, a subsequent epinephrine test dose may be unnecessary.

Shusee Visalyaputra, Jariya Lertakyamanee, Nuchsaroch Pethpaisit, Pradit Somprakit, Sudta Parakkamodom, and Plida Suwanapeum

Intraperitoneal Lidocaine Decreases Intraoperative Pain During Postpartum Tubal Ligation
Anesth Analg 1999 88: 1077-1080. [Abstract] [Full Text]  

Implications: Pain relief was inadequate in patients undergoing postpartum tubal ligation under local anesthesia, even after the administration of IM morphine. Instilling lidocaine into the abdominal cavity, however, effectively decreased intraoperative pain in these patients.

Christopher M. Viscomi, Louis J. Ptacek, and Donald Dudley

Anesthetic Management of Familial Hypokalemic Periodic Paralysis During Parturition (Case Report)
Anesth Analg 1999 88: 1081-1082. [Full Text]  

Alan Wang and Raymond S. Sinatra

Epidural Anesthesia for Cesarean Section in a Patient with von Hippel-Lindau Disease and Multiple Sclerosis (Case Report)
Anesth Analg 1999 88: 1083-1084. [Full Text]  

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

Alex Macario, Matthew Weinger, P. Truong, and M. Lee

Which Clinical Anesthesia Outcomes Are Both Common and Important to Avoid? The Perspective of a Panel of Expert Anesthesiologists
Anesth Analg 1999 88: 1085-1091. [Abstract] [Full Text] En Espanol  

Implications: Expert anesthesiologists reached a consensus on which low-morbidity clinical outcomes are common and important to the patient. The outcomes identified may be reasonable choices to be monitored as part of ambulatory anesthesia clinical quality improvement efforts.

David L. Reich, Suzan Uysal, Carol A. Bodian, Suzanne Gabriele, Mary Hibbard, Wayne Gordon, Martin Sliwinki, and Richard D. Kayne

The Relationship of Cognitive, Personality, and Academic Measures to Anesthesiology Resident Clinical Performance
Anesth Analg 1999 88: 1092-1100. [Abstract] [Full Text]  

Implications: Early academic test performance and certain cognitive and personality tests were associated with the clinical performance of anesthesiology residents. The predictive value of these findings should be confirmed in a prospective, multicenter study.

NEUROSURGICAL ANESTHESIA:

Pirjo H. Manninen, Sharon J. Burke, Richard Wennberg, Andres M. Lozano, and Hossam El Beheiry

Intraoperative Localization of an Epileptogenic Focus with Alfentanil and Fentanyl
Anesth Analg 1999 88: 1101-1106. [Abstract] [Full Text]  

Implications: Both alfentanil and fentanyl activate epileptiform activity in patients with temporal lobe epilepsy. These opioids can be used to assist in the localization of the epileptogenic focus during surgery.

CRITICAL CARE AND TRAUMA:

Roberto C. Valenzuela and David A. Rosen

Topical Lidocaine-Prilocaine Cream (EMLA) for Thoracostomy Tube Removal
Anesth Analg 1999 88: 1107-1108. [Abstract] [Full Text]  

Implications: Postoperatively applying a topical anesthetic cream onto chest tube sites of chest surgery patients 3 h before chest tube removal is more effective than IV morphine in blunting pain response.

REGIONAL ANESTHESIA AND PAIN MANAGEMENT:

Salvatore Sia and Antonella Lepri

Clonidine Administered as an Axillary Block Does Not Affect Postoperative Pain When Given as the Sole Analgesic
Anesth Analg 1999 88: 1109-1112. [Abstract] [Full Text]  

Implications: Used as the sole analgesic, clonidine produces analgesia after epidural, intrathecal, and intraarticular administration. It also prolongs the analgesic effect of brachial plexus block when mixed with local anesthetics. In this study, the administration of clonidine 150 µg alone into the brachial plexus sheath did not produce postoperative analgesia.

Philip B. Cornish, Lazar J. Greenfield, Michael O'Reilly, and Lora Allan

Indirect Versus Direct Measurement of Brachial Plexus Depth
Anesth Analg 1999 88: 1113-1116. [Abstract] [Full Text]  

Implications: In this study, we sought to minimize the risk of pneumothorax when approaching the brachial plexus through the supraclavicular fossa by developing a technique that could accurately estimate the depth of the nerves, within a range that is well clear of the lung.

Lisa M. Sullivan, Christian W. Hönemann, John A. Arledge, and Marcel E. Durieux

Synergistic Inhibition of Lysophosphatidic Acid Signaling by Charged and Uncharged Local Anesthetics
Anesth Analg 1999 88: 1117-1124. [Abstract] [Full Text]  

Implications: Lysophosphatidic acid may play a role in wound healing, and its signaling is inhibited by local anesthetics. We identified the membrane receptor as the local anesthetic site of action and showed that charged (QX314) and uncharged (benzocaine) local anesthetics inhibit lysophosphatidic acid signaling synergistically, which can be explained by the presence of different binding sites.

Sean R. Hall, Louie Wang, Brian Milne, and Christopher Loomis

Activation of the Rostral Ventrolateral Medulla in an Acute Anesthetized Rodent Strychnine Model of Allodynia
Anesth Analg 1999 88: 1125-1130. [Abstract] [Full Text]  

Implications: Neural injury-associated pain, as manifested by allodynia, is resistant to conventional treatment. In a rat model of allodynia, we demonstrated activation of the brain region involved in sympathetic control. Innovative therapies that target this region may be successful in managing this debilitating condition.

U. Mattsson, J. Cassuto, M. Jontell, A. Jönsson, R. Sinclair, and P. Tarnow

Digital Image Analysis of Erythema Development After Experimental Thermal Injury to Human Skin: Effect of Postburn Topical Local Anesthetics (EMLA®)
Anesth Analg 1999 88: 1131-1136. [Abstract] [Full Text]  

Implications: Burn injury constitutes a serious type of tissue damage that activates inflammatory mechanisms, often causing pain, disfiguration, or malfunction. We treated burns using an anesthetic cream and demonstrated a reduction in burn-induced inflammation by using computer-based color image analysis.

K. Elaine Tighe, Andrew M. Webb, and Gregory J. Hobbs

Persistently High Plasma Morphine-6-Glucuronide Levels Despite Decreased Hourly Patient-Controlled Analgesia Morphine Use After Single-Dose Diclofenac: Potential for Opioid-Related Toxicity
Anesth Analg 1999 88: 1137-1142. [Abstract] [Full Text]  

Implications: Plasma concentrations of morphine, morphine-6-glucuronide, and diclofenac were measured postoperatively after a single dose of rectal diclofenac 100 mg was added to morphine patient-controlled analgesia. Peak analgesia occurred 309 min and respiratory depression 197 min after diclofenac administration. Morphine consumption had decreased by 20%, but concentrations of the active metabolite morphine-6-glucuronide were unchanged. Vigilance is recommended in patients receiving patient-controlled analgesia opioids and nonsteroidal antiinflammatory drugs.

Elisabet U. M. Nyström, James E. Heavner, and Charles W. Buffington

Blood Pressure Is Maintained Despite Profound Myocardial Depression During Acute Bupivacaine Overdose in Pigs
Anesth Analg 1999 88: 1143-1148. [Abstract] [Full Text]  

Implications: The increase in vascular resistance that accompanies acute bupivacaine overdose maintains blood pressure but masks severe myocardial depression.

GENERAL ARTICLES:

Debra J. Janiszewski, Jeffrey L. Galinkin, P. Allan Klock, Dennis W. Coalson, Helene Pardo, and James P. Zacny

The Effects of Subanesthetic Concentrations of Sevoflurane and Nitrous Oxide, Alone and in Combination, on Analgesia, Mood, and Psychomotor Performance in Healthy Volunteers
Anesth Analg 1999 88: 1149-1154. [Abstract] [Full Text]  

Implications: Healthy volunteers inhaled subanesthetic concentrations of sevoflurane and nitrous oxide. Sevoflurane made nitrous oxide less effective as an analgesic, and nitrous oxide made sevoflurane less effective as a sedative. The two drugs may work at cross purposes on different end points of anesthesia.

Gunilla Islander and Eva Ranklev Twetman

Comparison Between the European and North American Protocols for Diagnosis of Malignant Hyperthermia Susceptibility in Humans
Anesth Analg 1999 88: 1155-1160. [Abstract] [Full Text]  

Implications: We compared the two major protocols for investigating malignant hyperthermia susceptibility. There was 87% accordance in diagnostic outcome. The diverging outcomes were seen in individuals with less reproducible test results near the cutoff limits. In scientific studies, such results should be considered as unknown.

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

Polyhalogenated Methyl Ethyl Ethers: Solubilities and Anesthetic Properties
Anesth Analg 1999 88: 1161-1167. [Abstract] [Full Text]  

Implications: The several potent, inhaled, polyhalogenated methyl ethyl ether anesthetics released for clinical use in the past four decades seem to have specific useful characteristics that set them apart from other methyl ethyl ethers. Properties of this class of compounds have implications for the future development of anesthetics and the mechanisms by which they act.

Helge Eilers, Christoph H. Kindler, and Philip E. Bickler

Different Effects of Volatile Anesthetics and Polyhalogenated Alkanes on Depolarization-Evoked Glutamate Release in Rat Cortical Brain Slices
Anesth Analg 1999 88: 1168-1174. [Abstract] [Full Text]  

Implications: The volatile anesthetics isoflurane and enflurane reduce depolarization-evoked glutamate release in rat brain slices. The transitional compound 1,1,2-trichlorotrifluoroethane reduces glutamate release to a much lesser extent, and the nonanesthetic 1,2-dichlorohexafluorocyclobutane does not reduce glutamate release. These findings support the hypothesis that the modulation of excitatory neurotransmission might be responsible, in part, for in vivo anesthetic action.

J. Boldt, W. Maleck, and K. P. Koetter

Which Countries Publish in Important Anesthesia and Critical Care Journals?
Anesth Analg 1999 88: 1175-1180. [Abstract] [Full Text] En Espanol  

Implications: In a MEDLINE-based analysis, we examined the number of publications in important anesthesia, pain, critical care, and emergency medicine journals (n = 30) for the years 1996 and 1997 and analyzed these with regard to national origin. The United States was by far the most active nation in this medical area (4283 articles [40.2%]), followed by the United Kingdom (13.3%). With regard to publications per million inhabitants, small highly industrialized nations contributed overproportionally to publications in this area.

CASE REPORTS:

Atsushi Seto, Kazuyoshi Aoyama, Ichiro Takenaka, and Tatsuo Kadoya

Ventilation Difficulties Through the Intubating Laryngeal Mask
Anesth Analg 1999 88: 1181-1182. [Full Text]  

Michele M. Locke, Burkhard F. Spiekermann, and George F. Rich

Trigeminovagal Reflex During Repair of a Nasal Fracture Under General Anesthesia
Anesth Analg 1999 88: 1183-1184. [Full Text]  

Monica Botero and F. Kayser Enneking

Reversal of Prolonged Unconsciousness by Naloxone After an Intravascular Injection of a Local Anesthetic and Clonidine
Anesth Analg 1999 88: 1185-1186. [Full Text]  

LETTERS TO THE EDITOR:

Jürgen T. Lutz, A.-Stephane Lambert, and Kathryn Rouine-Rapp

Damage to Pilot Cuff Tubing During Intraoperative Transesophageal Echocardiography
Anesth Analg 1999 88: 1187. [Full Text]  

P. R. Torralva, Alex Macario, and John G. Brock-Utne

Another Use of a Bronchoscopic Swivel Adapter
Anesth Analg 1999 88: 1187-1188. [Full Text]  

Heitor Moreno, Jr. and Jose Eduardo Tanus-Santos

Nitric Oxide Inhalation During Massive Pulmonary Embolism
Anesth Analg 1999 88: 1188. [Full Text]  

John M. Freedman and Mark P. Rudow

Bilateral Buttock and Leg Pain After Lidocaine Epidural Anesthesia
Anesth Analg 1999 88: 1188. [Full Text]  

Evan J. Goodman, Ida M. Hudson, and Allen Douglas

Desflurane Vaporizer Uses Minimal Electricity
Anesth Analg 1999 88: 1189. [Full Text]  

Makoto Tanaka, Toshiaki Nishikawa, Sibylle A. Kozek-Langenecker, and Margot Semsroth

Effective Dose of Isoproterenol-Containing Test Dose in Anesthetized Children • Response
Anesth Analg 1999 88: 1189-1190. [Full Text]  

Sharon Abramovitz, Yaakov Beilin, Howard H. Bernstein, and M. A. E. Marcus

Isoproterenol and Epidural Analgesia • Response
Anesth Analg 1999 88: 1190. [Full Text]  

Takehiko Adachi, Masatoshi Fukumoto, Nobuo Uetsuki, Ouki Yasui, and Michihiro Hayashi

Suspected Severe Methemoglobinemia Caused by Topical Application of an Ointment Containing Benzocaine Around the Enterostomy
Anesth Analg 1999 88: 1190-1191. [Full Text]  

T. J. Gan, D. A. Lubarsky, Mehernoor F. Watcha, and Paul F. White

Cost Effectiveness Ratio: An Often Misunderstood Term • Response
Anesth Analg 1999 88: 1191-1192. [Full Text]  

Seiji Ishikawa, Michael Zaugg, Eliana Lucchinetti, and Andreas Zollinger

Is Continuous Intraarterial Blood Gas Monitoring Reliable During One-Lung Ventilation? • Response
Anesth Analg 1999 88: 1192-1193. [Full Text]  

James E. Heavner, Per Rosenberg, and Alan A. Artru

Propofol for Lidocaine-Induced Seizures • Response
Anesth Analg 1999 88: 1193. [Full Text]  

Sheila E. Cohen and Franklin Dexter

Statistical Analysis of Total Labor Pain Using the Visual Analog Scale and Application to Studies of Analgesic Effectiveness During Childbirth • Response
Anesth Analg 1999 88: 1193-1194. [Full Text]  

Serge M. Broka, Pascale A. Gourdange, and Kurt L. Joucken

Sevoflurane and Desflurane Confusion
Anesth Analg 1999 88: 1194. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

Rebecca A. Barnett

The MGH Board Review of Anesthesiology. 5th ed. • Books and Multimedia Received
Anesth Analg 1999 88: 1195. [Full Text]  

To see an article, click its [Full Text] link. To review many abstracts, check the boxes to the left of the titles you want, and click the 'Get All Checked Abstract(s)' button. To see one abstract at a time, click its [Abstract] link.