EDITORIALS:

Martin R. Tramèr

How Can We Cope with the Internet?
Anesth Analg 1999 89: 271. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Federico Bilotta, Laura Fiorani, Eugenio Lendaro, Sergio Picardo, Italia La Rosa, Giovanni Rosa, and Francesco Fedele

Pulmonary Transit of Sonicated Albumin Microbubbles During Controlled Mechanical Ventilation: A Transthoracic Echocardiographic Study
Anesth Analg 1999 89: 273. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: During intermittent positive pressure ventilation, IV sonicated albumin microbubbles pass through the lungs poorly and inefficiently opacify the left ventricle compared with the effects observed during spontaneous ventilation.

Claude Mann, Gilles Boccara, Yvan Pouzeratte, Jacob Eliet, Claudine Serradeil-Le Gal, Christine Vergnes, Daniel G. Bichet, Gilles Guillon, Jean M. Fabre, and Pascal Colson

The Relationship Among Carbon Dioxide Pneumoperitoneum, Vasopressin Release, and Hemodynamic Changes
Anesth Analg 1999 89: 278. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Intraabdominal insufflation of CO2 is associated with hemodynamic and hormonal changes. Investigating CO2 and argon-insufflated pigs and using a vasopressin antagonist, we found that CO2 insufflation released vasopressin, which, in turn, induced hemodynamic perturbances.

Makoto Tanaka and Toshiaki Nishikawa

Sevoflurane Speeds Recovery of Baroreflex Control of Heart Rate After Minor Surgical Procedures Compared with Isoflurane
Anesth Analg 1999 89: 284. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Arterial baroreflex function is an important neural control system for maintaining cardiovascular stability. We found that baroreflex control of heart rate due to hypertensive perturbation returned to the preanesthetic level more quickly after sevoflurane than after isoflurane anesthesia.

Jerrold H. Levy, Melvin Pitts, Apostolos Thanopoulos, Fania Szlam, Robert Bastian, and John Kim

The Effects of Rapacuronium on Histamine Release and Hemodynamics in Adult Patients Undergoing General Anesthesia
Anesth Analg 1999 89: 290. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Rapacuronium, a new steroidal-derived muscle relaxant, may release histamine and produce slight changes in blood pressure and heart rate after administration.

Kyoko Oshita, Toshiharu Az-ma, Yasuhiro Osawa, and Osafumi Yuge

Quantitative Measurement of Thromboelastography as a Function of Platelet Count (Technical Communication)
Anesth Analg 1999 89: 296. [Full Text] [PDF] [Request Permissions]  

Masahiro Ide, Hiroyuki Ishida, and Hiroko Kato

Early Postoperative Stroke in a Patient with an Atrial Septal Aneurysm (Case Report)
Anesth Analg 1999 89: 300. [Full Text] [PDF] [Request Permissions]  

Marc Moutafis, Nicolas Dalibon, Arlette Colchen, and Marc Fischler

Improving Oxygenation During Bronchopulmonary Lavage Using Nitric Oxide Inhalation and Almitrine Infusion (Case Report)
Anesth Analg 1999 89: 302. [Full Text] [PDF] [Request Permissions]  

Gilbert J. Fanciullo, John F. Robb, Robert J. Rose, and John H. Sanders, Jr.

Spinal Cord Stimulation for Intractable Angina Pectoris (Case Report)
Anesth Analg 1999 89: 305. [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Pardeep Gill and Paul Sadler

Uvula Hematoma: An Unusual Complication of Streptokinase (Case Report)
Anesth Analg 1999 89: 307. [Full Text] [PDF] [Request Permissions]  

Jeffrey D. Swenson and David A. Bull

Intraoperative Diagnosis and Treatment of Pleural Effusion Based on Transesophageal Echocardiographic Findings (Case Report)
Anesth Analg 1999 89: 309. [Full Text] [PDF] [Request Permissions]  

AMBULATORY ANESTHESIA:

Rui Sun, Mehernoor F. Watcha, Paul F. White, Gary D. Skrivanek, James D. Griffin, Louis Stool, and Mark T. Murphy

A Cost Comparison of Methohexital and Propofol for Ambulatory Anesthesia
Anesth Analg 1999 89: 311. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Using methohexital as an alternative to propofol for the induction of anesthesia for ambulatory surgery seems to reduce drug costs. When fresh gas flow rates <=1 L/min are used, the combination of methohexital for the induction and desflurane for maintenance may be the most cost-effective general anesthetic technique for ambulatory surgery.

Kere Frey, Radha Sukhani, Julius Pawlowski, Ana Lucia Pappas, Marianna Mikat-Stevens, and Stephen Slogoff

Propofol Versus Propofol-Ketamine Sedation for Retrobulbar Nerve Block: Comparison of Sedation Quality, Intraocular Pressure Changes, and Recovery Profiles
Anesth Analg 1999 89: 317. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Anesthesiologists frequently perform retrobulbar blocks while simultaneously providing sedation. Using ketamine to supplement propofol sedation provided a faster onset and improved the quality of sedation during the retrobulbar block procedure.

PEDIATRIC ANESTHESIA:

Eva M. Gruber, Richard A. Jonas, Jane W. Newburger, David Zurakowski, Dolly D. Hansen, and Peter C. Laussen

The Effect of Hematocrit on Cerebral Blood Flow Velocity in Neonates and Infants Undergoing Deep Hypothermic Cardiopulmonary Bypass
Anesth Analg 1999 89: 322. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: There is an inverse relation between hematocrit and cerebral blood flow velocity during deep hypothermic cardiopulmonary bypass in neonates and infants. Further studies correlating Hct and cerebral blood flow velocity with cerebral metabolic rate and neurologic outcome are necessary to determine the optimal Hct during deep hypothermic cardiopulmonary bypass.

Susan G. Strauss, Anne M. Lynn, Susan L. Bratton, and Mary Kay Nespeca

Ventilatory Response to CO₂ in Children with Obstructive Sleep Apnea from Adenotonsillar Hypertrophy
Anesth Analg 1999 89: 328. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: Children with obstructive sleep apnea undergoing adenotonsillar surgery are at risk of postoperative respiratory compromise. We found that patients with a clinical history suggesting obstructive sleep apnea have a diminished ventilatory response to CO2 rebreathing, compared with controls.

Joan C. Bevan, Linda Collins, Carolyn Fowler, Raymond Kahwaji, Harold D. Rosen, Michael F. Smith, Louis deV Scheepers, Catherine A. Stephenson, and David R. Bevan

Early and Late Reversal of Rocuronium and Vecuronium with Neostigmine in Adults and Children
Anesth Analg 1999 89: 333. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: These results suggest that reversal of intense rocuronium or vecuronium neuromuscular blockade need not be delayed until return of appreciable neuromuscular function has been demonstrated. Although spontaneous and neostigmine-assisted recovery is more rapid in children than in adults, in neither is return of function as rapid as after succinylcholine administration.

Mahir Uslu, Hermann Mellinghoff, and Christoph Diefenbach

Mivacurium for Muscle Relaxation in a Child with Duchenne's Muscular Dystrophy (Case Report)
Anesth Analg 1999 89: 340. [Full Text] [PDF] [Request Permissions]  

Richard C. Leech, Andrew D. J. Watts, Nigel D. Heaton, and Dennis R. Potter

Intraoperative Cardiac Tamponade After Central Venous Cannulation in an Infant During Orthotopic Liver Transplantation (Case Report)
Anesth Analg 1999 89: 342. [Full Text] [PDF] [Request Permissions]  

CRITICAL CARE AND TRAUMA:

Catherine M. Pastor and Peter M. Suter

Hepatic Hemodynamics and Cell Functions in Human and Experimental Sepsis (Review Article)
Anesth Analg 1999 89: 344. [Full Text] [PDF] [Request Permissions]  

Stephen O. Heard, Karen Longtine, Ildiko Toth, Juan Carlos Puyana, Bruce Potenza, and Nicholas Smyrnios

The Influence of Liposome-Encapsulated Prostaglandin E₁ on Hydrogen Peroxide Concentrations in the Exhaled Breath of Patients with the Acute Respiratory Distress Syndrome (Review Article)
Anesth Analg 1999 89: 353. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: White blood cells (WBC) are thought to be part of the cause of the acute respiratory distress syndrome, a lung disease. WBC in the lung produce hydrogen peroxide, which is exhaled. Liposomal PGE1 inhibits WBC function but was found to have no effect in decreasing exhaled hydrogen peroxide in patients with the acute respiratory distress syndrome.

NEUROSURGICAL ANESTHESIA:

Gerard F. A. Jansen, Bas H. van Praagh, Mohan B. Kedaria, and Joseph A. Odoom

Jugular Bulb Oxygen Saturation During Propofol and Isoflurane/Nitrous Oxide Anesthesia in Patients Undergoing Brain Tumor Surgery
Anesth Analg 1999 89: 358. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: During propofol anesthesia at normoventilation, 50% of brain tumor patients showed signs suggesting cerebral hypoperfusion, but this could not be demonstrated during isoflurane/nitrous oxide anesthesia. During PaCO2 manipulations, consecutive measurements of the cerebral blood flow velocity may be inadequate to assess cerebral oxygenation.

Frank Mielck, Heidrun Stephan, Andreas Weyland, and Hans Sonntag

Effects of One Minimum Alveolar Anesthetic Concentration Sevoflurane on Cerebral Metabolism, Blood Flow, and CO₂ Reactivity in Cardiac Patients
Anesth Analg 1999 89: 364. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We used a modified Kety-Schmidt saturation technique to investigate the effects of 1 minimum alveolar anesthetic concentration (MAC) sevoflurane on cerebral blood flow, metabolism, and CO2 reactivity in cardiac patients. We found that the global cerebral blood flow and global cerebral metabolic rate of oxygen remained coupled and that cerebrovascular CO2 reactivity is not impaired by the administration of 1 MAC sevoflurane.

Hiroto Ohata, Hiroki Iida, Shuji Dohi, and Yukinaga Watanabe

Intravenous Dexmedetomidine Inhibits Cerebrovascular Dilation Induced by Isoflurane and Sevoflurane in Dogs
Anesth Analg 1999 89: 370. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The systemic administration of dexmedetomidine attenuates the dilation of cerebral vessels induced by isoflurane and sevoflurane in pentobarbital-anesthetized dogs. This interaction was not dependent on the clinical (0.5-2.0 {micro}g/kg) dose of dexmedetomidine and was not different between isoflurane and sevoflurane anesthesia.

OBSTETRIC ANESTHESIA:

Norman L. Herman, Kue C. Choi, Paul J. Affleck, Randy Calicott, Reid Brackin, Anu Singhal, Alyson Andreasen, Farida Gadalla, Jill Fong, Matthew C. Gomillion, Jinny K. Hartman, Howard D. Koff, Sung Hee Rhim Lee, and Tama K. Van Decar

Analgesia, Pruritus, and Ventilation Exhibit a Dose-Response Relationship in Parturients Receiving Intrathecal Fentanyl During Labor
Anesth Analg 1999 89: 378. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Intrathecal fentanyl induces rapid and satisfying dose-dependent analgesia in early labor; however, it also produces dose-related decreases in ventilation in the absence of overt somnolence.

REGIONAL ANESTHESIA AND PAIN MANAGEMENT:

Juraj Sprung, Denis L. Bourke, Jeffrey Grass, Jeffrey Hammel, Edward Mascha, Padmini Thomas, and Igor Tubin

Predicting the Difficult Neuraxial Block: A Prospective Study
Anesth Analg 1999 89: 384. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We studied a number of factors, including equipment, technique, and patient characteristics, that may indicate the ease or difficulty of performing neuraxial (spinal and epidural) blocks. Of these factors, only patient characteristics had significant predictive value. We found that an examination of the patient's back for the quality of landmarks and obvious anatomical deformity better predicts the ease or difficulty of neuraxial block than does body habitus.

James R. Hebl, Terese T. Horlocker, Robert C. Chantigian, and Darrell R. Schroeder

Epidural Anesthesia and Analgesia Are Not Impaired After Dural Puncture With or Without Epidural Blood Patch
Anesth Analg 1999 89: 390. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Patients with postdural puncture headache should not be denied the benefits of an epidural blood patch because of concerns about the impairment of subsequent epidural anesthetics. The success rate of subsequent epidural anesthesia and analgesia in patients who have undergone dural puncture with or without epidural blood patch is similar to that of patients who have undergone two prior epidural anesthetics.

Sandra Kampe, Christoph Weigand, Jost Kaufmann, Markus Klimek, Dietmar Pierre König, and John Lynch

Postoperative Analgesia with No Motor Block by Continuous Epidural Infusion of Ropivacaine 0.1% and Sufentanil After Total Hip Replacement
Anesth Analg 1999 89: 395. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This is the first randomized study comparing the efficacy of the epidural combination of ropivacaine 0.1% and sufentanil 1 {micro}g/mL versus plain ropivacaine 0.1% in treating pain after hip replacement. We found that ropivacaine 0.1% and sufentanil 1 {micro}g/mL led to a sixfold reduction in opioid requirements after total hip replacement by producing a negligible motor block.

Duncan J. Henderson, Brian S. Withington, John A. Wilson, and Lachlan M. M. Morrison

Perioperative Dextromethorphan Reduces Postoperative Pain After Hysterectomy
Anesth Analg 1999 89: 399. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Patients given dextromethorphan before and after surgery had a significant reduction in some pain scores at rest, but not on movement. There was a trend to lower morphine requirements in the first 24 h. Over the next 48 h, oral analgesic usage was significantly reduced.

Hartmut Buerkle, Esther Pogatzki, Matthias Pauser, Carsten Bantel, Gerd Brodner, Thomas Möllhoff, and Hugo Van Aken

Experimental Arthritis in the Rat Does Not Alter the Analgesic Potency of Intrathecal or Intraarticular Morphine
Anesth Analg 1999 89: 403. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In this animal study, we showed that the administration of morphine modulates thermal and mechanical antinociception at central and peripheral sites in inflammatory pain.

Helen L. Keates, Tess Cramond, and Maree T. Smith

Intraarticular and Periarticular Opioid Binding in Inflamed Tissue in Experimental Canine Arthritis
Anesth Analg 1999 89: 409. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The high density of opioid binding sites found in inflamed canine joint tissue supports the clinical use of intraarticular opioids in the treatment of postoperative and chronic inflammatory joint pain.

Noritaka Imamachi, Yoji Saito, Kaoru Hara, Shinichi Sakura, and Yoshihiro Kosaka

The Non-NMDA Glutamate Receptor Antagonist CNQX Augments Lidocaine Antinociception Through a Spinal Action in Rats
Anesth Analg 1999 89: 416. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We investigated the antinociceptive effects of 6-cyano-7-nitroquinoxaline-2,3-dione and its interaction with lidocaine at the spinal level in rats. Intrathecal 6-cyano-7-nitroquinoxaline-2,3-dione produced both somatic and visceral antinociception, and its coadministration with lidocaine showed synergistic antinociceptive effects.

Kaoru Hara, Yoji Saito, Yumiko Kirihara, Yuko Yamada, Shinichi Sakura, and Yoshihiro Kosaka

The Interaction of Antinociceptive Effects of Morphine and GABA Receptor Agonists Within the Rat Spinal Cord
Anesth Analg 1999 89: 422. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We examined the antinociceptive interaction between morphine and muscimol or baclofen at the spinal level in rats. Intrathecal muscimol or baclofen potentiated both somatic and visceral antinociceptive effects of morphine.

R. Pöyhiä, M. Xu, V. K. Kontinen, S. Paananen, and E. Kalso

Systemic Physostigmine Shows Antiallodynic Effects in Neuropathic Rats
Anesth Analg 1999 89: 428. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Physostigmine has different effects on allodynia and nociception, which suggests that different cholinergic (muscarinic) mechanisms may be involved in neuropathic and nociceptive pain.

Myung Ha Yoon and Tony L. Yaksh

The Effect of Intrathecal Gabapentin on Pain Behavior and Hemodynamics on the Formalin Test in the Rat
Anesth Analg 1999 89: 434. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: After tissue injury, there is an enhanced pain behavior and cardiovascular response, representing a facilitated state of spinal processing. Spinally delivered gabapentin had no evident effect on resting heart rate or blood pressure, but it attenuated the enhanced pain behavior and cardiovascular response otherwise produced by injury.

Robert Greif, Thomas Wasinger, Kurt Reiter, Michael Chwala, and Julius Neumark

Pleural Bupivacaine for Pain Treatment After Nephrectomy
Anesth Analg 1999 89: 440. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We conclude that pleural analgesia significantly prolongs the time until postoperative opioid was first requested and halves the total required dose. These data indicate that pleural analgesia is effective and provides a significant opioid-sparing effect.

Frédéric Adam, Maurice Libier, Thierry Oszustowicz, Daniel Lefebvre, Jacqueline Beal, and Jacques Meynadier

Preoperative Small-Dose Ketamine Has No Preemptive Analgesic Effect in Patients Undergoing Total Mastectomy
Anesth Analg 1999 89: 444. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We administered the same small dose of ketamine before or after surgery. The preoperative administration of 0.15 mg/kg ketamine in patients undergoing total mastectomy did not elicit a preemptive analgesic effect. Ketamine given at closure reduced the patient-controlled analgesia morphine requirement in the first 2 h after surgery.

R. J. Storella, Y. Shi, D. M. O'Connor, G. H. Pharo, J. T. Abrams, and J. Levitt

Relief of Chronic Pain May Be Accompanied by an Increase in a Measure of Heart Rate Variability (Technical Communication)
Anesth Analg 1999 89: 448. [Full Text] [PDF] [Request Permissions]  

Andrew A. Konen, Girish P. Joshi, and Cindy K. Kelly

Epidural Analgesia for Pain Relief After Scoliosis Surgery in a Patient with Rett's Syndrome (Case Report)
Anesth Analg 1999 89: 451. [Full Text] [PDF] [Request Permissions]  

GENERAL ARTICLES:

Daqing Ma, Mihir K. Chakrabarti, and James G. Whitwam

The Combined Effects of Sevoflurane and Remifentanil on Central Respiratory Activity and Nociceptive Cardiovascular Responses in Anesthetized Rabbits
Anesth Analg 1999 89: 453. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Although sevoflurane caused relatively greater depression of nociceptive cardiovascular responses compared with phrenic nerve activity, remifentanil either alone or combined with sevoflurane caused a much greater depression of phrenic nerve activity than cardioaccelerator and pressor responses. This could imply that, during major surgery using anesthesia combining sevoflurane and remifentanil, spontaneous ventilation is not acceptable, and depression of the resting circulation may be much greater than anticipated.

Takehiko Ikeda, Makoto Ozaki, Daniel I. Sessler, Tomiei Kazama, Kazuyuki Ikeda, and Shigehito Sato

Intraoperative Phenylephrine Infusion Decreases the Magnitude of Redistribution Hypothermia
Anesth Analg 1999 89: 462. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Core hypothermia immediately after induction of general anesthesia results largely from core-to-peripheral redistribution of body heat. Core temperature reduction during the first hour of anesthesia decreased less in patients given phenylephrine than in untreated controls. These data suggest that maintaining precapillary vasoconstriction possibly reduces the magnitude of redistribution hypothermia.

Olivier Langeron, Catherine Coirault, Sylvia Fratea, Gilles Orliaguet, Pierre Coriat, and Bruno Riou

The Effects of Dantrolene on the Contraction, Relaxation, and Energetics of the Diaphragm Muscle
Anesth Analg 1999 89: 466. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Dantrolene induced a significant and concentration-dependent negative inotropic effect on diaphragm muscle but did not modify isotonic relaxation, which suggests no alteration of the calcium reuptake by the sarcoplasmic reticulum; up to 10-5 M dantrolene did not alter isometric relaxation, i.e., myofilament calcium sensitivity. Dantrolene did not modify the energetics of diaphragm muscle.

Diana G. McGregor, David H. Senjem, and Richard I. Mazze

Trace Nitrous Oxide Levels in the Postanesthesia Care Unit
Anesth Analg 1999 89: 472. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Our results indicate that the levels of nitrous oxide in postanesthesia care units with well maintained, modern ventilation systems are very low. Previous research suggests that the health of workers exposed to these levels should not be adversely affected.

Yoshitaka Fujii, Yuhji Saitoh, Hiroyoshi Tanaka, and Hidenori Toyooka

Comparison of Ramosetron and Granisetron for Preventing Postoperative Nausea and Vomiting After Gynecologic Surgery
Anesth Analg 1999 89: 476. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We compared the efficacy of granisetron and ramosetron for preventing postoperative nausea and vomiting in major gynecologic surgery. Prophylactic therapy with ramosetron was more effective than granisetron for preventing postoperative nausea and vomiting 24-48 h after anesthesia.

Philippe Juvin, Christine Clerici, Alain Loiseau, Jean Mantz, Michel Aubier, Gérard Friedlander, and Jean-Marie Desmonts

Halothane Stimulates a Na+H+ Antiporter Involved in the Regulation of Intracellular pH in Alveolar Epithelial Cells
Anesth Analg 1999 89: 480. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In vitro, halothane induces an intracellular alkalinization of pneumocytes II via the activation of a Na+H+ antiporter. Because acidification of these cells has been associated with alterations in the alveolar epithelial barrier, halothane might exhibit some protective effect in clinical situations, such as aspiration pneumonia.

Eiji Masaki and Ichiro Kondo

Methylene Blue, a Soluble Guanylyl Cyclase Inhibitor, Reduces the Sevoflurane Minimum Alveolar Anesthetic Concentration and Decreases the Brain Cyclic Guanosine Monophosphate Content in Rats
Anesth Analg 1999 89: 484. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Because the nitric oxide-cyclic guanosine monophosphate signal pathway mediates nociception and the site of action of halogenated volatile anesthetics is uncertain, we examined the possible involvement of inhibition of soluble guanylyl cyclase in the anesthetic mechanism. The inhibitory effect of sevoflurane on soluble guanylyl cyclase could be one of sites of this anesthetic.

Yann Péréon, Jean-Marc Bernard, Sylvie Nguyen The Tich, Robert Genet, Florence Petitfaux, and Pierre Guihéneuc

The Effects of Desflurane on the Nervous System: From Spinal Cord to Muscles
Anesth Analg 1999 89: 490. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We used neurophysiological techniques to assess the effects of desflurane on spinal cord conduction and excitability, motor and sensory peripheral nerve conduction, and neuromuscular transmission. Our data demonstrate that desflurane acts preferentially at the level of the spinal motoneuron, providing useful information for neurophysiological monitoring and immobilization during surgery and for minimum alveolar anesthetic concentration definition.

Henry P. Frizelle, Denis C. Moriarty, and John J. O'Connor

The Combined Effects of Halothane and Lamotrigine on Excitatory Postsynaptic Potentials and Use-Dependent Block in the Rat Dentate Gyrus In Vitro
Anesth Analg 1999 89: 496. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The general and local anesthetic drugs halothane and lamotrigine act at both the glutamate receptor and the Na+ channels and, in our experiments, independently inhibited synaptic transmission at low-frequency stimulation. Although halothane potentiated control use-dependent block, lamotrigine had no effect. Halothane attenuated the inhibitory dose-dependent effects of lamotrigine on synaptic transmission at a low frequency. The clinical importance of this interaction in patients presenting for anesthesia remains unanswered.

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

John B. Pollard and Leslie Olson

Early Outpatient Preoperative Anesthesia Assessment: Does It Help to Reduce Operating Room Cancellations?
Anesth Analg 1999 89: 502. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The operating room cancellation rate for outpatients evaluated 2-30 days before surgery was compared with the cancellation rate for outpatients who received their anesthesia evaluation within 24 h of surgery. Because both groups had similar rates, outpatients may be seen at a convenient time without adversely affecting operating room cancellations.

Ulrich Bothner, Michael Georgieff, and Bernhard Schwilk

The Impact of Minor Perioperative Anesthesia-Related Incidents, Events, and Complications on Postanesthesia Care Unit Utilization
Anesth Analg 1999 89: 506. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: It is desirable to know how anesthesia-related incidents, events, and complications influence postanesthesia care. Analyses of standardized and routine perioperative outcome data, as proposed by the German anesthesia quality project, can show that even minor events consume relevant resources and are thus important to measure and follow.

E. Bennett-Guerrero, I. Welsby, T. J. Dunn, L. R. Young, T. A. Wahl, T. L. Diers, B. G. Phillips-Bute, M. F. Newman, and M. G. Mythen

The Use of a Postoperative Morbidity Survey to Evaluate Patients with Prolonged Hospitalization After Routine, Moderate-Risk, Elective Surgery
Anesth Analg 1999 89: 514. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Little is known about the overall incidence and pattern of complications in patients with prolonged hospitalization after routine, elective surgery. We prospectively assessed these complications using a novel postoperative morbidity survey. The postoperative morbidity survey can be used in future clinical outcome trials, as well as in routine hospital-based quality assurance.

Angel A. Hernández-Borges, Pablo Macías-Cervi, M. Asunción Gaspar-Guardado, M. Luisa Torres-Álvarez de Arcaya, Ana Ruiz-Rabaza, and Carlos Ormazábal-Ramos

Assessing the Relative Quality of Anesthesiology and Critical Care Medicine Internet Mailing Lists (Special Article)
Anesth Analg 1999 89: 520. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: Internet publishing is not governed by rules that assure certain basic quality standards. Methods for assessing these standards are needed. We compared discussion groups with medical journals and conferences on anesthesiology and critical care medicine by calculating the impact factor of their members and first authors, respectively. Our study shows that qualified authors may be found in all three media.

TECHNICAL COMMUNICATIONS:

Nobuhiro Saruki, Shigeru Saito, Jun Sato, Noriko Kon, and Ryuji Tozawa

Swift Conversion from Laryngoscopic to Fiberoptic Intubation with a New, Handy Fiberoptic Stylet
Anesth Analg 1999 89: 526. [Full Text] [PDF] [Request Permissions]  

CASE REPORTS:

Jocelyn Manullang and Talmage D. Egan

Remifentanil's Effect Is Not Prolonged in a Patient with Pseudocholinesterase Deficiency
Anesth Analg 1999 89: 529. [Full Text] [PDF] [Request Permissions]  

LETTERS TO THE EDITOR:

Paul G. Loubser and Norio Ueda

Right Ventricular Response to Aortic Unclamping During Aneurysmectomy • Response
Anesth Analg 1999 89: 531. [Full Text] [PDF] [Request Permissions]  

Gordon B. Drummond and Jeffrey Kirsch

Respiratory System Mechanics or Pulmonary Mechanics in the Prone Position • Response
Anesth Analg 1999 89: 531. [Full Text] [PDF] [Request Permissions]  

Philippe Van der Linden, Jean-Louis Vincent, and Henning Schou

Normovolemic Hemodilution and Acute Hemorrhage • Response
Anesth Analg 1999 89: 532. [Full Text] [PDF] [Request Permissions]  

Nishan G. Goudsouzian and Hajo Schneck

Anesthesia for Cesarean Section and Acid Aspiration Prophylaxis • Response
Anesth Analg 1999 89: 533. [Full Text] [PDF] [Request Permissions]  

Ottmar Kick and Jean Pierre Estebe

A New Stimulating Stylet for Immediate Control of Catheter Tip Position in Continuous Peripheral Nerve Blocks
Anesth Analg 1999 89: 533. [Full Text] [PDF] [Request Permissions]  

A. Murat Kaynar

Epidural Infusion: Continuous or Bolus?
Anesth Analg 1999 89: 534. [Full Text] [PDF] [Request Permissions]  

John C. Drummond, Scott M. Kuhnert, and David G. Piepgras

Macroglossia, Deja Vu • Response
Anesth Analg 1999 89: 534. [Full Text] [PDF] [Request Permissions]  

Gunther K. Federolf and Marilyn Lauwers

Remifentanil for Regional Anesthesia • Response
Anesth Analg 1999 89: 535. [Full Text] [PDF] [Request Permissions]  

Aaron F. Kopman

The Train-of-Four Count and Recovery from Mivacurium
Anesth Analg 1999 89: 536. [Full Text] [PDF] [Request Permissions]  

J. Brimacombe, C. Keller, Takashi Asai, and Koh Shingu

Laryngeal Mask Usage in the Unstable Neck • Response
Anesth Analg 1999 89: 536. [Full Text] [PDF] [Request Permissions]  

Ratan Alexander and Pekka O. Talke

Do Not Remove the Laryngeal Mask Airway • Response
Anesth Analg 1999 89: 536. [Full Text] [PDF] [Request Permissions]  

Shuya Kiyama and Takashi Asai

Use of a Laryngeal Mask in a Patient with an Unstable Neck: At Induction or During Emergence? • Response
Anesth Analg 1999 89: 537. [Full Text] [PDF] [Request Permissions]  

Stanislav S. Malov, Brenda A. Bucklin, and Carl V. Smith

Intrathecal Catheter as a Secondary Prophylaxis of Postdural Puncture Headache • Response
Anesth Analg 1999 89: 538. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Stanley Muravchick

Lippincott-Raven Interactive Anesthesia Library. Ver. 2. • Books and Multimedia Received
Anesth Analg 1999 89: 539. [Full Text] [PDF] [Request Permissions]  

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