CARDIOVASCULAR ANESTHESIA:

Michael K. Urban, Steven M. Markowitz, Michael A. Gordon, Barbara L. Urquhart, and Paul Kligfield

Postoperative Prophylactic Administration of ß-Adrenergic Blockers in Patients at Risk for Myocardial Ischemia
Anesth Analg 2000 90: 1257-1261. [Abstract] [Full Text] En Espanol  

Implications: Prophylactic {beta} adrenergic blockade administeredafter elective total knee arthroplasty was associated with areduced prevalence and duration of postoperative myocardialischemia detected with Holter monitoring.

Kumi Matsuyama, Tomoko Goto, Tomoko Baba, Yoshihiro Shibata, Yoichiro Otsuka, Ryuzo Sakata, and Hidenori Terasaki

Echocardiographic and Pathological Evaluation of Atherosclerosis in the Ascending Aorta During Coronary Artery Bypass Grafting
Anesth Analg 2000 90: 1262-1268. [Abstract] [Full Text]  

Implications: We performed epiaortic echocardiography duringcoronary artery bypass grafting and found that the presenceof atheroma and deformities at the cross-clamping site weresignificantly more prevalent in nonisoechoic walls than isoechoicwalls.

Jouni Ahonen, Klaus T. Olkkola, Kalervo Verkkala, Leo Heikkinen, Antero Järvinen, and Markku Salmenperä

A Comparison of Remifentanil and Alfentanil for Use with Propofol in Patients Undergoing Minimally Invasive Coronary Artery Bypass Surgery
Anesth Analg 2000 90: 1269-1274. [Abstract] [Full Text]  

Implications: Recovery of patients undergoing Minimally InvasiveDirect Coronary Artery Bypass Surgery is significantly shorterand more predictable after total IV anesthesia with remifentanil-propofolthan with alfentanil-propofol, which may be important if thegoal is that patients will be awakened and tracheally extubatedin the operating room.

Shohei Takeda, Teruaki Tomaru, and Yutaka Inada

Splanchnic Organ Blood Flow During Calcitonin Gene-Related Peptide-Induced Hypotension With or Without Propranolol in Dogs
Anesth Analg 2000 90: 1275-1280. [Abstract] [Full Text]  

Implications: The reductions in splanchnic organ blood flowsduring CGRP-induced hypotension with propranolol are due toa reflex augmentation in sympathetic vasoconstrictor tone causedby an increase in plasma catecholamine concentrations. Thesefindings suggest that propranolol may impair splanchnic organblood flow during CGRP-induced hypotension.

Rao Saleem, Matthew Bigham, Edward Spitznagel, and George J. Despotis

The Effect of Epsilon-Aminocaproic Acid on HemoSTATUS® and Kaolin-Activated Clotting Time Measurements
Anesth Analg 2000 90: 1281-1285. [Abstract] [Full Text]  

Implications: Values from two activated coagulation time-basedtest systems used to identify significant heparin resistanceor platelet dysfunction after cardiopulmonary bypass were notsignificantly affected by epsilon-aminocaproic acid administeredIV.

Yuri Nakae, Satoshi Fujita, and Akiyoshi Namiki

Propofol Inhibits Ca²⁺ Transients but Not Contraction in Intact Beating Guinea Pig Hearts
Anesth Analg 2000 90: 1286-1292. [Abstract] [Full Text]  

Implications: This is the first study of the effects of propofolon intracellular Ca2+ concentration and myofilament Ca2+ sensitivityunder physiologic conditions in intact isolated beating guineapig hearts.

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

Nonuniform Behavior of Intravenous Anesthetics on Postischemic Adhesion of Neutrophils in the Guinea Pig Heart
Anesth Analg 2000 90: 1293-1300. [Abstract] [Full Text]  

Implications: Ketamine, thiopental, and midazolam, but not etomodateor fentanyl, reduce postischemic adhesion of neutrophils inthe coronary system of isolated perfused guinea pig hearts,suggesting a role in mitigating myocardial reperfusion injury.

Marc De Kock, Pierre-Francois Laterre, Patricia Andruetto, Lionel Vanderessen, Sylvie Dekrom, Bernard Vanderick, and Patricia Lavand’homme

Ornipressin (Por 8): An Efficient Alternative to Counteract Hypotension During Combined General/Epidural Anesthesia
Anesth Analg 2000 90: 1301-1307. [Abstract] [Full Text]  

Implications: In the population studied, small-dose ornipressinwas effective to restore arterial blood pressure without causingmajor ischemic side effects.

Stuart G. Morrison, Javier J. Dominguez, Philippe Frascarolo, and Sebastian Reiz

A Comparison of the Electrocardiographic Cardiotoxic Effects of Racemic Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Swine
Anesth Analg 2000 90: 1308-1314. [Abstract] [Full Text]  

Implications: Animal experiments have shown levobupivacaineand ropivacaine to be less cardiotoxic than racemic bupivacaine.This in vivo study, using a validated swine model, comparedthe relative direct cardiotoxicities of these three local anesthetics.The lethal dose did not differ between levobupivacaine and ropivacaine,but was lowest for racemic bupivacaine.

Ajeet D. Sharma, Gautam Sreeram, Thomas Erb, Hilary P. Grocott, and Thomas F. Slaughter

Leukocyte-Reduced Blood Transfusions: Perioperative Indications, Adverse Effects, and Cost Analysis (Review Article)
Anesth Analg 2000 90: 1315-1323. [Full Text]  

PEDIATRIC ANESTHESIA:

Bruce E. Miller, Nina A. Guzzetta, Steven R. Tosone, and Jerrold H. Levy

Rapid Evaluation of Coagulopathies After Cardiopulmonary Bypass in Children Using Modified Thromboelastography
Anesth Analg 2000 90: 1324-1330. [Abstract] [Full Text]  

Implications: Thromboelastography is useful in assessing thecoagulopathies that follow cardiopulmonary bypass in children.Modifying blood samples with celite or tissue factor and heparinaseallows thromboelastography begun before the termination of cardiopulmonarybypass to become a rapid point-of-care monitor to provide objectivedata for guiding blood component therapy to manage these coagulopathies.

Jacek A. Wojtczak

The Hemodynamic Effects of Halothane and Isoflurane in Chick Embryo
Anesth Analg 2000 90: 1331-1335. [Abstract] [Full Text]  

Implications: In equipotent, clinically relevant concentrations,halothane, but not isoflurane, markedly decreased aortic bloodflow and cardiac performance measured with ultrasound techniquesin chick embryos. Chick and human embryos are similar duringearly stages of development; therefore, chick embryo may bea useful model to study the cardiovascular effects of anesthetics.

Shobha Malviya, Paul I. Reynolds, Terri Voepel-Lewis, Monica Siewert, David Watson, Alan R. Tait, and Kevin Tremper

False Alarms and Sensitivity of Conventional Pulse Oximetry Versus the Masimo SET^TM Technology in the Pediatric Postanesthesia Care Unit
Anesth Analg 2000 90: 1336-1340. [Abstract] [Full Text]  

Implications: Pulse oximetry that incorporates Masimo SignalExtraction TechnologyTM (Masimo Corporation, Irvine, CA) mayoffer an advantage over conventional pulse oximetry by reducingthe incidence of false alarms while identifying a higher numberof true alarms in children in the postanesthesia care unit.

David E. Cohen and Thomas P. Keon

Factitious Arterial Blood Pressure Measurements from Automated Oscillotonometer (Case Report)
Anesth Analg 2000 90: 1341-1342. [Abstract] [Full Text]  

Implications: Automated, noninvasive blood pressure devicesfacilitate repeated blood pressure measurements in anesthetizedpatients. The authors report the recording of multiple factitiousmeasurements of blood pressure in a small infant by using oneof these devices.

AMBULATORY ANESTHESIA:

Franklin Dexter and Alex Macario

What Is the Relative Frequency of Uncommon Ambulatory Surgery Procedures Performed in the United States with an Anesthesia Provider?
Anesth Analg 2000 90: 1343-1347. [Abstract] [Full Text]  

Implications: Approximately one third of all ambulatory caseswere a procedure or combination of procedures possibly performedas infrequently as once per year per facility. This could impairthe effectiveness of predicting the durations of ambulatorycases by using historical case-duration data.

Sujit K. Pandit, Katherine W. Loberg, and Uma A. Pandit

Toast and Tea Before Elective Surgery? A National Survey on Current Practice
Anesth Analg 2000 90: 1348-1351. [Abstract] [Full Text]  

Implications: Findings of this national survey conducted amongactive members of the Society for Ambulatory Anesthesia mayencourage anesthesiologists throughout the world to take a moreliberal attitude toward allowing clear liquids 2-3 h anda light breakfast 6 h before an elective surgery in healthypatients.

Eduardo Zarate, Mehernoor F. Watcha, Paul F. White, Kevin W. Klein, Monica Sa Rego, and D. Greg Stewart

A Comparison of the Costs and Efficacy of Ondansetron Versus Dolasetron for Antiemetic Prophylaxis
Anesth Analg 2000 90: 1352-1358. [Abstract] [Full Text]  

Implications: When administered at the end of surgery, 12.5mg of dolasetron IV is as effective as 25 mg of dolasetron IV,4 mg of ondansetron IV, and 8 mg of ondansetron IV in preventingemetic symptoms after otolaryngologic surgery and was associatedwith similar patient satisfaction at a reduced cost. There wereno differences in the antiemetic efficacy of the 4 and 8 mgdoses of ondansetron.

INTRAVENOUS ANESTHESIA:

Enno Freye, Helmut Schmidhammer, and Leo Latasch

14-Methoxymetopon, A Potent Opioid, Induces No Respiratory Depression, Less Sedation, and Less Bradycardia than Sufentanil in the Dog
Anesth Analg 2000 90: 1359-1364. [Abstract] [Full Text]  

Implications: Compared with sufentanil, 14-methoxymetopone doesnot induce hypoxia and hypercarbia, induces less hypotensionand bradycardia, and induces less sedative effects (electroencephalogram).Antinociception is similar to sufentanil (skin-twitch method,amplitude depression in the evoked potential). All effects arereversed by naltrexone. Interaction of {kappa}-receptor is suggested.

TaeHyung Han, DaeWoo Kim, HoYeong Kil, and Yoshimi Inagaki

The Effects of Plasma Fentanyl Concentrations on Propofol Requirement, Emergence from Anesthesia, and Postoperative Analgesia in Propofol-Nitrous Oxide Anesthesia
Anesth Analg 2000 90: 1365-1371. [Abstract] [Full Text]  

Implications: The addition of fentanyl, a potent opioid, reducedthe intraoperative requirement of propofol, an IV anesthetic,in the order of the plasma fentanyl concentrations. The ceilingeffects of fentanyl were demonstrated in the reduction of propofolrequirements and recovery of consciousness but not in the fentanylrequirements for postoperative analgesia.

CRITICAL CARE AND TRAUMA:

Fritz Mertzlufft, Andreas Koster, Helmut Steinhart, Joachim F. Schenk, and George J. Crystal

Fechtner’s Syndrome: Considerations of Anesthetic Management (Case Report)
Anesth Analg 2000 90: 1372. [Abstract] [Full Text]  

Implications: Fechtner's syndrome is a rare form of macrothrombocytopenia(potentially associated with other hemostatic deficiencies,e.g., von Willebrand's disease and protein Z deficiency),which can exacerbate the risk of uncontrollable bleeding duringsurgery. We describe the management of a patient with Fechtner'ssyndrome involving desmopressin, prednisone, and platelets,which produced safe and effective results during cochlear implantsurgery.

NEUROSURGICAL ANESTHESIA:

Aleksa Cenic, Rosemary A. Craen, Vicky L. Howard-Lech, Ting-Yim Lee, and Adrian W. Gelb

Cerebral Blood Volume and Blood Flow at Varying Arterial Carbon Dioxide Tension Levels in Rabbits During Propofol Anesthesia
Anesth Analg 2000 90: 1376-1383. [Abstract] [Full Text]  

Implications: During propofol anesthesia in rabbits with normalbrains, a reduction in the arterial carbon dioxide level maynot always be accompanied by a reduction in brain blood flowand blood volume.

OBSTETRIC ANESTHESIA:

David C. Campbell, Rhonda M. Zwack, Lesley-Ann L. Crone, and Ray W. Yip

Ambulatory Labor Epidural Analgesia: Bupivacaine Versus Ropivacaine
Anesth Analg 2000 90: 1384-1389. [Abstract] [Full Text] En Espanol  

Implications: As compared with a similar dilute concentrationof bupivacaine, 20 mL of dilute (0.08%) ropivacaine combinedwith fentanyl (2 {micro}g/mL) effectively initiates epiduralanalgesia in nulliparous women in early, established labor whilepreserving their ability to micturate and ambulate. Of importance,it appears that a true ambulatory epidural analgesic for womenin labor is now possible.

Warwick D. Ngan Kee, Kim S. Khaw, Bee B. Lee, Tze K. Lau, and Tony Gin

A Dose-Response Study of Prophylactic Intravenous Ephedrine for the Prevention of Hypotension During Spinal Anesthesia for Cesarean Delivery
Anesth Analg 2000 90: 1390-1395. [Abstract] [Full Text]  

Implications: We investigated different doses of IV ephedrineas prophylaxis for hypotension during spinal anesthesia forcesarean delivery and found that the smallest effective dosewas 30 mg. However, this dose did not completely eliminate hypotension,caused reactive hypertension in some patients, and did not improveneonatal outcome.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

Kha M. Tran, Steven M. Frank, Srinivasa N. Raja, Hossam K. El-Rahmany, Lauren J. Kim, and Brian Vu

Lumbar Sympathetic Block for Sympathetically Maintained Pain: Changes in Cutaneous Temperatures and Pain Perception
Anesth Analg 2000 90: 1396-1401. [Abstract] [Full Text]  

Implications: Cutaneous toe temperatures approaching core temperatureprovide a useful monitor of lumbar sympathetic block and maypredict relief of sympathetically maintained pain. Iohexol willnot compromise temperature changes or pain relief.

Stephen M. Klein, Arthur Bergh, Susan M. Steele, Gregory S. Georgiade, and Roy A. Greengrass

Thoracic Paravertebral Block for Breast Surgery
Anesth Analg 2000 90: 1402-1405. [Abstract] [Full Text]  

Implications: Paravertebral nerve block has the potential tooffer long-lasting pain relief and few postoperative side effectswhen used for breast surgery. We demonstrated that paravertebralnerve block, when compared with general anesthesia, is an alternativetechnique for breast surgery that may offer pain relief superiorto general anesthesia alone.

Shinichi Sakura, Yasuko Sakaguchi, Masahide Shinzawa, Kaoru Hara, and Yoji Saito

The Assessment of Dermatomal Level of Surgical Anesthesia After Spinal Tetracaine
Anesth Analg 2000 90: 1406-1410. [Abstract] [Full Text]  

Implications: Our results show that the loss of sensation totranscutaneous electrical stimulation at 10 mA, but not cold,pinprick, or touch, is a good predictor of the dermatomal levelof block to transcutaneous electrical stimulation at 60 mA,which is considered equivalent to the dermatomal level of surgicalanesthesia after the administration of spinal anesthesia.

Paola Sacerdote, Mauro Bianchi, Leda Gaspani, Barbara Manfredi, Antonio Maucione, Giovanni Terno, Mario Ammatuna, and Alberto E. Panerai

The Effects of Tramadol and Morphine on Immune Responses and Pain After Surgery in Cancer Patients
Anesth Analg 2000 90: 1411-1414. [Abstract] [Full Text]  

Implications: Recent studies suggest that opioids can have anadverse impact on the immune system. Because surgical stressalso induces immune dysfunction, the search for analgesic drugsdevoid of immunosuppressive effects is of import. This studycompared the effects on immune responses of morphine and ofthe atypical opioid analgesic, tramadol, given for postoperativepain to gynecological cancer patients. Tramadol and morphineshowed comparable analgesic activity; however, tramadol, incontrast to morphine, induced an improvement of postoperativeimmunosuppression and, therefore, may be preferred to morphinefor the treatment of postoperative pain.

CASE REPORTS:

Paul M. Kempen, John O’Donnell, Robert Lawler, and Venkat Mantha

Acute Respiratory Insufficiency During Interscalene Plexus Block (Case Report)
Anesth Analg 2000 90: 1415-1416. [Full Text]  

Peter G. Nay and Katherine O’Brien

Acute Vasospastic Attack After Extradural Block in a Patient with Raynaud’s Disease (Case Report)
Anesth Analg 2000 90: 1417-1418. [Abstract] [Full Text]  

Implications: Raynaud's disease is an episodic and debilitatingdisease of the circulation to the fingers and toes. This casereport describes an acute exacerbation of Raynaud's diseasein a patient undergoing surgery with epidural anesthesia. Thispotentially hazardous complication has not been previously reported.

GENERAL ARTICLES:

Vegard Dahl, P. E. Ernoe, T. Steen, Johan C. Raeder, and Paul F. White

Does Ketamine Have Preemptive Effects in Women Undergoing Abdominal Hysterectomy Procedures?
Anesth Analg 2000 90: 1419-1422. [Abstract] [Full Text]  

Implications: Even though ketamine 0.4 mg/kg IV has short-lastingacute analgesic effects, it failed to produce a preemptive effectwhen given before abdominal hysterectomy procedures.

Robert M. Powell and Donal J. Buggy

Ondansetron Given Before Induction of Anesthesia Reduces Shivering After General Anesthesia
Anesth Analg 2000 90: 1423-1427. [Abstract] [Full Text] En Espanol  

Implications: In a randomized, double-blinded, placebo-controlled,clinical study, ondansetron 8 mg IV, given just before the induction,reduced the incidence of postanesthetic shivering compared withsaline. The anticipated core-to-peripheral redistribution ofbody temperature during general anesthesia was not affected.This implies that ondansetron probably acts by a central inhibitorymechanism, and that 5-hydroxytryptaminergic pathways have arole in regulating postanesthetic shivering.

Caroline R. Stabernack, Ronald Brown, Michael J. Laster, Raphael Dudziak, and Edmond I Eger, II

Absorbents Differ Enormously in Their Capacity to Produce Compound A and Carbon Monoxide
Anesth Analg 2000 90: 1428-1435. [Abstract] [Full Text]  

Implications: Production of the toxic substances, carbon monoxideand Compound A, from anesthetic degradation by carbon dioxideabsorbents, might be minimized by the use of one of two specificabsorbents, Amsorb(R) (Armstrong Medica, Ltd., Coleraine,Northern Ireland) (calcium hydroxide which also includes 0.7%polyvinylpyrrolidine, calcium chloride, and calcium sulfate)or lithium hydroxide.

Hubert Hautmann, Fernando Gamarra, Markus Henke, Stephanie Diehm, and Rudolf M. Huber

High Frequency Jet Ventilation in Interventional Fiberoptic Bronchoscopy
Anesth Analg 2000 90: 1436-1440. [Abstract] [Full Text]  

Implications: Safe ventilation is desired when performing tracheobronchialstent implantation and balloon dilation with the fiberscope.High frequency jet ventilation, applied with a 14F insufflationcatheter through the nasotracheal route, offers safe ventilatorysupport with minimal complications. This was evaluated in 161procedures treating benign and malignant airway stenoses.

Myung Hee Kim and Tae Hyung Hahn

The Effect of Clonidine Pretreatment on the Perioperative Proinflammatory Cytokines, Cortisol, and ACTH Responses in Patients Undergoing Total Abdominal Hysterectomy
Anesth Analg 2000 90: 1441-1444. [Abstract] [Full Text]  

Implications: We assessed the effect of the {alpha}2-adrenoreceptoragonist clonidine on the immunoendocrine activity during theperioperative period. Clonidine 0.15 mg given as oral premedicationresulted in the reduced Interleukin-6 production in responseto total abdominal hysterectomy.

Vance G. Nielsen, Manuel S. Baird, Brian T. Geary, and Sadis Matalon

Halothane Does Not Decrease Amiloride-Sensitive Alveolar Fluid Clearance in Rabbits
Anesth Analg 2000 90: 1445-1449. [Abstract] [Full Text]  

Implications: Unlike the rat, the ability of the rabbit to clearfluid from the alveolar space through amiloride-sensitive pathwaysis not decreased by halothane anesthesia.

TECHNICAL COMMUNICATIONS:

James T. Stewart, Flynn W. Warren, Frances C. Maddox, Karthick Viswanathan, and Janet L. Fox

The Stability of Remifentanil Hydrochloride and Propofol Mixtures in Polypropylene Syringes and Polyvinylchloride Bags at 22^o-24^oC
Anesth Analg 2000 90: 1450-1451. [Abstract] [Full Text]  

Implications: Remifentanil and propofol mixtures may be preparedextemporaneously. This study demonstrated that such mixturesare stable for 0 to 36 h, depending on relative concentrationsof the drugs and the storage container used. The most stablemixtures were stored in syringes and used large concentrationsof the two drugs.

Akihiko Fujita, Jun Higuchi, Toshiaki Nagai, Shogo Tokudome, and Hideaki Sakio

A Simple Method for Detecting Plasma Propofol
Anesth Analg 2000 90: 1452-1454. [Abstract] [Full Text]  

Implications: We measured plasma propofol levels by head space-gaschromatography analysis using solid-phase microextraction. Thismethod saves time, and does not require elimination of interferingsubstances in the plasma. The coefficient variation was {+/-}5%to {+/-}30%. The detection limit was 10 ng/mL.

LETTERS TO THE EDITOR:

Menno F. TerRiet, Jeffrey S. Jacobs, Michael C. Lewis, Gerard J. A. DeSouza, Wei C. Lau, Carmen R. Green, Gary Faerber, Alan R. Tait, and Julie A. Golembiewski

Propofol and Analgesia • Response
Anesth Analg 2000 90: 1455. [Full Text]  

Gary R. Haynes, Melinda K. Bailey, T. J. Gan, E. Bennett-Guerrero, and M. G. Mythen

Excessive Use of Hetastarch: An Iatrogenic Cause of Bleeding and Hypocalcemia? • Response
Anesth Analg 2000 90: 1455-1456. [Full Text]  

Fernando Cassinello, Francisco J. Rodrigo, Luis Muñoz-Alameda, Gloria Perez-Tejerizo, and Daniel Vallejo

Postoperative Pulmonary Aspiration of Gastric Contents in an Infant After General Anesthesia with Laryngeal Mask Airway (LMA)
Anesth Analg 2000 90: 1457. [Full Text]  

Kazuyoshi Aoyama, Ichiro Takenaka, Etsuko Nagaoka, Tatsuo Kadoya, Nobuhiro Saruki, and Shigeru Saito

Jaw Thrust Maneuver for Endotracheal Intubation Using a Fiberoptic Stylet • Response
Anesth Analg 2000 90: 1457-1458. [Full Text]  

Andranik Ovassapian, Jerome M. Klafta, and Timothy B. Gilbert

Bronchial Injury: An Avoidable Complication During Bronchial Intubation • Response
Anesth Analg 2000 90: 1458-1459. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

Lydia Cassorla, Norig Ellison, Keith J. Ruskin, Richard D. Carr, Peter J. Davis, Marily Green Larach, Timothy L. Sternberg, Eric B. Furman, John A. Youngberg, and Terese T. Horlocker

Video Atlas of Perioperative Transesophageal Echocardiography • Stedman’s Medical Dictionary, 27th ed • MEDLINE: A Guide to Effective Searching • Conscious Sedation, Vol. 37, No. 4 of International Anesthesiology Clinics • Pediatric Procedural Sedation and Analgesia • Anesthesia for Genetic, Metabolic, and Dysmorphic Syndromes of Childhood • The Pain Clinic Manual. 2nd ed • Anesthesia and Pain Management for the Pediatrician • Problems in Anesthesia: Vascular Anesthesia. Vol II, No. 2 • Clinical Pharmacology of Local Anesthetics • Books and Multimedia Received
Anesth Analg 2000 90: 1460-1465. [Full Text]  

ARTICLES:

GUEST REVIEWERS LIST— OCTOBER 1999 TO MARCH 2000
Anesth Analg 2000 90: 1466-1469. [Abstract] [Full Text]  

ERRATA:

Correction for vol. 90, p. 970
Anesth Analg 2000 90: 1383. [Full Text]  

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