EDITORIALS:

Charles Berde and Brian Cairns

Developmental Pharmacology Across Species: Promise and Problems
Anesth Analg 2000 91: 1. [Full Text] [PDF]  

PEDIATRIC ANESTHESIA:

Masahiko Fujinaga, Ryan Doone, M. Frances Davies, and Mervyn Maze

Nitrous Oxide Lacks the Antinociceptive Effect on the Tail Flick Test in Newborn Rats
Anesth Analg 2000 91: 6. [Abstract] [Full Text] [PDF]  

Implications: The present study indicates that rats below 3wk old lack an antinociceptive effect to nitrous oxide by usingthe tail flick test. Because a 3-wk-old rat is comparable inneurological development with the toddler stage in humans, wemay anticipate that patients below this age may not experiencethe usual analgesic effect of nitrous oxide.

John M. Park, Constance S. Houck, Navil F. Sethna, Lorna J. Sullivan, Anthony Atala, Joseph G. Borer, Bartley G. Cilento, David A. Diamond, Craig A. Peters, Alan B. Retik, and Stuart B. Bauer

Ketorolac Suppresses Postoperative Bladder Spasms After Pediatric Ureteral Reimplantation
Anesth Analg 2000 91: 11. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: We studied the efficacy of ketorolac, a prostaglandinsynthesis inhibitor, in the treatment of bladder spasm afterureteroneocystostomy (antireflux operation). Patients wererandomized in a double-blinded manner to receive either ketorolacor placebo after the surgery. We demonstrate that ketorolacreduces the frequency and severity of postoperative bladderspasm.

Allison Kinder Ross, John B. Eck, and Joseph D. Tobias

Pediatric Regional Anesthesia: Beyond the Caudal (Review Article)
Anesth Analg 2000 91: 16. [Full Text] [PDF] [En Espanol]   

Gary A. Frankowski, Joel O. Johnson, and Joseph D. Tobias

Rapacuronium Administration to Two Children with Duchenne’s Muscular Dystrophy (Case Report)
Anesth Analg 2000 91: 27. [Abstract] [Full Text] [PDF]  

Implications: Children with Duchenne's muscular dystrophyshould not be exposed to succinylcholine because of the riskof hyperkalemic cardiac arrest and rhabdomyolysis. This reportdescribes the response to rapacuronium bromide in two patientswith Duchenne's muscular dystrophy. Both patients hada recovery index 2 times longer than that reported in childrenwith normal neuromuscular function.

CARDIOVASCULAR ANESTHESIA:

Antonia Dalmau, Antoni Sabaté, Fernando Acosta, Lucia Garcia-Huete, Maylin Koo, Tomás Sansano, Antoni Rafecas, Juan Figueras, Eduard Jaurrieta, and Pascual Parrilla

Tranexamic Acid Reduces Red Cell Transfusion Better than -Aminocaproic Acid or Placebo in Liver Transplantation
Anesth Analg 2000 91: 29. [Abstract] [Full Text] [PDF]  

Implications: In a randomized study of 132 consecutive patientsundergoing liver transplantation, we found that tranexamic acid,but not {epsilon}-aminocaproic acid, reduced intraoperative total packedred blood cell transfusion.

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

Evaluation of the Contribution of Platelets to Clot Strength by Thromboelastography in Rabbits: The Role of Tissue Factor and Cytochalasin D
Anesth Analg 2000 91: 35. [Abstract] [Full Text] [PDF]  

Implications: Rabbits may serve as a model of hemostasis thatclosely approximates human situations to mechanistically determinethe etiology of coagulopathy. The contribution of platelet functionto total clot strength is similar to that observed in humans.

Dale F. Szpisjak, David S. Edgell, and Bruno Bissonnette

Potassium as a Surrogate Marker of Debris in Cell-Salvaged Blood
Anesth Analg 2000 91: 40. [Abstract] [Full Text] [PDF]  

Implications: No convenient test has been validated as an indicatorof salvaged erythrocyte cleanliness. This in vitro study suggeststhat residual potassium concentration seems to be a good indicatorof quality after washing with a contemporary intraoperativesalvage system.

Malte Silomon, Thorsten Claus, Hanno Huwer, Andreas Biedler, Reinhard Larsen, and Gerd Molter

Interpleural Analgesia Does Not Influence Postthoracotomy Pain
Anesth Analg 2000 91: 44. [Abstract] [Full Text] [PDF]  

Implications: The efficacy of interpleural analgesia to reducepostoperative pain intensity in patients after lateral thoracotomyis controversial. In this study, we demonstrated a lack of efficacyof interpleural analgesia.

Leena H. Mildh, Leena M. Tuomisto, Mika Scheinin, and Olli A. Kirvelä

Morphine-Induced Cardiovascular Stimulation: The Effects of Two Doses on Healthy Subjects
Anesth Analg 2000 91: 51. [Abstract] [Full Text] [PDF]  

Implications: In this double-blinded, randomized study, we evaluatedwhether morphine could induce immediate cardiovascular stimulation,as seen previously in animal studies. In healthy volunteers,during a painful stimulus, morphine caused an initial, transienthemodynamic stimulation, accompanied by increased oxygen consumption,without detectable release of histamine or catecholamines intothe plasma. Oxycodone caused only minor hemodynamic alterations.

Peter Elliott, Ronan O’Hare, K. Moyna Bill, Anne S. Phillips, Fiona M. Gibson, and Rajinder K. Mirakhur

Severe Cardiovascular Depression with Remifentanil
Anesth Analg 2000 91: 58. [Abstract] [Full Text] [PDF]  

Implications: This study investigates the effect on the heartand blood vessels of various rates of administration of bolusesof a relatively new potent opiate, remifentanil, to patientswith coronary artery disease. The results show that remifentanilshould be given only by slow infusion to such patients.

Wesam F. Mousa, Taijiro Enoki, and Kazuhiko Fukuda

Thiopental Induces Contraction of Rat Aortic Smooth Muscle Through Ca²⁺ Release from the Sarcoplasmic Reticulum
Anesth Analg 2000 91: 62. [Abstract] [Full Text] [PDF]  

Implications: This is the first study providing evidence thatthiopental-induced vascular contraction is caused by Ca2+ releasefrom the sarcoplasmic reticulum of the smooth muscle.

Juraj Sprung, Monique L. Ogletree-Hughes, and Christine S. Moravec

The Effects of Etomidate on the Contractility of Failing and Nonfailing Human Heart Muscle
Anesth Analg 2000 91: 68. [Abstract] [Full Text] [PDF]  

Implications: Etomidate produced a similar dose-dependent negativeinotropic effect in both failing and nonfailing human myocardium.This effect was present only at concentrations exceeding thoseattained clinically and was reversible with {beta}-adrenergicstimulation.

Kyung W. Park, Hai B. Dai, Mark E. Comunale, Alok Gopal, and Frank W. Sellke

Dilation by Isoflurane of Preconstricted, Very Small Arterioles from Human Right Atrium Is Mediated in Part by K+-ATP Channel Opening
Anesth Analg 2000 91: 76. [Abstract] [Full Text] [PDF]  

Implications: Vasodilation of very small coronary arteriolesby isoflurane depends on preexisting tone and may in part bemediated by the K+-ATP channels.

Patrick P. McCaslin and John Butterworth

Bupivacaine Suppresses [Ca²⁺]_i Oscillations in Neonatal Rat Cardiomyocytes with Increased Extracellular K+ and Is Reversed with Increased Extracellular Mg²⁺
Anesth Analg 2000 91: 82. [Abstract] [Full Text] [PDF]  

Implications: Evaluation of intracellular Ca2+ oscillationsin neonatal rat myocytes suggests that increased extracellularK+ may be an important component of bupivacaine cardiotoxicity.

Damon C. Sutton and Anne Rother

Endoluminal Abdominal Aortic Aneurysm Repair Complicated by Intracardiac Guidewire Placement and Massive Transfusion (Case Report)
Anesth Analg 2000 91: 89. [Full Text] [PDF]  

AMBULATORY ANESTHESIA:

Margarita Coloma, Jen W. Chiu, Paul F. White, W. Kendall Tongier, Larry L. Duffy, and Steven C. Armbruster

Fast-Tracking After Immersion Lithotripsy: General Anesthesia Versus Monitored Anesthesia Care
Anesth Analg 2000 91: 92. [Abstract] [Full Text] [PDF]  

Implications: A desflurane-based general anesthetic techniqueusing the cuffed oropharyngeal airway device was found to bea highly acceptable alternative to propofol-based monitoredanesthesia care sedation for outpatient immersion lithotripsy.

Susan L. Hogue, Pat Ray Reese, Michael Colopy, Lee A. Fleisher, Kenneth J. Tuman, Rebecca S. Twersky, David S. Warner, and Brenda Jamerson

Assessing a Tool to Measure Patient Functional Ability After Outpatient Surgery
Anesth Analg 2000 91: 97. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: This study assessed the validity of a novel functionalability questionnaire that measured functional status afterrecovery from anesthesia and satisfaction 24 h after outpatientsurgery. The content, construct, discriminant, and criterion(predictive) validities demonstrated the utility of this assessmentinstrument in the outpatient setting.

Jacques Ripart, Jean-Yves Lefrant, Joël L’Hermite, Faouzi Borzli, Emmanuel Nouvellon, Pascale Fabbro-Peray, Christophe Dadure, Alain Jaussaud, Gérard Dupeyron, Jean-Emmanuel de la Coussaye, and Jean-Jacques Eledjam

Caruncle Single Injection Episcleral (Sub-Tenon) Anesthesia for Cataract Surgery: Mepivacaine Versus a Lidocaine-Bupivacaine Mixture
Anesth Analg 2000 91: 107. [Abstract] [Full Text] [PDF]  

Implications: We compared the classic mixture of lidocaine 2%plus bupivacaine 0.5% to mepivacaine 2% for caruncle episcleral(sub-Tenon) anesthesia for cataract surgery. Mepivacaine provideda more efficient block with a quicker onset and a quicker recovery.However, these differences were very small and were of littleclinical interest.

INTRAVENOUS ANESTHESIA:

Igor Kissin, Cheryl A. Bright, and Edwin L. Bradley, Jr.

Acute Tolerance to Continuously Infused Alfentanil: The Role of Cholecystokinin and N-Methyl-D-Aspartate-Nitric Oxide Systems
Anesth Analg 2000 91: 110. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: The mechanism of acute tolerance to the analgesiceffect of alfentanil depends on participation of multiple systemsof adaptation that include cholecystokininB receptors and N-methyl-D-asparticacid-nitric oxide cascade. Drugs that inhibit function of thesesystems attenuate tolerance development.

Alex Y. Bekker, Paul Berklayd, Irene Osborn, Marc Bloom, Joel Yarmush, and Herman Turndorf

The Recovery of Cognitive Function After Remifentanil- Nitrous Oxide Anesthesia Is Faster than After an Isoflurane-Nitrous Oxide-Fentanyl Combination in Elderly Patients
Anesth Analg 2000 91: 117. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: Maintenance of anesthesia with remifentanil-nitrousoxide (N2O), compared with isoflurane-N2O-fentanyl, can safelyshorten postoperative recovery of cognitive function in a geriatricpopulation. Earlier recovery may facilitate postoperative neurologicalassessment. Use of remifentanil-N2O for maintenance did notshorten the overall length of stay in the postanesthesia careunit, a stay often related to multiple administrative issues,rather than cognitive recovery.

Torsten Loop and Hans-Joachim Priebe

Recovery After Anesthesia with Remifentanil Combined with Propofol, Desflurane, or Sevoflurane for Otorhinolaryngeal Surgery
Anesth Analg 2000 91: 123. [Abstract] [Full Text] [PDF]  

Implications: Remifentanil anesthesia, combined with small-dosepropofol, desflurane, or sevoflurane, enables predictably fastand smooth early recovery after ear, nose, and throat surgery.Despite such faster, early recovery and less need for postoperativeanalgesic and antiemetic medication, late recovery was comparableamong the remifentanil combination groups and the control group.

Carole Coste, Bruno Guignard, Christophe Menigaux, and Marcel Chauvin

Nitrous Oxide Prevents Movement During Orotracheal Intubation Without Affecting BIS Value
Anesth Analg 2000 91: 130. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: We demonstrated that 0.6 minimal alveolar concentrationof nitrous oxide combined with a potent anesthetic and an opioidprevents movement after orotracheal intubation without affectingthe bispectral index. This demonstrates that the bispectralindex is not a useful neurophysiologic variable to monitor thelevel of anesthesia when nitrous oxide is added to a generalanesthetic regimen using propofol and remifentanil.

Jhi-Joung Wang, Shung-Tai Ho, Jann-Inn Tzeng, and Chao-Shun Tang

The Effect of Timing of Dexamethasone Administration on Its Efficacy as a Prophylactic Antiemetic for Postoperative Nausea and Vomiting
Anesth Analg 2000 91: 136. [Abstract] [Full Text] [PDF]  

Implications: We evaluated the effect of timing of dexamethasoneadministration on its efficacy as a prophylactic antiemeticon postoperative nausea and vomiting. We found that dexamethasone,when given immediately before the induction of anesthesia, wasmore effective than when given at the end of anesthesia.

NEUROSURGICAL ANESTHESIA:

Katsuyoshi Kishi, Masahiko Kawaguchi, Koukichi Kurehara, Satoki Inoue, Takanori Sakamoto, Toshi Einaga, Katsuyasu Kitaguchi, and Hitoshi Furuya

Hypothermia Attenuates the Vasodilatory Response of Pial Arterioles to Hemorrhagic Hypotension in the Cat
Anesth Analg 2000 91: 140. [Abstract] [Full Text] [PDF]  

Implications: Deliberate mild hypothermia has been proposedas a means of providing cerebral protection during neurosurgicalprocedures. Our results suggest that cerebral blood flow autoregulationin response to hemorrhagic hypotension may be impaired duringhypothermic conditions, indicating the importance of maintainingperfusion pressure during hypothermic therapy to prevent cerebralischemia.

Bengt Nellgård, G. Burkhard Mackensen, Gary Massey, Robert D. Pearlstein, and David S. Warner

The Effects of Anesthetics on Stress Responses to Forebrain Ischemia and Reperfusion in the Rat
Anesth Analg 2000 91: 145. [Abstract] [Full Text] [PDF]  

Implications: Differential anesthetic effects on ischemic outcomeare independent of effects on adrenergic/noradrenergic responsesto ischemia. The absence of a consistent differential effectof anesthetics on either corticosterone or cytokine responsesto ischemia serves to further refute the hypothesis that isofluraneneuroprotection can be attributed to dampening of adverse stressresponses to ischemic insults.

Nigel M. Bedforth, Jonathan G. Hardman, and Michael H. Nathanson

Cerebral Hemodynamic Response to the Introduction of Desflurane: A Comparison with Sevoflurane
Anesth Analg 2000 91: 152. [Abstract] [Full Text] [PDF]  

Implications: The introduction of desflurane after the inductionof anesthesia leads to significant disturbances in cerebraland systemic hemodynamics suggesting loss of cerebral autoregulationand cerebral hyperemia. This may have implications for patientsundergoing anesthesia for intracranial surgery.

Christian Kolbitsch, Ingo H. Lorenz, Christoph Hörmann, Michael Schocke, Christian Kremser, Fritz Zschiegner, Alexander Löckinger, Karl P. Pfeiffer, Stephan Felber, and Arnulf Benzer

A Subanesthetic Concentration of Sevoflurane Increases Regional Cerebral Blood Flow and Regional Cerebral Blood Volume and Decreases Regional Mean Transit Time and Regional Cerebrovascular Resistance in Volunteers
Anesth Analg 2000 91: 156. [Abstract] [Full Text] [PDF]  

Guruswamy Balakrishnan, Peter Raudzens, Satwant K. Samra, Kenneth Song, Jean A. Boening, Voytek Bosek, Brenda D. Jamerson, and David S. Warner

A Comparison of Remifentanil and Fentanyl in Patients Undergoing Surgery for Intracranial Mass Lesions
Anesth Analg 2000 91: 163. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: Patients given remifentanil-based anesthesia forcraniotomy had faster recovery times from anesthesia than didthose given fentanyl-based anesthesia.

CRITICAL CARE AND TRAUMA:

A. Nikolic, K. Lampl, C. Klasen, C. Weinstabl, and C. G. Krenn

The Use of a Tracheostomy Tube for Enteral Stomal Control (Case Report)
Anesth Analg 2000 91: 170. [Abstract] [Full Text] [PDF]  

Implications: We found that the use of a zero-pressure trachealfoam cuff was the ideal way to drain the intestines througha colostomy, reducing skin irritations and mucosal damage.

OBSTETRIC ANESTHESIA:

Heui-Ming Yeh, Li-Kuei Chen, Chen-Jung Lin, Wei-Hung Chan, Yen-Po Chen, Chou-Shun Lin, Wei-Zen Sun, Ming-Jiuh Wang, and Shen-Kou Tsai

Prophylactic Intravenous Ondansetron Reduces the Incidence of Intrathecal Morphine-Induced Pruritus in Patients Undergoing Cesarean Delivery
Anesth Analg 2000 91: 172. [Abstract] [Full Text] [PDF]  

Implications: Ondansetron prophylaxis significantly decreasesthe incidence of pruritus, a common side effect of intrathecalmorphine used to treat postcesarean delivery pain.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

François J. Singelyn and Jean-Marie A. Gouverneur

Extended "Three-in-One" Block After Total Knee Arthroplasty: Continuous Versus Patient-Controlled Techniques
Anesth Analg 2000 91: 176. [Abstract] [Full Text] [PDF]  

Implications: We demonstrated that, after total knee arthroplasty,an extended "3-in-1" block consisting of patient-controlledanalgesia boluses (10 mL/60 min) of 0.125% bupivacaine with1 {micro}g/mL clonidine provides efficient postoperative analgesiaand significantly minimizes local anesthetic consumption.

Andrea Casati, Guido Fanelli, Paolo Beccaria, Gianluca Cappelleri, Marco Berti, Giorgio Aldegheri, and Giorgio Torri

The Effects of the Single or Multiple Injection Technique on the Onset Time of Femoral Nerve Blocks with 0.75% Ropivacaine
Anesth Analg 2000 91: 181. [Abstract] [Full Text] [PDF]  

Implications: This prospective, randomized, blinded study wasconducted to evaluate the effect of searching for multiple musculartwitches when performing femoral nerve block with small volumesof 0.75% ropivacaine. Our results demonstrated that multipleinjections markedly shortened the onset time and improved thequality of nerve blockade. This technique-related effect mustbe carefully considered when different clinical studies evaluatingthe use of new local anesthetic solutions for peripheral nerveblocks are compared.

Klaus Eckhardt, Susanne Ammon, Ute Hofmann, Anja Riebe, Nadja Gugeler, and Gerd Mikus

Gabapentin Enhances the Analgesic Effect of Morphine in Healthy Volunteers
Anesth Analg 2000 91: 185. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: In a randomized, placebo-controlled, double-blindedtrial with 12 healthy volunteers, we studied the interactionof morphine and gabapentin using the cold pressor test. Theanticonvulsant gabapentin enhanced the acute analgesic effectof morphine. Furthermore, the plasma concentration of gabapentinwas increased when morphine was administered concomitantly.Therefore, the well tolerated combination of gabapentin andmorphine may improve pain therapy, especially in pain states,like chronic and neuropathic pain, which respond poorly to opioids.

Ko Takakura, Ikunobu Muramatsu, Eriko Miyamoto, and Satoru Fukuda

Adsorption of Lidocaine into a Plastic Infusion Balloon (Brief Report)
Anesth Analg 2000 91: 192. [Abstract] [Full Text] [PDF]  

Implications: An infusion balloon is a well established deviceused to continuously supply drugs for pain management. In thisstudy, we determined the concentration of lidocaine that flowedout of a balloon because the balloon is made from plastics thatadsorb local anesthetics.

GENERAL ARTICLES:

S. Kihara, S. Watanabe, J. Brimacombe, N. Taguchi, Y. Yaguchi, and Y. Yamasaki

Segmental Cervical Spine Movement with the Intubating Laryngeal Mask During Manual In-Line Stabilization in Patients with Cervical Pathology Undergoing Cervical Spine Surgery
Anesth Analg 2000 91: 195. [Abstract] [Full Text] [PDF] [En Espanol]   

Implications: The intubating laryngeal mask produces segmentalmovement of the cervical spine, despite manual in-line stabilizationin patients with cervical spine pathology undergoing cervicalspine surgery. This motion is in the opposite direction to directlaryngoscopy, suggesting that different approaches to airwaymanagement may be more appropriate depending on the nature ofthe cervical instability.

Carl Fagan, Henry P. Frizelle, John Laffey, Vincent Hannon, and Michael Carey

The Effects of Intracuff Lidocaine on Endotracheal-Tube-Induced Emergence Phenomena After General Anesthesia
Anesth Analg 2000 91: 201. [Abstract] [Full Text] [PDF]  

Implications: Tracheal intubation with an endotracheal tubeis often necessary during anesthesia. After intubation, inflatinga cuff around the endotracheal tube maintains a seal. This canresult in coughing during emergence from anesthesia. Our studyshows that inflating the cuff of an endotracheal tube with lidocainerather than air can reduce the incidence of postextubation coughing.

Stefan W. Suttner, Christian C. Schmidt, Joachim Boldt, Ingo Hüttner, Bernhard Kumle, and Swen N. Piper

Low-Flow Desflurane and Sevoflurane Anesthesia Minimally Affect Hepatic Integrity and Function in Elderly Patients
Anesth Analg 2000 91: 206. [Abstract] [Full Text] [PDF]  

Implications: We measured the lidocaine metabolite monoethylglycinexylidide,the cytosolic liver enzyme, {alpha} glutathione S-transferase, andgastric mucosal tonometry-derived variables to evaluate theeffects of desflurane and sevoflurane on hepatic function inelderly patients. Liver function was well preserved, whereasincreased {alpha} glutathione S-transferase levels and changes in tonometry-derivedvariables indicated a reduction in splanchnic blood flow anda temporary impairment of hepatocyte oxygenation for both anesthetics.

Hwan S. Joo and William J. Perks

Sevoflurane Versus Propofol for Anesthetic Induction: A Meta-Analysis
Anesth Analg 2000 91: 213. [Abstract] [Full Text] [PDF]  

Implications: Sevoflurane and propofol had similar efficacyfor anesthetic induction. However, for routine outpatient surgery,propofol may still be the preferred induction anesthetic becauseof its favorable induction of anesthesia characteristics, highpatient satisfaction, and less frequent incidence of postoperativenausea and vomiting.

Michiaki Yamakage, Shigeyuki Yamada, Xiangdong Chen, Sohshi Iwasaki, Naoki Tsujiguchi, and Akiyoshi Namiki

Carbon Dioxide Absorbents Containing Potassium Hydroxide Produce Much Larger Concentrations of Compound A from Sevoflurane in Clinical Practice
Anesth Analg 2000 91: 220. [Abstract] [Full Text] [PDF]  

Implications: Carbon dioxide absorbents containing potassiumhydroxide/sodium hydroxide produce much larger concentrationsof Compound A from sevoflurane in clinical practice. An absorbentcontaining neither potassium hydroxide nor sodium hydroxideproduces the smallest concentrations of Compound A.

Tomohiro Yamakura, Kenji Sakimura, and Koki Shimoji

The Stereoselective Effects of Ketamine Isomers on Heteromeric N-Methyl-D-Aspartate Receptor Channels
Anesth Analg 2000 91: 225. [Abstract] [Full Text] [PDF]  

Implications: The potency order and ratio of ketamine isomersfor inhibition of N-methyl-D-aspartate receptor channels maynot be so different between the brain region and the developmentalstage.

Masahiro Irifune, Tomoaki Sato, Yoshiko Kamata, Takashige Nishikawa, Toshihiro Dohi, and Michio Kawahara

Evidence for GABA_A Receptor Agonistic Properties of Ketamine: Convulsive and Anesthetic Behavioral Models in Mice
Anesth Analg 2000 91: 230. [Abstract] [Full Text] [PDF]  

Implications: We examined the potentiation by ketamine of the{gamma}-aminobutyric acidA receptor function using convulsive and anestheticbehavioral models in mice. Subanesthetic doses of ketamine-inhibitedtonic convulsions induced by the {gamma}-aminobutyric acidA receptorantagonist bicuculline. The {gamma}-aminobutyric acidA receptor agonist,muscimol, potentiated ketamine-induced anesthesia. Bicucullineantagonized ketamine anesthesia, but the benzodiazepine receptorantagonist, flumazenil, and the {gamma}-aminobutyric acid synthesisinhibitor, L-allyglycine, did not. The effects of ketamine onthe {gamma}-aminobutyric acidA receptors appear to correlate with itsanesthetic actions.

REVIEW ARTICLES:

Sushma Thapa and Sorin J. Brull

Succinylcholine-Induced Hyperkalemia in Patients with Renal Failure: An Old Question Revisited
Anesth Analg 2000 91: 237. [Full Text] [PDF]  

CASE REPORTS:

Andrew M. Elizaga and Robert L. Frerichs

Nitrogen Purging of Oxygen Pipelines: An Unusual Cause of Intraoperative Hypoxia
Anesth Analg 2000 91: 242. [Abstract] [Full Text] [PDF]  

Implications: Intraoperative hypoxia occurred in two patientsduring the maintenance of the medical gas system. Engineerswere purging oxygen pipelines with nitrogen to remove particulatedebris but were unaware of a connection to operating room pipelines.This case illustrates the importance of communication betweenanesthesia providers and engineers servicing the gas system.

LETTERS TO THE EDITOR:

H. S. Bhogal

What May Be Done with the Jeweled Tongue?
Anesth Analg 2000 91: 244. [Full Text] [PDF]  

Keyvan Karkouti, Edna Zohar, Brian Fredman, Martin Ellis, and Robert Jedeikin

Is Tranexamic Acid Indicated for Total Knee Replacement Surgery? • Response
Anesth Analg 2000 91: 244. [Full Text] [PDF]  

Michael S. Stix and Carl J. Borromeo

Rattling of Unidirectional Valves as a Sign of Secretions
Anesth Analg 2000 91: 245. [Full Text] [PDF]  

Michael J. Bishop, G. Alec Rooke, W. Habre, and P. D. Sly

Sevoflurane for Patients with Asthma • Response
Anesth Analg 2000 91: 245. [Full Text] [PDF]  

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

Global Cerebral Hypoperfusion and PaCO₂ • Response
Anesth Analg 2000 91: 246. [Full Text] [PDF]  

Ichiro Takenaka, Tatsuo Kadoya, and Kazuyoshi Aoyama

Is Awake Intubation Necessary When the Laryngeal Mask Airway Is Feasible?
Anesth Analg 2000 91: 246. [Full Text] [PDF]  

Patrick Narchi, Hanane Barakat, S. Ganapathy, J. Watson, R. Wasserman, K. Armstrong, and D. G. Chess

Regional Analgesia After Total Knee Replacement • Response
Anesth Analg 2000 91: 247. [Full Text] [PDF]  

Srikanth S. Patankar, Gregory B. Hammer, and Jay B. Brodsky

Single-Lung Ventilation in Young Children: Practical Tips on Using Conventional Cuffed Endotracheal Tubes for VATS • Response
Anesth Analg 2000 91: 248. [Full Text] [PDF]  

Maximilian W. B. Hartmannsgruber and David G. Silverman

Applying Parametric Tests to Visual Analog Scores
Anesth Analg 2000 91: 248. [Full Text] [PDF]  

Sreekrishna Raghavendran and Lakshmi Vas

The Visible Epiglottis Revisited
Anesth Analg 2000 91: 249. [Full Text] [PDF]  

Theodore M. Wynnychenko, Joseph W. Szokol, and Glenn S. Murphy

Infusion Pump Use in the MRI
Anesth Analg 2000 91: 249-250. [Full Text] [PDF]  

Kiyoshi Nagase, Kaori Ando-Nagase, Zeev N. Kain, and Inna Maranets

Preoperative Anxiety and Intraoperative Anesthetic Requirements • Response
Anesth Analg 2000 91: 250. [Full Text] [PDF]  

Nurten Bakan, Ender Gedik, and Ozcan Ersoy

Early Detection of the TURP Syndrome
Anesth Analg 2000 91: 250. [Full Text] [PDF]  

BOOK AND MULTIMEDIA REVIEWS:

Eldar Søreide, J. Jeffrey Andrews, MD Russell C. Brockwell, and Stacy B. Lewin

Pain Management and Regional Anesthesia in Trauma • Understanding Anesthesia Equipment. 4th ed • Obstetric Anesthesia, in Problems in Anesthesia • Books and Multimedia Received
Anesth Analg 2000 91: 252. [Full Text] [PDF]  

ERRATA:

Correction for vol. 90, p. 1252
Anesth Analg 2000 91: 67. [Full Text]  

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