EDITORIALS:

Volker Wenzel, Andreas W. Prengel, and Karl H. Lindner

A Strategy to Improve Endobronchial Drug Administration
Anesth Analg 2000 91: 255-256. [Full Text]  

CARDIOVASCULAR ANESTHESIA:

Susan M. Beath, Gregory A. Nuttall, David N. Fass, William C. Oliver, Jr., Mark H. Ereth, and Lance J. Oyen

Plasma Aprotinin Concentrations During Cardiac Surgery: Full- Versus Half-Dose Regimens
Anesth Analg 2000 91: 257-264. [Abstract] [Full Text]  

Implications: The current dosing schedule for aprotinin results in a large variation in aprotinin plasma concentrations among patients and a large variation within each patient over time. We combined the information provided by our study with that of a previous pharmacokinetic study to develop a potentially improved, weight-based, dosing regime for aprotinin.

Andreas Koster, Frank Merkle, Roland Hansen, Mathias Loebe, Herrmann Kuppe, Roland Hetzer, George J. Crystal, and Fritz Mertzlufft

Elimination of Recombinant Hirudin by Modified Ultrafiltration During Simulated Cardiopulmonary Bypass: Assessment of Different Filter Systems
Anesth Analg 2000 91: 265-269. [Abstract] [Full Text]  

Implications: Modified ultrafiltration may enhance the eliminationof recombinant-hirudin, although plasmapheresis systems providethe most rapid and complete elimination of recombinant-hirudinduring simulated cardiopulmonary bypass. The decision to usea specific system will ultimately depend on the prevailing clinicalsituation and overall health of the patient.

Kazuhiro Nakanishi, Shinhiro Takeda, Katsuyuki Terajima, Teruo Takano, and Ryo Ogawa

Myocardial Dysfunction Associated with Proinflammatory Cytokines After Esophageal Resection
Anesth Analg 2000 91: 270-275. [Abstract] [Full Text]  

Implications: We examined the association between myocardialfunction and proinflammatory cytokines after esophagectomy.Interleukin-6 may be the cytokine that most sensitively reflectsthe postoperative myocardial dysfunction.

Duncan L. Hamilton, Mark R. Boyett, Simon M. Harrison, Lucinda A. Davies, and Philip M. Hopkins

The Concentration-Dependent Effects of Propofol on Rat Ventricular Myocytes
Anesth Analg 2000 91: 276-282. [Abstract] [Full Text]  

Implications: By using intact, isolated rat heart ventriclecells, we investigated the mechanisms and concentration dependenceof the depressant effect of propofol on contractility of theheart. We conclude that direct effects of propofol on the heartare unlikely to be of significance at the clinical dosage usuallygiven.

Eduardo Zarate, Paige Latham, Paul F. White, Robert Bossard, Lisa Morse, Linda K. Douning, Chen Shi, and Lei Chi

Fast-Track Cardiac Anesthesia: Use of Remifentanil Combined with Intrathecal Morphine as an Alternative to Sufentanil During Desflurane Anesthesia
Anesth Analg 2000 91: 283-287. [Abstract] [Full Text]  

Implications: As part of a cardiac fast-tracking program involvingdesflurane anesthesia, the use of intrathecal morphine in combinationwith a remifentanil infusion provided improved postoperativepain control, compared with IV sufentanil alone.

Mark A. Chaney, Mauricio Morales, and Mamdouh Bakhos

Severe Incisional Pain and Long Thoracic Nerve Injury After Port-Access Minimally Invasive Mitral Valve Surgery (Case Report)
Anesth Analg 2000 91: 288-290. [Abstract] [Full Text]  

Implications: The authors describe the occurrence of severepostoperative pain and long thoracic nerve injury after Port-Accessminimally invasive mitral valve surgery. The potential for theseevents and the impact on postoperative hospitalization and rehabilitationare emphasized.

Rebecca A. Schroeder, Gregg L. Wood, Jeffrey S. Plotkin, and Paul C. Kuo

Intraoperative Use of Inhaled PGI₂ for Acute Pulmonary Hypertension and Right Ventricular Failure (Case Report)
Anesth Analg 2000 91: 291-295. [Abstract] [Full Text]  

Implications: Inhaled prostacyclin (PGI2) can be used as aneffective pulmonary vasodilator intraoperatively to treat pulmonaryhypertension and impending right ventricular failure.

Christopher J. O’Connor, David Roozeboom, Russell Brown, and Kenneth J. Tuman

Pulmonary Thromboembolism During Liver Transplantation: Possible Association with Antifibrinolytic Drugs and Novel Treatment Options (Case Report)
Anesth Analg 2000 91: 296-299. [Abstract] [Full Text]  

Implications: The authors describe two cases of massive intraoperativepulmonary thromboembolism resulting in cardiovascular collapseduring liver transplantation. The potential role of antifibrinolyticdrugs is discussed, along with the use of treatment modalitiesnot previously applied in this setting.

Raul A. Peragallo and Jeffrey D. Swenson

Congenital Tracheal Bronchus: The Inability to Isolate the Right Lung with a Univent Bronchial Blocker Tube (Case Report)
Anesth Analg 2000 91: 300-301. [Abstract] [Full Text]  

Implications: Tracheal bronchus is a congenital anomaly in whichthe right upper lobe bronchus originates from the lateral trachealwall. This anatomic variant is reported in approximately 1 of250 patients at bronchoscopy. Although it is usually of littleclinical significance, this atypical origin of the right upperlobe bronchus may complicate one-lung ventilation during thoracicsurgery.

Ronald M. Witteles, Edwin L. Kaplan, and Michael F. Roizen

Safe and Cost-Effective Preoperative Preparation of Patients with Pheochromocytoma (Brief Report)
Anesth Analg 2000 91: 302-304. [Abstract] [Full Text]  

Implications: This study examines the management of patientsdiagnosed with pheochromocytoma at a major academic teachinghospital. The findings indicate that most patients can be safelymanaged as outpatients preoperatively, resulting in significantlyshorter hospitalizations and no adverse sequelae.

PEDIATRIC ANESTHESIA:

Shinichi Kihara, Shinichi Inomata, Yuichi Yaguchi, Hidenori Toyooka, Yasuyuki Baba, and Yukinao Kohda

The Awakening Concentration of Sevoflurane in Children
Anesth Analg 2000 91: 305-308. [Abstract] [Full Text]  

Implications: The awakening concentration of sevoflurane inunpremedicated children was 0.78%. Oral clonidine premedicationat a dose of 2 {micro}g/kg reduced the awakening concentrationto 0.36%. However, an additional decrease in this value wasnot observed after the administration of the larger dose ofclonidine premedication (4 {micro}g/kg).

H. Eugene Harker, John D. Emhardt, and Bryan E. Hainline

Propionic Acidemia in a Four-Month-Old Male: A Case Study and Anesthetic Implications (Case Report)
Anesth Analg 2000 91: 309-311. [Abstract] [Full Text]  

Implications: Propionic acidemia is a rare genetic disease associatedwith significant medical problems. When patients with this diseasepresent for surgery, their anesthetic must be tailored to meettheir special needs. This case report provides information regardingpropionic acidemia and its anesthetic management.

AMBULATORY ANESTHESIA:

Marianne Mikat-Stevens, Radha Sukhani, Ana L. Pappas, Elaine Fluder, Bruce Kleinman, and Rom A. Stevens

Is Succinylcholine After Pretreatment with d-Tubocurarine and Lidocaine Contraindicated for Outpatient Anesthesia?
Anesth Analg 2000 91: 312-316. [Abstract] [Full Text]  

Implications: The results of this study show that the frequencyof muscle pains after surgery in outpatients is approximately20%, regardless of whether succinylcholine (after precurarization)or mivacurium is used to assist in insertion of the breathingtube.

CRITICAL CARE AND TRAUMA:

Kiyokazu Naganobu, Yuzo Hasebe, Yuka Uchiyama, Mitsuyoshi Hagio, and Hiroyuki Ogawa

A Comparison of Distilled Water and Normal Saline as Diluents for Endobronchial Administration of Epinephrine in the Dog
Anesth Analg 2000 91: 317-321. [Abstract] [Full Text]  

Implications: Using a small volume of distilled water as thediluent for endobronchial epinephrine administration significantlyincreased epinephrine absorption and arterial pressure in comparisonwith normal saline, without having a serious detrimental effecton PaO2, in an anesthetized, noncardiopulmonary, resuscitationdog model.

Yong-Sup Shin, Heidrun Fink, Raman Khiroya, Chikwendu Ibebunjo, and Jeevendra Martyn

Prednisolone-Induced Muscle Dysfunction Is Caused More by Atrophy than by Altered Acetylcholine Receptor Expression
Anesth Analg 2000 91: 322-328. [Abstract] [Full Text]  

Implications: The mechanisms by which chronic glucocorticoidtherapy alters neuromuscular physiology and pharmacology areunclear. We suggest that the observed effects are dose-dependentand derive primarily from muscle atrophy and derive less fromchanges in acetylcholine receptor expression.

Thierry Rapenne, Daniel Moreau, François Lenfant, Vincent Boggio, Yves Cottin, and Marc Freysz

Could Heart Rate Variability Analysis Become an Early Predictor of Imminent Brain Death? A Pilot Study
Anesth Analg 2000 91: 329-336. [Abstract] [Full Text]  

Implications: A total of 14 brain-injured patients with theclinical criteria of imminent brain death were enrolled forelectrocardiogram recording and heart rate variability analysis(a noninvasive method to investigate autonomic nervous systemactivity). For 6 h before brain death, we observed a progressiveextinction of autonomic nervous system activity which was notpresent as soon as brain death was clinically evoked.

Richard H. Epstein and Franklin Dexter

Economic Analysis of Linking Operating Room Scheduling and Hospital Material Management Information Systems for Just-in-Time Inventory Control
Anesth Analg 2000 91: 337-343. [Abstract] [Full Text]  

Implications: In a hospital with a sophisticated material managementinformation system, operating room managers will probably achievegreater cost reductions from focusing on negotiating less expensivepurchase prices for items than on trying to link the operatingroom information system with the hospital's material managementinformation system to achieve just-in-time inventory control.

Philippe Juvin, Frédéric Teissière, Fabrice Brion, Jean-Marie Desmonts, and Michel Durigon

Postoperative Death and Malpractice Suits: Is Autopsy Useful? (Brief Report)
Anesth Analg 2000 91: 344-346. [Abstract] [Full Text]  

Implications: This report demonstrates the extremely high yieldof autopsies performed in the case of postoperative death withsuspicion of malpractice. They frequently identified undetectedcomplications. They could also suggest faulty or negligent practicethat would otherwise go unrecognized. This report supports thewidespread use of autopsies to investigate perioperative death.

NEUROSURGICAL ANESTHESIA:

Yuji Morimoto, Yoshiko Morimoto, Osamu Kemmotsu, Satoshi Gando, Takaki Shibano, and Hirochika Shikama

The Effect of Calcium Channel Blockers on Cerebral Oxygenation During Tracheal Extubation
Anesth Analg 2000 91: 347-352. [Abstract] [Full Text]  

Implications: This study is a preliminary report evaluatingthe changes in cerebral oxygenation during the tracheal extubation.Cerebral oxygenated hemoglobin increased significantly, presumablycaused by the increase in cerebral blood flow during extubation.In addition, these changes were enhanced by calcium channelblockers.

Ye Chen, Zhong Zhao, William E. Code, and Leif Hertz

A Correlation Between Dexmedetomidine-Induced Biphasic Increases in Free Cytosolic Calcium Concentration and Energy Metabolism in Astrocytes
Anesth Analg 2000 91: 353-357. [Abstract] [Full Text]  

Implications: Cytosolic calcium concentration and metabolismwere measured in cultured astrocytes, the predominant glialcells. The results suggest that dexmedetomidine may owe itsanesthetic effects to a Ca2+-dependent increase in astrocyticenergy metabolism, allowing these cells to more effectivelyremove extracellular glutamate and potassium ions, and thus,decreasing neuronal excitability.

Jennifer M. Fabling, Tong J. Gan, Habib E. El-Moalem, David S. Warner, and Cecil O. Borel

A Randomized, Double-Blinded Comparison of Ondansetron, Droperidol, and Placebo for Prevention of Postoperative Nausea and Vomiting After Supratentorial Craniotomy
Anesth Analg 2000 91: 358-361. [Abstract] [Full Text]  

Implications: Nausea and vomiting after brain surgery are particularlytroubling, because effective treatment may cause sedation, makingpostoperative neurological assessment difficult. Our study showsthat both ondansetron and droperidol are effective in reducingnausea, and that droperidol is particularly effective in reducingvomiting. Neither drug caused more sedation than placebo.

Yoshihiro Momota, Alan A. Artru, Karen M. Powers, Douglas S. Mautz, and Yutaka Ueda

Concentrations of Lidocaine and Monoethylglycine Xylidide in Brain, Cerebrospinal Fluid, and Plasma During Lidocaine-Induced Epileptiform Electroencephalogram Activity in Rabbits: The Effects of Epinephrine and Hypocapnia
Anesth Analg 2000 91: 362-368. [Abstract] [Full Text]  

Implications: Hypocapnia increases the toxic dose of lidocainegiven IV without altering lidocaine concentrations in blood,brain, or cerebrospinal fluid. Whole-brain monoethylglycinexylidide concentration is greater during hypocapnia than duringnormocapnia, and the addition of epinephrine to lidocaine increasesthe concentration of monoethylglycine xylidide in plasma.

OBSTETRIC ANESTHESIA:

Deanna M. Dorantes, Alan R. Tait, and Norah N. Naughton

Informed Consent for Obstetric Anesthesia Research: Factors that Influence Parturients’ Decisions to Participate
Anesth Analg 2000 91: 369-373. [Abstract] [Full Text]  

Implications: Obtaining informed consent for obstetric anesthesiastudies presents a challenge to the anesthesiologist. Resultsfrom this study suggest that the environment in which consentfor obstetric studies is sought is not coercive. However, itis important that the anesthesiologist ensures that the patientfully understands the study and develops a rapport with thepatient to allay any anxiety associated with her participationas a potential research subject.

Neil Roy Connelly, Robert K. Parker, Veda Vallurupalli, Shailesh Bhopatkar, and Steven Dunn

Comparison of Epidural Fentanyl Versus Epidural Sufentanil for Analgesia in Ambulatory Patients in Early Labor
Anesth Analg 2000 91: 374-378. [Abstract] [Full Text]  

Implications: In early laboring patients, epidural fentanyl100 {micro}g, after a lidocaine and epinephrine test dose, providesanalgesia comparable to that of sufentanil 20 {micro}g.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

Scott S. Reuben and John P. Reuben

Brachial Plexus Anesthesia with Verapamil and/or Morphine
Anesth Analg 2000 91: 379-383. [Abstract] [Full Text]  

Implications: The addition of verapamil to brachial plexus blockwith lidocaine and morphine prolongs the duration of sensoryanesthesia, but has no effect on analgesic duration or 24 hanalgesic use.

Kohki Nishikawa, Noriaki Kanaya, Masayasu Nakayama, Motohiko Igarashi, Kazumasa Tsunoda, and Akiyoshi Namiki

Fentanyl Improves Analgesia but Prolongs the Onset of Axillary Brachial Plexus Block by Peripheral Mechanism
Anesth Analg 2000 91: 384-387. [Abstract] [Full Text]  

Implications: It is still unclear whether the addition of aperipheral opioid is useful for nerve blockade in humans. Peripheralapplication of fentanyl to lidocaine for axillary brachial plexusblockade in this study provided an improved success rate ofsensory blockade and prolonged duration.

Andrea Casati, Luca Magistris, Guido Fanelli, Paolo Beccaria, Gianluca Cappelleri, Giorgio Aldegheri, and Giorgio Torri

Small-Dose Clonidine Prolongs Postoperative Analgesia After Sciatic-Femoral Nerve Block with 0.75% Ropivacaine for Foot Surgery
Anesth Analg 2000 91: 388-392. [Abstract] [Full Text]  

Implications: This prospective, randomized, double-blinded studydemonstrated that, when providing combined sciatic-femoral nerveblock for hallux valgus repair, the addition of 1 {micro}g/kgclonidine to 0.75% ropivacaine prolongs the duration of postoperativeanalgesia by 3 h, with only a slight and short-lived increasein the degree of sedation and no hemodynamic adverse effects.

Kevin R. Milligan, Philip N. Convery, Paul Weir, Patricia Quinn, and Denis Connolly

The Efficacy and Safety of Epidural Infusions of Levobupivacaine With and Without Clonidine for Postoperative Pain Relief in Patients Undergoing Total Hip Replacement
Anesth Analg 2000 91: 393-397. [Abstract] [Full Text]  

Implications: In patients undergoing total hip replacement,the addition of the {alpha}2-adrenergic agonist clonidine to epiduralinfusions of levobupivacaine significantly improved postoperativeanalgesia.

Osamu Shimoda and Yoshihiro Ikuta

The Current Perception Thresholds Vary Between Horizontal and 70° Tilt-Up Positions
Anesth Analg 2000 91: 398-402. [Abstract] [Full Text]  

Implications: Current perception thresholds at the 70{degrees} tilt-upposture were significantly lower than those at the horizontalposture. When the compensatory mechanism for preserving bloodpressure was emphasized, the current perception thresholds wouldhave a relational connection to mean systolic blood pressure,similar to the concept of hypertension-induced hypoalgesia.

Andrei Goldstein, Patrick Grimault, Aude Henique, Michèle Keller, Anne Fortin, and Emile Darai

Preventing Postoperative Pain by Local Anesthetic Instillation After Laparoscopic Gynecologic Surgery: A Placebo-Controlled Comparison of Bupivacaine and Ropivacaine
Anesth Analg 2000 91: 403-407. [Abstract] [Full Text]  

Implications: Local anesthetic instillation (ropivacaine ratherthan bupivacaine) at the end of laparoscopy prevents postoperativepain and dramatically decreases the need for morphine. Thistechnique, compared with placebo, is safe, improves patientcomfort, shortens the stay in the postoperative care unit anddecreases nursing care in the ward.

Hiroshi Iwama and Yoichi Akama

The Superiority of Water-Diluted 0.25% to Neat 1% Lidocaine for Trigger-Point Injections in Myofascial Pain Syndrome: A Prospective, Randomized, Double-Blinded Trial (Brief Report)
Anesth Analg 2000 91: 408-409. [Abstract] [Full Text]  

Implications: Trigger-point injection with a mixture of commerciallyavailable 1% lidocaine in sterile distilled water at a ratioof 1:3 compared with 1% lidocaine alone resulted in better efficacyand less injection pain. This simple procedure may be suitablefor treatments of a wide range of myofascial pain syndromes.

Alla B. Khodorova and Gary R. Strichartz

The Addition of Dilute Epinephrine Produces Equieffectiveness of Bupivacaine Enantiomers for Cutaneous Analgesia in the Rat (Brief Report)
Anesth Analg 2000 91: 410-416. [Abstract] [Full Text]  

Implications: Here we show that the more potent optical R-isomerof bupivacaine (Bup) can be used at a smaller dose (80%) thanthe S-isomer of Bup to give equal pain relief of a skin prick.Although the analgesia from R-Bup is briefer than that fromequipotent S-Bup solutions, the durations become equal whena very dilute solution of the vasoconstrictor epinephrine ismixed with the R-isomer. The resulting vasoconstriction thusreduces vascular drug uptake and peak blood levels of systemicdrug, reducing potential toxicity.

Stuart A. Dunbar, Ivan G. Karamov, and Hartmut Buerkle

The Effect of Spinal Ibuprofen on Opioid Withdrawal in the Rat (Brief Report)
Anesth Analg 2000 91: 417-422. [Abstract] [Full Text]  

Implications: This study shows that spinal ibuprofen blocksopioid withdrawal hyperalgesia in the rat in a stereospecificfashion, implicating the likely release of spinal prostaglandinsduring withdrawal and their possible role as neuromodulatorsin the enhancement of nociception that accompanies this phenomenon.

Tomoki Nishiyama, Rodney J. Y. Ho, Danny D. Shen, and Tony L. Yaksh

The Effects of Intrathecal Morphine Encapsulated in L- and D-Dipalmitoylphosphatidyl Choline Liposomes on Acute Nociception in Rats (Brief Report)
Anesth Analg 2000 91: 423-428. [Abstract] [Full Text]  

Implications: Two isomers of liposome (L-dipalmitoylphosphatidylcholine and D-dipalmitoylphosphatidyl choline) encapsulationof morphine prolonged the analgesic effect on acute thermal-inducedpain when administered intrathecally and could decrease sideeffects, compared with morphine alone.

Hussein A. Huraibi, Joseph Phillips, Robert J. Rose, Henry Pallatroni, Heloise Westbrook, and Gilbert J. Fanciullo

Intrathecal Baclofen Pump Implantation Complicated by Epidural Lipomatosis (Case Report)
Anesth Analg 2000 91: 429-431. [Abstract] [Full Text]  

Implications: Intrathecal baclofen is a useful therapy in patientswith spasticity. We describe a patient who underwent an intrathecalpump implant, complicated by epidural lipomatosis that ultimatelyrequired a single level laminectomy and fat debulking beforesuccessful implantation.

Herbert Krenn, Helmuth Jellinek, Herbert Haumer, Wolfgang Oczenski, and Robert Fitzgerald

Naloxone-Resistant Respiratory Depression and Neurological Eye Symptoms After Intrathecal Morphine (Case Report)
Anesth Analg 2000 91: 432-433. [Abstract] [Full Text]  

Implications: We describe a case of neurological symptoms afterthe intrathecal use of an opioid. These symptoms were not reversibleby the use of an opioid-antagonist.

GENERAL ARTICLES:

Hideyuki Higuchi, Yushi Adachi, Shinya Arimura, Masuyuki Kanno, and Tetsuo Satoh

Compound A Concentrations During Low-Flow Sevoflurane Anesthesia Correlate Directly with the Concentration of Monovalent Bases in Carbon Dioxide Absorbents
Anesth Analg 2000 91: 434-439. [Abstract] [Full Text]  

Implications: Sevoflurane degradation to Compound A is decreasedby lowering the concentration of monovalent bases in the carbondioxide absorbent (Dragersorb 800 Plus(R) [Drager,Luebeck, Germany] and Medisorb(R) [Datex-Ohmeda, Bromma, Sweden])and is virtually eliminated in the absence of these bases (Amsorb(R)[Armstrong Medical, Coleraine, Northern Ireland]).

Akira Kudoh and Akitomo Matsuki

Sevoflurane Stimulates Inositol 1,4,5-Trisphosphate in Skeletal Muscle
Anesth Analg 2000 91: 440-445. [Abstract] [Full Text]  

Implications: Inhaled anesthetics increase intracellular ionizedcalcium in the skeletal muscle cell and the ionized calciumincrease is partly released from the intracellular store byinositol 1,4,5-triphosphate (IP3) formation. IP3 plays an importantrole in excitation-contraction coupling and malignant hyperthermia.We studied whether sevoflurane affects IP3 formation and themechanisms that modulate IP3.

Erich Knolle and Hermann Gilly

Absorption of Carbon Dioxide by Dry Soda Lime Decreases Carbon Monoxide Formation from Isoflurane Degradation
Anesth Analg 2000 91: 446-451. [Abstract] [Full Text]  

Implications: We determined, in vitro, that carbon monoxide(CO) formation from isoflurane by dry soda lime is reduced bycarbon dioxide (CO2). We believe that the potential for injuryfrom CO is less in the clinical milieu than suggested by datafrom experiments without CO2 because of an interdependence betweenCO formation and CO2 absorption.

Helle Ørding, Gunilla Islander, Diana Bendixen, and Eva Ranklev-Twetman

Between-Center Variability of Results of the In Vitro Contracture Test for Malignant Hyperthermia Susceptibility
Anesth Analg 2000 91: 452-457. [Abstract] [Full Text]  

Implications: The diagnostic outcomes of tests for malignanthyperthermia susceptibility were compared between two laboratoriesby using muscle tissue from the same patients. Identical outcomeswere found for 56% of the patients. Almost all diverging outcomeswere seen in cases with a few small contractures near the cutofflimit. Different diagnostic criteria for clinical and scientificpurposes are suggested.

Harald Andel, Gerhard Klune, Dorothea Andel, Michael Felfernig, Andrew Donner, Wolfgang Schramm, and Michael Zimpfer

Propofol Without Muscle Relaxants for Conventional or Fiberoptic Nasotracheal Intubation: A Dose-Finding Study
Anesth Analg 2000 91: 458-461. [Abstract] [Full Text]  

Implications: In this study, contrary to all preceding studiesusing predefined doses of propofol and opioids, we determinedthe minimal required propofol dose in combination with fentanylfor conventional or fiberoptic nasotracheal intubation withoutmuscle relaxants.

Yi Zhang, Edmond I Eger, II, Robert C. Dutton, and James M. Sonner

Inhaled Anesthetics Have Hyperalgesic Effects at 0.1 Minimum Alveolar Anesthetic Concentration
Anesth Analg 2000 91: 462-466. [Abstract] [Full Text]  

Implications: The inhaled anesthetics isoflurane, halothane,nitrous oxide, and diethyl ether produce antianalgesia at subanestheticconcentrations, with a maximal effect at approximately one-tenththe concentration required for anesthesia. This effect may enhanceperception of pain when such small concentrations are reachedduring recovery from anesthesia.

Merja T. Lähteenmäki, Matti S. Salo, Jorma O. Tenovuo, Antti V. Helminen, Pekka J. Vilja, and Risto K. Huupponen

The Effects of Glycopyrrolate on Oral Mucous Host Defenses in Healthy Volunteers
Anesth Analg 2000 91: 467-472. [Abstract] [Full Text]  

Implications: Glycopyrrolate induces long-lasting hyposalivationand decreases the secretion of salivary immunologic and nonimmunologicdefense factors in healthy volunteers.

Mohamed Naguib and Abdulhamid H. Samarkandi

The Comparative Dose-Response Effects of Melatonin and Midazolam for Premedication of Adult Patients: A Double-Blinded, Placebo-Controlled Study
Anesth Analg 2000 91: 473-479. [Abstract] [Full Text]  

Implications: Premedication with 0.05 mg/kg melatonin was associatedwith preoperative anxiolysis and sedation without impairmentof cognitive and psychomotor skills or affecting the qualityof recovery.

Henning Joensen, Christopher L. Sadler, José Ponte, Yuji Yamamoto, Sten G. E. Lindahl, and Lars I. Eriksson

Isoflurane Does Not Depress the Hypoxic Response of Rabbit Carotid Body Chemoreceptors
Anesth Analg 2000 91: 480-485. [Abstract] [Full Text]  

Implications: By measuring single-fiber chemoreceptor activityin anesthetized rabbits, we showed that isoflurane at 1.0% end-tidalconcentration does not depress the hypoxic chemosensitivityof peripheral chemoreceptors during either hypo-, normo-, orhypercapnia in this species.

SPECIAL ARTICLES:

Helen Askitopoulou, Ioanna A. Ramoutsaki, and Eleni Konsolaki

Analgesia and Anesthesia: Etymology and Literary History of Related Greek Words
Anesth Analg 2000 91: 486-491. [Full Text]  

CASE REPORTS:

Takahiro Suzuki, Takashi Nakamura, Shigeru Saeki, and Setsuro Ogawa

Vecuronium-Induced Neuromuscular Blockade in a Patient with Cerebral Palsy and Hemiplegia
Anesth Analg 2000 91: 492-493. [Abstract] [Full Text]  

Implications: We evaluated vecuronium-induced neuromuscularblock in both arms of a patient with cerebral palsy and hemiplegia.A remarkable resistance to vecuronium was observed in the hemiplegiaside compared with cerebral palsy side. Complete recovery fromneuromuscular block should be assessed in the cerebral palsyside that shows a delayed recovery.

LETTERS TO THE EDITOR:

Zafer Salim Tabboush

Airway Obstruction from Uvular Edema After Traumatic Adenoidectomy
Anesth Analg 2000 91: 494. [Full Text]  

John G. Brock-Utne, Jay B. Brodsky, Gordon R. Haddow, and H. S. Bhogal

Bearded Sikhs and Tracheal Intubation • Response
Anesth Analg 2000 91: 494. [Full Text]  

Gert Poortmans, Guido Schüpfer, Carl Roosens, and J. Poelaert

Additional View of the Mitral Valve
Anesth Analg 2000 91: 494-495. [Full Text]  

Spyros D. Mentzelopoulos, Marina V. Tsitsika, and Evangelia A. Karamichali

Difficult Airway Management with Fogarty Catheter Balloon Inflation
Anesth Analg 2000 91: 495. [Full Text]  

Lawrence J. Saidman and Ronald D. Miller

Drug Company-Supported Symposia: What Should Be Disclosed? • Response
Anesth Analg 2000 91: 495-496. [Full Text]  

Eric A. Voth, Paul Sharpe, and Graham Smith

Cannabis Is Not Equivalent to Cannabinoids • Response
Anesth Analg 2000 91: 496. [Full Text]  

Eduardo Figueredo, Senthilkumar Sadhasivam, Abha Saxena, S. Kathirvel, and T. R. Kannan

Ondansetron and Evidence-Based Medicine • Response
Anesth Analg 2000 91: 496-497. [Full Text]  

Petra Innerhofer, Gabriele Kühbacher, Wolfgang Schobersberger, Edna Zohar, Brian Fredman, Martin Ellis, and Robert Jedeikin

Antifibrinolytic Therapy Reduces Blood Loss in Knee Replacement Surgery • Response
Anesth Analg 2000 91: 497-498. [Full Text]  

Hirokatsu Toyoyama, Koh Mizutani, Humiko Kuki, and Yoshiro Toyoda

Misdiagnosis of ECG Artifacts May Lead to Drastic and Unnecessary Interventions
Anesth Analg 2000 91: 498-499. [Full Text]  

Anne Rother, Brian Smith, David H. Adams, and Charles D. Collard

Transesophageal Echocardiographic Diagnosis of Acute Aortic Valve Insufficiency After Mitral Valve Repair
Anesth Analg 2000 91: 499-500. [Full Text]  

Sylvia Dolinski and J. C. Gerancher

Two Suggestions to Facilitate Patient Positioning in the Performance of Regional Anesthesia
Anesth Analg 2000 91: 500. [Full Text]  

Miriam J. P. Harnett and Ronald Hurley

Anesthesia for Fetal Intervention
Anesth Analg 2000 91: 500. [Full Text]  

Shinsuke Hamaguchi, Hirotoshi Egawa, Yasuhisa Okuda, Toshimitsu Kitajima, and Takashi Asai

Use of a Fiberscope and Closed-Circuit Television for Teaching Laryngeal Mask Insertion
Anesth Analg 2000 91: 501. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

William S. Whitley and Michael W. Russell

Anesthesia Review • Intensive Care Medicine. 4th ed • Books and Multimedia Received
Anesth Analg 2000 91: 502-503. [Full Text]  

ERRATA:

Correction for vol. 91, p. 145
Anesth Analg 2000 91: 308. [Full Text]  

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