EDITORIALS:

Denise J. Wedel

Don’t Try This at Home!
Anesth Analg 2000 91: 771-772. [Full Text] [PDF] [Request Permissions]  

Wiebke Gogarten and Hugo Van Aken

A Century of Regional Analgesia in Obstetrics
Anesth Analg 2000 91: 773-775. [Full Text] [PDF] [En Espanol]  [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Félix R. Montes, Sandra I. Sanchez, Juan C. Giraldo, José D. Rincón, Ismael E. Rincón, María V. Vanegas, and Hernán Charris

The Lack of Benefit of Tracheal Extubation in the Operating Room After Coronary Artery Bypass Surgery
Anesth Analg 2000 91: 776-780. [Abstract] [Full Text] [PDF] [En Espanol]  [Request Permissions]  

Implications: Tracheal extubation in the operating room after uncomplicated coronary artery bypass grafting is not associated with significantly decreased intensive care unit and postoperative length of stay. This practice is, however, associated with a moderate risk of reintubation.

Jaideep J. Pandit, Stephen Bree, Patrick Dillon, David Elcock, Ian D. McLaren, and Bruce Crider

A Comparison of Superficial Versus Combined (Superficial and Deep) Cervical Plexus Block for Carotid Endarterectomy: A Prospective, Randomized Study
Anesth Analg 2000 91: 781-786. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Carotid endarterectomy may be performed satisfactorily by using either superficial or combined block, and it is found that peroperative lidocaine requirements will be the same regardless of which block is used. The decision to use one block or the other might, therefore, reasonably be influenced by the relative safety of the superficial block compared with the combined block, because previous work suggests the deep injection is associated with a more frequent complication rate.

Jost Müllenheim, Benedikt Preckel, Detlef Obal, Marc Heiderhoff, Juliane Hoff, Volker Thämer, and Wolfgang Schlack

Left Stellate Ganglion Block Has Only Small Effects on Left Ventricular Function in Awake Dogs Before and After Induction of Heart Failure
Anesth Analg 2000 91: 787-792. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Left stellate ganglion blockade with local anesthetic produces only very small global hemodynamic and regional myocardial function changes in awake dogs, even in the presence of pacing-induced heart failure.

Pekka O. Talke, James E. Caldwell, Charles A. Richardson, and Tom Heier

The Effects of Clonidine on Human Digital Vasculature
Anesth Analg 2000 91: 793-797. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: At clinically relevant doses, clonidine produced vasoconstriction in digital vasculature and increased blood pressure in anesthetized volunteers, while producing the opposite effect in the awake state.

George Mychaskiw, II, Ahmed E. Badr, Robert Tibbs, Ben R. Clower, and John H. Zhang

Optison (FS069) Disrupts the Blood-Brain Barrier in Rats
Anesth Analg 2000 91: 798-803. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Optison appears to disrupt the blood-brain barrier when introduced directly into the cerebral arterial circulation. This may be related to the octafluoropropane gas used in Optison as a contrast medium. Optison should be used with caution when the possibility of a right-to-left shunt exists.

Phillip T. Leese, Robert J. Noveck, Jolene S. Shorr, Catherine M. Woods, Kathryn E. Flaim, and Peter E. Keipert

Randomized Safety Studies of Intravenous Perflubron Emulsion. I. Effects on Coagulation Function in Healthy Volunteers
Anesth Analg 2000 91: 804-811. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In major surgical procedures, perfluorocarbon-based temporary oxygen carriers are potentially important alternatives to blood transfusion. Newer, second-generation perfluorocarbon-based oxygen carriers have been developed to improve on the short-term side effects observed with earlier formulations. This report summarizes Phase I clinical safety data in healthy volunteers receiving the oxygen carrier, perflubron emulsion.

Robert J. Noveck, E. J. Shannon, Phillip T. Leese, Jolene S. Shorr, Kathryn E. Flaim, Peter E. Keipert, and Catherine M. Woods

Randomized Safety Studies of Intravenous Perflubron Emulsion. II. Effects on Immune Function in Healthy Volunteers
Anesth Analg 2000 91: 812-822. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In major surgical procedures, perfluorocarbon-based temporary oxygen carriers are potentially important alternatives to blood transfusion. Early perfluorocarbon-based oxygen carriers were limited by side effects that have been overcome with the newer, second-generation oxygen carriers. This report summarizes Phase I clinical safety findings of an improved second-generation oxygen carrier, perflubron emulsion.

Birgit Stögermüller, Josef Stark, Harald Willschke, Michael Felfernig, Klaus Hoerauf, and Sibylle A. Kozek-Langenecker

The Effect of Hydroxyethyl Starch 200 kD on Platelet Function
Anesth Analg 2000 91: 823-827. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The present data indicate that an antiplatelet effect of hydroxyethyl starch 200 kD should be considered during plasma volume expansion with this synthetic colloid.

Idit Matot, J. Y. Sichel, Valeri Yofe, and Yaacov Gozal

The Effect of Clonidine Premedication on Hemodynamic Responses to Microlaryngoscopy and Rigid Bronchoscopy
Anesth Analg 2000 91: 828-833. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Premedication with 300-{micro}g oral clonidine attenuates the hemodynamic response to microlaryngoscopy and bronchoscopy. These data should encourage routine premedication with clonidine in patients undergoing microlaryngoscopic and bronchoscopic procedures.

PEDIATRIC ANESTHESIA:

Michael A. Seropian and Berklee Robins

Smaller-than-Expected Sevoflurane Concentrations Using the Sevotec 5® Vaporizer at Low Fill States and High Fresh Gas Flows (Technical Communication)
Anesth Analg 2000 91: 834-836. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Smaller-than-expected concentrations of sevoflurane were delivered by Sevotec 5(R) vaporizers (Datex-Ohmeda, Madison, WI) at low-fill states, 8% dialed concentrations, and high fresh gas flows. Clinically, this would lead to prolonged induction times. The risk of complications from prolonged inhaled induction could be increased when using a vaporizer with these characteristics.

Merlin G. Butler, Blaine G. Hayes, Melanie M. Hathaway, and Michael L. Begleiter

Specific Genetic Diseases at Risk for Sedation/Anesthesia Complications (Special Article)
Anesth Analg 2000 91: 837-855. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This article provides a brief description of potential problematic genetic disorders and associated complications that may manifest during sedation or anesthesia. Recommendations for presedation evaluation and checklist items are given that may impact on the delivery of care for these patients.

Stephanie Bourlon-Figuet, Anne-Marie Dubousset, Dan Benhamou, and Jean Xavier Mazoit

Transient Neurologic Symptoms After Epidural Analgesia in a Five-Year-Old Child (Case Report)
Anesth Analg 2000 91: 856-857. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Transient neurologic symptoms occurred in a five-year-old child after discontinuation of epidural analgesia with bupivacaine and morphine, which had been established for two days after thoracotomy. The symptoms resolved within 12 hours with acetaminophen.

Ze’ev Shenkman, Offer Sheffer, Ilan Erez, Ita Litmanovitc, and Robert Jedeikin

Spinal Anesthesia For Gastrostomy in an Infant with Nemaline Myopathy (Case Report)
Anesth Analg 2000 91: 858-859. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We report a case of spinal anesthesia in an infant with nemaline myopathy. Spinal anesthesia was administered to preempt the potential problems of difficult tracheal intubation and prolonged mechanical ventilation secondary to muscle weakness after the use of IV anesthetics in this patient.

AMBULATORY ANESTHESIA:

Michael F. Mulroy, Kathleen L. Larkin, Peter S. Hodgson, James D. Helman, Julia E. Pollock, and Spencer S. Liu

A Comparison of Spinal, Epidural, and General Anesthesia for Outpatient Knee Arthroscopy
Anesth Analg 2000 91: 860-864. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: For outpatient knee arthroscopy, anesthesia can be provided adequately with regional or general anesthesia. Epidural and general anesthesia provide equal recovery times and patient satisfaction, whereas spinal anesthesia may prolong recovery and have increased side effects. The choice of anesthesia may depend primarily on the patient's interest in being alert or asleep during the procedure.

Bruce Ben-David, Michael Maryanovsky, Alexander Gurevitch, Christen Lucyk, David Solosko, Roman Frankel, Gershon Volpin, and Patrick J. DeMeo

A Comparison of Minidose Lidocaine-Fentanyl and Conventional-Dose Lidocaine Spinal Anesthesia
Anesth Analg 2000 91: 865-870. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The use of a small-dose lidocaine plus fentanyl combination for spinal anesthesia provides greater hemodynamic stability, faster recovery, and a significantly reduced incidence of transient neurologic symptoms than a conventional dose (50 mg) of spinal lidocaine.

Xinli Shao, Hong Li, Paul F. White, Kevin W. Klein, Christine Kulstad, and Andrew Owens

Bisulfite-Containing Propofol: Is it a Cost-Effective Alternative to Diprivan^TM for Induction of Anesthesia?
Anesth Analg 2000 91: 871-875. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Bisulfite-containing propofol and DiprivanTM (AstraZeneca, Wilmington, DE) were similar with respect to their induction characteristics; however, the generic formulation was associated with a smaller incidence of injection pain. Assuming that the drug costs are similar, these data suggest that the bisulfite-containing formulation of propofol is a cost-effective alternative to DiprivanTM.

Dajun Song, Nancy B. Greilich, Paul F. White, Mehernoor F. Watcha, and W. Kendall Tongier

Recovery Profiles and Costs of Anesthesia for Outpatient Unilateral Inguinal Herniorrhaphy
Anesth Analg 2000 91: 876-881. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Local anesthesia with propofol sedation for inguinal hernia repair was associated with a faster recovery, higher patient satisfaction, and lower costs compared with general and spinal anesthesia.

CRITICAL CARE AND TRAUMA:

Christian Byhahn, Hans-Joachim Wilke, Stephan Halbig, Volker Lischke, and Klaus Westphal

Percutaneous Tracheostomy: Ciaglia Blue Rhino Versus the Basic Ciaglia Technique of Percutaneous Dilational Tracheostomy
Anesth Analg 2000 91: 882-886. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: To assess practicability and safety of the Ciaglia Blue Rhino (Cook Critical Care, Bloomington, IL)—an extensively modified technique of percutaneous dilatational tracheostomy—50 critically ill adults on long-term ventilation underwent either new Ciaglia Blue Rhino or percutaneous dilatational tracheostomy in a prospective, randomized clinical trial.

Joachim Boldt

The Good, the Bad, and the Ugly: Should We Completely Banish Human Albumin from Our Intensive Care Units? (Special Article)
Anesth Analg 2000 91: 887-895. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Human albumin is still widely used in critically ill patients for volume replacement therapy or for correcting hypoproteinemia. Most meta-analyses on the value of albumin administration are over 15 yr old and raise more questions than they answer. With the help of a MEDLINE analysis, we examined more recent studies in humans using albumin. Most of these studies have recommended a very cautious use of albumin in critically ill patients.

NEUROSURGICAL ANESTHESIA:

Hirotsugu Okamoto, Richard J. Roman, John P. Kampine, and Anthony G. Hudetz

Endotoxin Augments Cerebral Hyperemic Response to Halothane by Inducing Nitric Oxide Synthase and Cyclooxygenase
Anesth Analg 2000 91: 896-903. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Excess nitric oxide and prostaglandins after lipopolysaccharide treatment in the brain augment halothane-induced increases in cerebral blood flow.

Ronald A. Kross, Enrico Ferri, Denis Leung, Margaret Pratila, Clara Broad, Michele Veronesi, and Jose A. Melendez

A Comparative Study Between a Calcium Channel Blocker (Nicardipine) and a Combined -ß-Blocker (Labetalol) for the Control of Emergence Hypertension During Craniotomy for Tumor Surgery
Anesth Analg 2000 91: 904-909. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: When given in combination with enalaprilat, nicardipine is a good alternative to labetalol for controlling emergence hypertension after craniotomies.

Joy E. Schabel, Edward D. Wang, and Peter S. A. Glass

Arm Pain as an Unusual Presentation of Postdural Puncture Intracranial Hypotension (Case Report)
Anesth Analg 2000 91: 910-912. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We report a case of a patient experiencing severe arm pain after dural puncture. This complication has not been reported previously. The patient was successfully treated with an epidural patch.

OBSTETRIC ANESTHESIA:

Jeffrey C. Livingston, Bill C. Mabie, and Jaya Ramanathan

Crack Cocaine, Myocardial Infarction, and Troponin I Levels at the Time of Cesarean Delivery (Case Report)
Anesth Analg 2000 91: 913-915. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: During the peripartum period, cocaine-abusing women are highly susceptible to myocardial infarction. This report describes a case of myocardial infarction diagnosed by increased troponin I levels in a pregnant patient with a history of recent crack cocaine use and severe preeclampsia.

Manuel C. Vallejo, Gordon L. Mandell, Daniel P. Sabo, and Sivam Ramanathan

Postdural Puncture Headache: A Randomized Comparison of Five Spinal Needles in Obstetric Patients
Anesth Analg 2000 91: 916-920. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We compared the rates of postdural puncture headache and epidural blood patch (EBP) with five different spinal needles in obstetric patients undergoing cesarean delivery. The least expensive Quincke needle had the highest postdural puncture headache and EBP rates. Patient discomfort as well as the cost of an EBP must be considered when choosing a spinal needle. Our results support using pencil-point spinal needles in obstetric patients.

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

Richard G. Gillerman and Richard A. Browning

Drug Use Inefficiency: A Hidden Source of Wasted Health Care Dollars
Anesth Analg 2000 91: 921-924. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Unadministered drug amounts were measured for six study drugs over one fiscal year and found to be significant; the cost of unadministered drugs totaled $165,667. The reason most cited for waste was disposal of full, or partially full, syringes.

Franklin Dexter

A Strategy to Decide Whether to Move the Last Case of the Day in an Operating Room to Another Empty Operating Room to Decrease Overtime Labor Costs
Anesth Analg 2000 91: 925-928. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The use of other information technologies to assist in the decision of whether to move a case, such as real-time patient tracking information systems, closed-circuit cameras, or graphical airport-style displays, can, on average, reduce overtime by no more than only 2 to 4 min per case that can be moved.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

Øivind Klaastad, Finn G. Lilleås, Jan S. Røtnes, Harald Breivik, and Erik Fosse

A Magnetic Resonance Imaging Study of Modifications to the Infraclavicular Brachial Plexus Block
Anesth Analg 2000 91: 929-933. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We studied methods for the administration of regional anesthesia of the upper extremity demanding needle insertion in the chest region by magnetic resonance imaging, without the use of any needle. The study suggests increasing the needle angle to the skin for better precision, still with a minimal risk for lung injury.

Helena Kallio, Markku Paloheimo, and Eeva-Liisa Maunuksela

Hyaluronidase as an Adjuvant in Bupivacaine-Lidocaine Mixture for Retrobulbar/Peribulbar Block
Anesth Analg 2000 91: 934-937. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We conclude that the addition of hyaluronidase 3.75 or 7.5 IU/mL improved the success of the initial retrobulbar/peribulbar block and akinesia and reduced the need for supplementary block.

Rosina Zarauza, Ana N. Sáez-Fernández, María J. Iribarren, Francisco Carrascosa, María Adame, Isabel Fidalgo, and Pablo Monedero

A Comparative Study with Oral Nifedipine, Intravenous Nimodipine, and Magnesium Sulfate in Postoperative Analgesia
Anesth Analg 2000 91: 938-943. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The increase of intracellular calcium plays a key role in spinal transmission of pain and in the establishment of central sensitization. We examined the effects of nifedipine, nimodipine, and magnesium sulfate in postoperative analgesia after colorectal surgery. We found no differences in morphine consumption with the administration of each drug alone.

Yuko Kanai, Hiroshi Katsuki, and Mayumi Takasaki

Lidocaine Disrupts Axonal Membrane of Rat Sciatic Nerve In Vitro
Anesth Analg 2000 91: 944-948. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This study demonstrates that exposing the rat myelinated nerve to lidocaine at a clinically used concentration for more than 30 min causes enough membrane damage to allow enzyme leakage. In clinical practice, the smallest effective dose should be used.

Paul F. White, William F. Craig, Akshay S. Vakharia, El-sayed A. Ghoname, Hesham E. Ahmed, and Mohammed A. Hamza

Percutaneous Neuromodulation Therapy: Does the Location of Electrical Stimulation Effect the Acute Analgesic Response?
Anesth Analg 2000 91: 949-954. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The location of peripheral electrical stimulation influences the acute analgesic response to percutaneous modulation therapy in patients with long-term neck pain. This study demonstrates that electrical stimulation at the involved dermatomal levels produced a greater hypoalgesic effect than remote dermatomal stimulation. These data suggest that percutaneous modulation therapy-induced analgesia results from neuromodulatory changes.

Salahadin Abdi, Natalia Vilassova, Isabelle Decosterd, Nusrat Feroz, and David Borsook

The Effects of KRN5500, a Spicamycin Derivative, on Neuropathic and Nociceptive Pain Models in Rats
Anesth Analg 2000 91: 955-959. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Implications: We have demonstrated that KRN5500 may have value in the treatment of neuropathic pain.

Lone Nikolajsen, Hanne Gottrup, Anders G. D. Kristensen, and Troels S. Jensen

Memantine (a N-Methyl-D-Aspartate Receptor Antagonist) in the Treatment of Neuropathic Pain After Amputation or Surgery: A Randomized, Double-Blinded, Cross-Over Study
Anesth Analg 2000 91: 960-966. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In a randomized, double-blinded and cross-over study, the analgesic effect of memantine (a drug which reduces the excitability of sensitized neurons in the dorsal horn) was examined in 19 patients with chronic pain after nerve injury.

Jesper Dirks, Peder Fabricius, Karin L. Petersen, Michael C. Rowbotham, and Jørgen B. Dahl

The Effect of Systemic Lidocaine on Pain and Secondary Hyperalgesia Associated with the Heat/Capsaicin Sensitization Model in Healthy Volunteers
Anesth Analg 2000 91: 967-972. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The efficacy of systemic lidocaine in nonneuropathic pain remains uncertain. This study investigates the effect of systemic lidocaine on experimental-induced hyperalgesia in 25 volunteers. Hyperalgesia was induced by using an experimental pain model that uses heat and capsaicin in combination. Systemic lidocaine showed a selective effect on secondary hyperalgesia.

GENERAL ARTICLES:

Kodali Bhavani-Shankar and James H. Philip

Defining Segments and Phases of a Time Capnogram
Anesth Analg 2000 91: 973-977. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Presently, the division of a time capnogram into inspiratory and expiratory segments is arbitrary. Demarcation of a time capnogram into various components using the gas flow signals facilitates prompt detection of the cause of abnormal capnograms that can widen the scope of future clinical applications of time capnography.

Marianne Winkler, Ozan Akça, Beatrice Birkenberg, Hubert Hetz, Thomas Scheck, Cem F. Arkiliç, Barbara Kabon, Elvine Marker, Alexander Grübl, Robert Czepan, Manfred Greher, Veronika Goll, Florian Gottsauner-Wolf, Andrea Kurz, and Daniel I. Sessler

Aggressive Warming Reduces Blood Loss During Hip Arthroplasty
Anesth Analg 2000 91: 978-984. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Aggressive warming better maintained core temperature (36.5{degrees} vs 36.1{degrees}C) and slightly decreased intraoperative blood pressure. Aggressive warming also decreased blood loss by approximately 200 mL. Aggressive warming may thus, be beneficial in patients undergoing hip arthroplasty.

Michael J. Laster, Edmond I Eger, II, William R. Cherry, and Diane Gong

Fractional Distillation of Acid Contaminants from Sevoflurane
Anesth Analg 2000 91: 985-988. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The acidic products produced by the rare degradation of sevoflurane distill more rapidly than sevoflurane vaporizes. The distillation of these products leaves only a small amount of acid in the remaining sevoflurane. Delivery of such products to human lungs might produce pulmonary injury.

Takehiko Iijima, Zenkou Nakamura, Yasuhide Iwao, and Hiroshi Sankawa

The Epileptogenic Properties of the Volatile Anesthetics Sevoflurane and Isoflurane in Patients with Epilepsy
Anesth Analg 2000 91: 989-995. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The stronger epileptogenicity of sevoflurane than isoflurane was confirmed in a controlled study in patients with epilepsy. Hyperventilation and supplementation of nitrous oxide under sevoflurane anesthesia suppressed epileptogenicity. A combination of sevoflurane and nitrous oxide may be a safer method for seizure-prone patients than the use of sevoflurane alone.

Xiangdong Chen, Michiaki Yamakage, Naoki Tsujiguchi, Yasuhiro Kamada, and Akiyoshi Namiki

Interaction Between Volatile Anesthetics and Hypoxia in Porcine Tracheal Smooth Muscle
Anesth Analg 2000 91: 996-1002. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Hypoxia inhibits agonist-induced tracheal smooth muscle contraction with an increase in free Ca2+ [Ca2+]i, which comes from intracellular Ca2+ stores. Hypoxia also potentiates the inhibitory effect of volatile anesthetics on airway smooth muscle contraction. Conversely, there is a possibility that the treatment of asthmatic patients with oxygen partially attenuates the inhibitory effect of volatile anesthetics on airway smooth muscle contractility.

J. Brimacombe, C. Keller, and J. Margreiter

A Pilot Study of Left Tracheal Pulse Oximetry
Anesth Analg 2000 91: 1003-1006. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Tracheal oximetry is feasible and provides similar readings to arterial blood samples and more accurate readings than finger oximetry in hemodynamically stable, well oxygenated, anesthetized patients with normal thoracic anatomy. Tracheal oximetry readings are not primarily derived from the tracheal mucosa. The technique merits further evaluation.

Philip G. Morgan, Gregory W. Radke, and Margaret M. Sedensky

Effects of Nonimmobilizers and Halothane on Caenorhabditis elegans
Anesth Analg 2000 91: 1007-1012. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: As in mammals, nonimmobilizers antagonize the effects of halothane on the nematode, C. elegans. The variation in slopes in the response to halothane in different strains is consistent with multiple sites of action. These results support the use of C. elegans as a model for the study of anesthetics.

Anya J. Maurer, Daniel I. Sessler, Edmond I Eger, II, and James M. Sonner

The Nonimmobilizer 1,2-Dichlorohexafluorocyclobutane Does Not Affect Thermoregulation in the Rat
Anesth Analg 2000 91: 1013-1016. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Unlike inhaled anesthetics, the nonimmobilizer 2N (1,2-dichlorohexafluorocyclobutane) minimally affects temperature regulation in rats. Thus, 2N may be useful in mechanistic studies of temperature regulation. Cellular and molecular sites that mediate the capacity of inhaled anesthetics to depress thermoregulation should be influenced by anesthetics but not by 2N.

Christian Keller, Joseph Brimacombe, Axel Kleinsasser, and Alex Loeckinger

Does the ProSeal Laryngeal Mask Airway Prevent Aspiration of Regurgitated Fluid?
Anesth Analg 2000 91: 1017-1020. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The correctly placed ProSeal laryngeal mask airway allows fluid in the esophagus to bypass the oropharynx in the cadaver model. This may have implications for airway protection in unconscious patients.

CASE REPORTS:

Michael S. Stix, Carl J. Borromeo, Sana Ata, and Paul D. Teague

A Modified Intubating Laryngeal Mask for Endotracheal Tube Exchange
Anesth Analg 2000 91: 1021-1023. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: It is often necessary to change a patient's breathing tube (endotracheal tube). This can be a risky procedure. This report describes a technique for changing an endotracheal tube by using a modified "intubating laryngeal mask" (a commonly used airway and breathing device) and a fiberoptic bronchoscope.

Ghassem E. Larijani, David Cypel, Irwin Gratz, Lynn Mroz, Robert Mandel, Mary Afshar, and Michael E. Goldberg

The Efficacy and Safety of EMLA^® Cream for Awake Fiberoptic Endotracheal Intubation
Anesth Analg 2000 91: 1024-1026. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: EMLA(R) Cream (Astra, Westborough, MA) provides satisfactory topical anesthesia of the oropharynx and should be considered a safe and effective alternative for anesthetizing the airway for awake oral fiberoptic intubation.

Mark Blas, Kurt S. Briesacher, and Emilio B. Lobato

Bacitracin Irrigation: A Cause Of Anaphylaxis in the Operating Room
Anesth Analg 2000 91: 1027-1028. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We report a unique case of acute anaphylaxis after mediastinal irrigation with a dilute bacitracin solution.

S. Kathirvel, A. Prakash, B. Ningegowda Lokesh, and Parv Sujatha

The Anesthetic Management of a Patient with Paroxysmal Nocturnal Hemoglobinuria
Anesth Analg 2000 91: 1029-1031. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This case report describes the anesthetic considerations for a patient with paroxysmal nocturnal hemoglobinuria. Specific strategies to be applied in the perioperative period to prevent hemolytic episodes and venous thrombosis are also discussed.

Joshua E. Lane, Alrick G. Brooks, Mary S. Logan, Walter H. Newman, and Manuel R. Castresana

An Unusual Case of Malignant Hyperthermia During Desflurane Anesthesia in an African-American Patient
Anesth Analg 2000 91: 1032-1034. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Malignant hyperthermia is an uncommon, heritable condition triggered by anesthesia and is followed by an increase in temperature that may be fatal without prompt treatment. It is rare with desflurane and in black individuals of African descent. We present a case of malignant hyperthermia in an African-American patient during desflurane anesthesia.

BRIEF COMMUNICATION:

Yoshitaka Fujii, Takuo Hoshi, Shinji Takahashi, and Hidenori Toyooka

The Effect of Sedative Drugs on Diaphragmatic Contractility in Dogs: Propofol Versus Midazolam
Anesth Analg 2000 91: 1035-1037. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: A sedative dose (0.1 mg {middle dot} kg-1 {middle dot} h-1) of midazolam, compared with a subhypnotic dose (1.5 mg {middle dot} kg-1 {middle dot} h-1) of propofol, decreases the contractility of the diaphragm in dogs.

LETTERS TO THE EDITOR:

Peter H. Breen and Aaron Hong

Beware of Air in the Blood Pump
Anesth Analg 2000 91: 1038. [Full Text] [PDF] [Request Permissions]  

Laszlo Gyermek and Jay Yang

Muscle Relaxants and 5-HT₃ Receptors • Response
Anesth Analg 2000 91: 1039. [Full Text] [PDF] [Request Permissions]  

Georgios Ekatodramis, Bettina Hutter, Alain Borgeat, Marcio L. Horta, Lourenço Ramos, and Zonia R. Gonçalves

Inhibition of Epidural Morphine-Induced Pruritus by Epidural Droperidol • Response
Anesth Analg 2000 91: 1039-1040. [Full Text] [PDF] [Request Permissions]  

Berklee Robins and Michael Seropian

Sticker Sedation
Anesth Analg 2000 91: 1040. [Full Text] [PDF] [Request Permissions]  

Gerhard A. Baer and Andreas Bacher

No Need for Claims: Facts Rule Performance of Jet Ventilation • Response
Anesth Analg 2000 91: 1040-1041. [Full Text] [PDF] [Request Permissions]  

Daniel E. Supkis, Jr, Luca Bigatello, William Hurford, and Dean Hess

Nitric Oxide Delivery System • Response
Anesth Analg 2000 91: 1041-1042. [Full Text] [PDF] [Request Permissions]  

C. Sarantopoulos, Erik Jensen, and Nader D. Nader

Intravenous Lidocaine and Intrathecal Opioids • Response
Anesth Analg 2000 91: 1042. [Full Text] [PDF] [Request Permissions]  

B. Al-Shaikh

New Cuff Design Prevents N₂O Diffusion
Anesth Analg 2000 91: 1042. [Full Text] [PDF] [Request Permissions]  

Bruce Ben-David

NMDA Receptor Blockade: From the Laboratory to Clinical Application
Anesth Analg 2000 91: 1042-1043. [Full Text] [PDF] [Request Permissions]  

David Gozal and Yaacov Gozal

An Unusual Cause of Failed Sedation
Anesth Analg 2000 91: 1043. [Full Text] [PDF] [Request Permissions]  

D. De Amici, C. Klersy, F. Ramajoli, and L. Brustia

More About the Hawthorne Effect
Anesth Analg 2000 91: 1043. [Full Text] [PDF] [Request Permissions]  

Miriam J. P. Harnett and Scott Segal

Presence of Placental Tissue Is Necessary for TNG to Provide Uterine Relaxation
Anesth Analg 2000 91: 1043-1044. [Full Text] [PDF] [Request Permissions]  

Hae Keum Kil and C. E. Allison

Hypercapnea Is an Important Adjuvant Factor of Oculocardiac Reflex During Strabismus Surgery • Response
Anesth Analg 2000 91: 1044. [Full Text] [PDF] [Request Permissions]  

Christopher M. B. Heard, Björn Gunnarsson, and James E. Fletcher

Teaching Fiberoptic Intubation in the Pediatric Patient
Anesth Analg 2000 91: 1044. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Peter Rock and J. G. Reves

Thoracic Anesthesia/Hyperbaric Medicine. Vol. 38 International Anesthesiology Clinics • Geriatric Anesthesia, Vol. 18, No. 1 of Anesthesiology Clinics of North America • Books and Multimedia Received
Anesth Analg 2000 91: 1045-1046. [Full Text] [PDF] [Request Permissions]  

ERRATA:

Correction for vol. 90, p. 1217
Anesth Analg 2000 91: 833. [Full Text] [Request Permissions]  

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