CARDIOVASCULAR ANESTHESIA:

Michael J. A. Robson, R. Peter Alston, Ian J. Deary, Peter J. D. Andrews, Michael J. Souter, and Shona Yates

Cognition After Coronary Artery Surgery Is Not Related to Postoperative Jugular Bulb Oxyhemoglobin Desaturation
Anesth Analg 2000 91: 1317-1326. [Abstract] [Full Text]  

Implications: Postoperative cerebral hypoperfusion, indicated by oxyhemoglobin desaturation < 50%, occurs in many patients after coronary artery bypass graft surgery. However, this measurement of hypoperfusion does not appear to influence long-term cognition after coronary artery bypass graft surgery.

Benedikt Preckel, Jost Müllenheim, Andrej Moloschavij, Volker Thämer, and Wolfgang Schlack

Xenon Administration During Early Reperfusion Reduces Infarct Size After Regional Ischemia in the Rabbit Heart In Vivo
Anesth Analg 2000 91: 1327-1332. [Abstract] [Full Text]  

Implications: Xenon might be a suitable volatile anesthetic in an ischemia-reperfusion situation.

Andreas Meißner, Thomas P. Weber, Hugo Van Aken, Kai Zbieranek, and Norbert Rolf

Recovery from Myocardial Stunning Is Faster with Desflurane Compared with Propofol in Chronically Instrumented Dogs
Anesth Analg 2000 91: 1333-1338. [Abstract] [Full Text]  

Implications: The use of the volatile anesthetic desflurane during cardiac ischemia is controversial because of its effect of sympathetic activation. In chronically instrumented dogs, recovery from myocardial stunning was faster when desflurane was used for anesthesia during ischemia compared with propofol.

Georg Grubhofer, Walter Plöchl, Michael Skolka, Martin Czerny, Marek Ehrlich, and Andrea Lassnigg

Comparing Doppler Ultrasonography and Cerebral Oximetry as Indicators for Shunting in Carotid Endarterectomy
Anesth Analg 2000 91: 1339-1344. [Abstract] [Full Text]  

Implications: Although cerebral oximetry was easy to apply but considerably unspecific (13% false positives), transcranial Doppler ultrasonography was more accurate in indicating the risk of cerebral hypoperfusion during carotid cross-clamping. Additionally, the improvement in cerebral blood flow velocity after inducing arterial hypertension might prevent cerebral hypoperfusion during cross-clamping.

Yoshio Hashimoto, Kazuyoshi Hirota, Hideki Yoshioka, Tsuyoshi Kudo, Hironori Ishihara, and Akitomo Matsuki

A Comparison of the Spasmolytic Effects of Olprinone and Aminophylline on Serotonin-Induced Pulmonary Hypertension and Bronchoconstriction With or Without ß-Blockade in Dogs
Anesth Analg 2000 91: 1345-1350. [Abstract] [Full Text]  

Implications: We compared the relaxant effects of olprinone and aminophylline on serotonin-induced pulmonary hypertension and bronchoconstriction in dogs. Olprinone was a more potent pulmonary vasodilator and bronchodilator than aminophylline. In addition, olprinone may produce greater effects on phosphodiesterase-3 in pulmonary vascular than in airway smooth muscle.

Masato Nakasuji and Michael J. Bookallil

Pathophysiological Mechanisms of Postrevascularization Hyperkalemia in Orthotopic Liver Transplantation
Anesth Analg 2000 91: 1351-1355. [Abstract] [Full Text]  

Implications: We demonstrate that serum K+ concentration, serum lactate, and cardiac index during the anhepatic phase predict K+ concentration just after revascularization in orthotopic liver transplantation and that the extent of preservation injury of graft liver and duration of cold ischemia do not contribute significantly to the induction of hyperkalemia.

Anthony M.-H. Ho, David C. Chung, Beng A. Tay, L. M. Yu, and Patricia Yeo

Diluted Venous Blood Appears Arterial: Implications for Central Venous Cannulation (Brief Report)
Anesth Analg 2000 91: 1356-1357. [Abstract] [Full Text]  

Implications: There is always a danger of arterial puncture during central venous access. One can usually identify an inadvertent arterial puncture when the aspirated blood is bright red. This sign is removed if one were to put saline in the aspirating syringe, as dusky venous blood turns bright red on dilution.

Ajeet D. Sharma, C. L. Parmley, Gautam Sreeram, and Hilary P. Grocott

Peripheral Nerve Injuries During Cardiac Surgery: Risk Factors, Diagnosis, Prognosis, and Prevention (Review Article)
Anesth Analg 2000 91: 1358-1369. [Full Text]  

Mauricio Nino, Simon C. Body, and Philip M. Hartigan

The Use of a Bronchial Blocker To Rescue an Ill-Fitting Double-Lumen Endotracheal Tube (Case Report)
Anesth Analg 2000 91: 1370-1371. [Abstract] [Full Text]  

Implications: Using certain specialized endotracheal tubes designed to allow single-lung ventilation for certain thoracic surgical procedures may be fraught with technical difficulties owing to common anatomic anomalies. This case report describes a simple solution for an ill-fitting right double-lumen endotracheal tube using a balloon-tipped catheter.

Nabil W. Doss, Marthur Ambrish, Joseph Ipe, Rafik Michael, and Jonas Gintautas

Epidural Blood Patch After Thoracotomy for Treatment of Headache Caused by Surgical Tear of Dura (Case Report)
Anesth Analg 2000 91: 1372-1374. [Abstract] [Full Text]  

Implications: During a right lobectomy operation, a patient with carcinoma of the lung developed postoperative headache caused by a leak of cerebrospinal fluid from an area of dura injured during the procedure. Conservative treatment was unsuccessful. Injection of 10 mL of the patient's own blood into the epidural space relieved the headache.

ERRATUM:

Erratum
Anesth Analg 2000 91: 1333-1338. [Full Text]  

PEDIATRIC ANESTHESIA:

Shinji Kawahito, Hiroshi Kitahata, Katsuya Tanaka, Junpei Nozaki, and Shuzo Oshita

Intraoperative Evaluation of Pulmonary Artery Flow During the Fontan Procedure by Transesophageal Doppler Echocardiography
Anesth Analg 2000 91: 1375-1380. [Abstract] [Full Text]  

Implications: We evaluated intraoperative pulmonary artery flow velocity patterns with transesophageal Doppler echocardiography (TEE) in patients during a Fontan procedure. Because pulmonary artery flow is influenced by pulmonary vascular resistance and ventricular function, intraoperative evaluation of pulmonary artery flow using TEE should be further evaluated as a predictor of surgical outcome after a Fontan procedure.

Ilan Keidan, Gavin F. Fine, Tetsuro Kagawa, Francis X. Schneck, and Etsuro K. Motoyama

Work of Breathing During Spontaneous Ventilation in Anesthetized Children: A Comparative Study Among the Face Mask, Laryngeal Mask Airway and Endotracheal Tube
Anesth Analg 2000 91: 1381-1388. [Abstract] [Full Text]  

Implications: We studied work of breathing (WOB) measured with four airway devices, with and without application of continuous positive airway pressure (CPAP). Laryngeal mask airway and mask with oral airway decrease WOB compared with mask alone. CPAP decreases WOB with all devices except the endotracheal tube. Increased WOB appears mostly because of soft tissue upper airway obstruction.

Ronald S. Litman, Jyothsna Ponnuri, and Igor Trogan

Anesthesia for Tracheal or Bronchial Foreign Body Removal in Children: An Analysis of Ninety-Four Cases (Brief Report)
Anesth Analg 2000 91: 1389-1391. [Abstract] [Full Text]  

Implications: This report is a description of the ventilation techniques used in 94 children undergoing general anesthesia for foreign body removal of the bronchus. No particular technique was found to be associated with a greater incidence of adverse outcomes.

David Mills Cara, Pauline Armory, and Ravi Prakash Mahajan

Prolonged Duration of Neuromuscular Block with Rapacuronium in the Presence of Sevoflurane (Case Report)
Anesth Analg 2000 91: 1392-1393. [Abstract] [Full Text]  

Implications: We report three cases of prolonged paralysis resulting from rapacuronium in the presence of sevoflurane.

Jeffrey L. Galinkin, Robert R. Gaiser, David E. Cohen, Timothy M. Crombleholme, Mark Johnson, and C. Dean Kurth

Anesthesia for Fetoscopic Fetal Surgery: Twin Reverse Arterial Perfusion Sequence and Twin-Twin Transfusions Syndrome (Case Report)
Anesth Analg 2000 91: 1394-1397. [Abstract] [Full Text]  

Implications: Twin reversed arterial perfusion sequence and twin-twin transfusion syndrome can be managed by fetoscopic fetal surgery. It is important to consider the fetal, uteroplacental, and maternal issues when choosing an anesthetic technique. We report on three patients with differing anesthetic issues using fetoscopic surgery for umbilical cord coagulation.

INTRAVENOUS ANESTHESIA:

Vincent Bonhomme, Gilles Plourde, Pascal Meuret, Pierre Fiset, and Steven B. Backman

Auditory Steady-State Response and Bispectral Index for Assessing Level of Consciousness During Propofol Sedation and Hypnosis
Anesth Analg 2000 91: 1398-1403. [Abstract] [Full Text]  

Implications: We have compared two methods for predicting whether the amount of propofol given to a human subject is sufficient to cause unconsciousness, defined as failure to respond to a simple verbal command. The two methods studied are the auditory steady-state response, which measures the electrical response of the brain to sound, and the bispectral index, which is a number derived from the electroencephalogram. The results showed that both methods are very good predictors of the level of consciousness; however, bispectral was easier to use.

AMBULATORY ANESTHESIA:

Jhi-Joung Wang, Shung-Tai Ho, Shih-Chun Lee, Yao-Chi Liu, and Chiu-Ming Ho

The Use of Dexamethasone for Preventing Postoperative Nausea and Vomiting in Females Undergoing Thyroidectomy: A Dose-Ranging Study
Anesth Analg 2000 91: 1404-1407. [Abstract] [Full Text]  

Implications: We evaluated four doses of IV dexamethasone in preventing postoperative nausea and vomiting in women undergoing thyroidectomy. We found that dexamethasone 5 mg was as effective as dexamethasone 10 mg, and was more effective than saline control. Dexamethasone 5 mg is suggested to be the minimum effective dose for this purpose.

Phillip E. Scuderi, Robert L. James, Lynne Harris, and Grover R. Mims, III

Multimodal Antiemetic Management Prevents Early Postoperative Vomiting After Outpatient Laparoscopy
Anesth Analg 2000 91: 1408-1414. [Abstract] [Full Text]  

Implications: Use of a multimodal clinical care algorithm eliminates predischarge vomiting and improves satisfaction in patients undergoing outpatient laparoscopy.

Lucio Glantz, Benjamin Drenger, and Yaacov Gozal

Perioperative Myocardial Ischemia in Cataract Surgery Patients: General Versus Local Anesthesia
Anesth Analg 2000 91: 1415-1419. [Abstract] [Full Text]  

Implications: In patients with risk factors for ischemic heart disease, cataract surgery occurs in 30% of the cases with ischemic events of short duration. There were significantly less intraoperative episodes in the local anesthesia group, suggesting that local anesthesia may be safer than general anesthesia in patients during this type of surgery.

Richard A. Beers, J. Robert Calimlim, Emmanuel Uddoh, Barbara F. Esposito, and Enrico M. Camporesi

A Comparison of the Cost-Effectiveness of Remifentanil Versus Fentanyl as an Adjuvant to General Anesthesia for Outpatient Gynecologic Surgery
Anesth Analg 2000 91: 1420-1425. [Abstract] [Full Text]  

Implications: As an opioid adjuvant to general anesthesia for outpatient gynecologic laparoscopy and hysteroscopy, the benefits of remifentanil did not offset its added cost as compared with fentanyl.

Franklin Dexter and Rodney D. Traub

The Lack of Systematic Month-to-Month Variation Over One-Year Periods in Ambulatory Surgery Caseload -Application to Anesthesia Staffing
Anesth Analg 2000 91: 1426-1430. [Abstract] [Full Text]  

Implications: The average number of ambulatory surgery cases performed with an anesthesia provider each day in the United States per 10,000 population did not vary systematically month to month on a medium-range (11-mo) basis. These findings suggest that the relatively simple statistical methods that are available to estimate future anesthesia workload will work for many anesthesia groups.

CRITICAL CARE AND TRAUMA:

Bruno Jawan, Hak-Kim Cheung, Zu-Kong Chong, Yan-Yuen Poon, Yu-Feng Cheng, Han-Shiang Chen, Chia-Jung Huang, and J. H. Lee

Aspiration in Transtracheal Oxygen Insufflation with Different Insufflation Flow Rates During Cardiopulmonary Resuscitation in Dogs
Anesth Analg 2000 91: 1431-1435. [Abstract] [Full Text]  

Implications: In case of difficult airway during cardiopulmonary resuscitation, insertion of an IV catheter through the trachea is easy, and insufflation of 10 L/min of oxygen through the needle can not only maintain the oxygenation but also prevent aspiration.

OBSTETRIC ANESTHESIA:

Brian Fredman, Arie Shapiro, Edna Zohar, Ella Feldman, Shy Shorer, Narinder Rawal, and Robert Jedeikin

The Analgesic Efficacy of Patient-Controlled Ropivacaine Instillation After Cesarean Delivery
Anesth Analg 2000 91: 1436-1440. [Abstract] [Full Text]  

Implications: Ropivacaine wound instillation via an elastometric pump is a simple technique that provides safe and effective analgesia after cesarean delivery.

Toshihide Sato, Akira Hashiguchi, and Tetsuro Mitsuse

Anesthesia for Cesarean Delivery in a Pregnant Woman with Acute Hepatic Failure (Case Report)
Anesth Analg 2000 91: 1441-1442. [Abstract] [Full Text]  

Implications: A case of reactivation of hepatitis B and development of fulminant hepatic failure in a pregnant hepatitis B virus carrier is reported. Although the occurrence or reactivation of hepatitis B in pregnancy are rare and usually not considered to be medical indications for termination of pregnancy, decisions regarding delivery and liver transplantation must be made if severe hepatic failure develops.

NEUROSURGICAL ANESTHESIA:

Elizabeth H. Sinz, W. Andrew Kofke, and Robert H. Garman

Phenytoin, Midazolam, and Naloxone Protect Against Fentanyl-Induced Brain Damage in Rats
Anesth Analg 2000 91: 1443-1449. [Abstract] [Full Text]  

Implications: Narcotics in large doses can cause brain damage in rats. This brain damage is attenuated by a narcotic antagonist, a sedative, and an antiepileptic drug.

Chuanyao Tong, Matthias W. König, Pamela R. Roberts, Stephen B. Tatter, and Xin-Hui Li

Autonomic Dysfunction Secondary to Intracerebral Hemorrhage (Case Report)
Anesth Analg 2000 91: 1450-1451. [Abstract] [Full Text]  

Implications: We report a case of autonomic dysfunction secondary to intracranial hemorrhage. The patient had periodical episodes of hypertension, tachycardia, tachypnea, and diaphoresis that responded dramatically to Thorazine, but not to conventional measures.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

Kristiina S. Kuusniemi, Kalevi K. Pihlajamäki, Mikko T. Pitkänen, Hans Y. Helenius, and Olli A. Kirvelä

The Use of Bupivacaine and Fentanyl for Spinal Anesthesia for Urologic Surgery
Anesth Analg 2000 91: 1452-1456. [Abstract] [Full Text]  

Implications: Bupivacaine 5 mg with 25 {micro}g of fentanyl for spinal anesthesia resulted in short-acting motor block. On the contrary, the addition of 25 {micro}g of fentanyl to 10 mg of bupivacaine resulted in an increase in the motor block intensity and duration.

Jean-Marc Malinovsky, Florence Charles, Ottmar Kick, Jean-Yves Lepage, Myriam Malinge, Antoine Cozian, Olivier Bouchot, and Michel Pinaud

Intrathecal Anesthesia: Ropivacaine Versus Bupivacaine
Anesth Analg 2000 91: 1457-1460. [Abstract] [Full Text]  

Implications: Inadequate intrathecal anesthesia was observed in 16% of patients with 15 mg of ropivacaine, whereas intensity and duration of motor blockade was not different in comparison to 10 mg of bupivacaine. Ropivacaine appears to be less potent than bupivacaine at doses used in spinal anesthesia.

Kati Järvelä, Seppo E. Honkonen, Timo Järvelä, Tiit Kööbi, and Seppo Kaukinen

The Comparison of Hypertonic Saline (7.5%) and Normal Saline (0.9%) for Initial Fluid Administration Before Spinal Anesthesia
Anesth Analg 2000 91: 1461-1465. [Abstract] [Full Text]  

Implications: Initial fluid administration with isotonic fluids is often used for the prevention of hypotension before spinal anesthesia. We infused 1.6 mL/kg of hypertonic saline 7.5% or 13 mL/kg of normal saline for the initial fluid administration and found that, by using hypertonic saline solution, effective initial fluid administration can be achieved without excess free water administration.

Walter Schaffartzik, Jan Hirsch, Frank Frickmann, Peter Kuhly, and Arneborg Ernst

Hearing Loss after Spinal and General Anesthesia: A Comparative Study
Anesth Analg 2000 91: 1466-1472. [Abstract] [Full Text]  

Implications: The results of this study imply that hearing loss occurs after spinal as well as after general anesthesia. The positive correlation of low-frequency hearing loss and intraoperative fluid administration replacement suggests that cerebrospinal fluid leakage via the spinal puncture hole is not the only factor involved.

Stephen M. Klein, Stuart A. Grant, Roy A. Greengrass, Karen C. Nielsen, Kevin P. Speer, William White, David S. Warner, and Susan M. Steele

Interscalene Brachial Plexus Block with a Continuous Catheter Insertion System and a Disposable Infusion Pump
Anesth Analg 2000 91: 1473-1478. [Abstract] [Full Text]  

Implications: This study demonstrates that it is possible to achieve successful interscalene brachial plexus continuous catheter insertion and a high degree of persistent analgesia by using a catheter insertion system and a disposable infusion pump administering 0.2% ropivacaine.

Vera M. S. Azevedo, Gabriela R. Lauretti, Newton L. Pereira, and Marlene P. Reis

Transdermal Ketamine as an Adjuvant for Postoperative Analgesia After Abdominal Gynecological Surgery Using Lidocaine Epidural Blockade
Anesth Analg 2000 91: 1479-1482. [Abstract] [Full Text]  

Implications: Transdermal delivery of ketamine was an useful adjuvant to postoperative analgesia after epidural lidocaine blockade in the population studied.

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

The Effect of Ketamine on Opioid-Induced Acute Tolerance: Can It Explain Reduction of Opioid Consumption with Ketamine-Opioid Analgesic Combinations?
Anesth Analg 2000 91: 1483-1488. [Abstract] [Full Text]  

Implications: Ketamine attenuated the development of acute tolerance to analgesia during alfentanil infusion and suppressed rebound hyperalgesia observed the day after the infusion.

Philippe Dony, Virginie Dewinde, Bernard Vanderick, Olivier Cuignet, Philippe Gautier, Eric Legrand, Patricia Lavand’homme, and Marc De Kock

The Comparative Toxicity of Ropivacaine and Bupivacaine at Equipotent Doses in Rats
Anesth Analg 2000 91: 1489-1492. [Abstract] [Full Text]  

Implications: Our results clearly demonstrate that ropivacaine, even used at an equipotent dose, has a wider therapeutic index than bupivacaine.

Philip J. Siddall, Allan R. Molloy, Suellen Walker, Laurence E. Mather, Susan B. Rutkowski, and Michael J. Cousins

The Efficacy of Intrathecal Morphine and Clonidine in the Treatment of Pain After Spinal Cord Injury
Anesth Analg 2000 91: 1493-1498. [Abstract] [Full Text]  

Implications: Neuropathic pain after spinal cord injury is very difficult to control adequately by using currently available techniques. We have performed a placebo-controlled, double-blinded study demonstrating that administration of a combination of morphine and clonidine into the spinal fluid can provide substantial pain relief in some people with this type of pain.

Michael E. Bräu, Pierre Branitzki, Andrea Olschewski, Werner Vogel, and Gunter Hempelmann

Block of Neuronal Tetrodotoxin-Resistant Na+ Currents by Stereoisomers of Piperidine Local Anesthetics
Anesth Analg 2000 91: 1499-1505. [Abstract] [Full Text]  

Implications: Tetrodotoxin-resistant Na+ channels are important in peripheral nociception. During local anesthesia, these channels are blocked by mepivacaine, ropivacaine, and bupivacaine in a concentration and use-dependent manner, but not stereoselectively.

GENERAL ARTICLES:

Andreas Bacher, Thomas Lang, Johannes Weber, and Alexander Aloy

Respiratory Efficacy of Subglottic Low-Frequency, Subglottic Combined-Frequency, and Supraglottic Combined-Frequency Jet Ventilation During Microlaryngeal Surgery
Anesth Analg 2000 91: 1506-1512. [Abstract] [Full Text]  

Implications: The combination of high and low respiratory frequencies (600 and 15 breaths/min) improves pulmonary gas exchange during subglottic jet ventilation via an endotracheal catheter. However, subglottic combined-frequency jet ventilation is less effective than supraglottic combined-frequency jet ventilation via a jet ventilation laryngoscope.

Spyros D. Mentzelopoulos, Constantina N. Romana, Despina S. Corolanoglou, Maria J. Tzoufi, and Evangelia A. Karamichali

Balloon Versus Conventional Laryngoscopy: A Comparison of Laryngoscopic Findings and Intubation Difficulty
Anesth Analg 2000 91: 1513-1519. [Abstract] [Full Text]  

Implications: The results of this study show that balloon-assisted laryngoscopy facilitates the airway management of elective surgery patients by providing greater laryngeal exposure than conventional laryngoscopy. Thus, the routine use of a curved blade carrying the inflatable balloon of a 6F Fogarty catheter on its distal end is recommended.

Valter Perilli, Liliana Sollazzi, Patrizia Bozza, Cristina Modesti, Angelo Chierichini, Roberto Maria Tacchino, and Raffaela Ranieri

The Effects of the Reverse Trendelenburg Position on Respiratory Mechanics and Blood Gases in Morbidly Obese Patients During Bariatric Surgery
Anesth Analg 2000 91: 1520-1525. [Abstract] [Full Text]  

Implications: The aim of the study was to assess whether the reverse Trendelenburg position could improve pulmonary gas exchange in obese patients undergoing abdominal surgical procedures. Our work may have a clinical value because few studies deal with this issue.

Linda M. Collins, Joan C. Bevan, David R. Bevan, Giselle C. P. Villar, Raymond Kahwaji, Michael F. Smith, and François Donati

The Prolonged Duration of Rocuronium in Chinese Patients
Anesth Analg 2000 91: 1526-1530. [Abstract] [Full Text]  

Implications: The potency of rocuronium does not differ between adults and children of Caucasian and Chinese origins. If tracheal intubating doses of 0.6 mg/kg IV are given, similar levels of neuromuscular blockade are expected but recovery will be longer by 29%-30% in Chinese compared with Caucasian children and adults.

Shigeru Saito, Yuji Kadoi, Takeshi Nara, Makoto Sudo, Hideaki Obata, Toshihiro Morita, and Fumio Goto

The Comparative Effects of Propofol Versus Thiopental on Middle Cerebral Artery Blood Flow Velocity During Electroconvulsive Therapy
Anesth Analg 2000 91: 1531-1536. [Abstract] [Full Text]  

Implications: Cerebral blood flow velocity change, measured by transcranial Doppler sonography during electroconvulsive therapy, was minor using propofol anesthesia compared with barbiturate anesthesia. Propofol anesthesia may be suitable for patients who cannot tolerate abrupt cerebral hemodynamic change.

Yurie Tohdoh, Eichi Narimatsu, Mikito Kawamata, and Akiyoshi Namiki

The Involvement of Adenosine Neuromodulation in Pentobarbital-Induced Field Excitatory Postsynaptic Potentials Depression in Rat Hippocampal Slices
Anesth Analg 2000 91: 1537-1541. [Abstract] [Full Text]  

Implications: Adenosine neuromodulation contributes to mechanisms of pentobarbital-induced excitatory postsynaptic potentials depression.

Gerhard Hapfelmeier, Walter Zieglgänsberger, Rainer Haseneder, Hajo Schneck, and Eberhard Kochs

Nitrous Oxide and Xenon Increase the Efficacy of GABA at Recombinant Mammalian GABA_A Receptors
Anesth Analg 2000 91: 1542-1549. [Abstract] [Full Text]  

Implications: The anesthetic gases nitrous oxide (laughing gas) and xenon increase the activity of a mammalian GABAA receptor. This receptor is held responsible for the inhibition of important actions of the human brain, e.g., maintenance of consciousness and awareness.

CASE REPORTS:

Georgia Kostopanagiotou, Maria Mylona, Lina Massoura, and Ioanna Siafaka

Accidental Epidural Injection of Vecuronium
Anesth Analg 2000 91: 1550-1551. [Abstract] [Full Text]  

Implications: We report a case of accidental epidural injection of vecuronium in a female patient who underwent hemorrhoidectomy using epidural anesthesia. Because epidural injection of muscle relaxants may have serious side effects, immediate establishment of airway protection, monitoring of muscle relaxation, and follow-up for clinical signs of neurotoxicity are recommended.

J. Mark Matthews

Succinylcholine-Induced Hyperkalemia and Rhabdomyolysis in a Patient with Necrotizing Pancreatitis
Anesth Analg 2000 91: 1552-1554. [Abstract] [Full Text]  

Implications: Commonly used muscle relaxants may have serious side effects when used in critically ill patients. This case report relates some of these side effects and reviews the mechanisms by which they are thought to occur.

TECHNICAL COMMUNICATIONS:

Marie-José Colas, Jean-Pierre Tétrault, Lynne Dumais, Patrick Truong, Yves Claprood, and René Martin

The SiBI^TM Connector: A New Medical Device to Facilitate Preoxygenation and Reduce Waste Anesthetic Gases During Inhaled Induction with Sevoflurane
Anesth Analg 2000 91: 1555-1559. [Abstract] [Full Text]  

Implications: The SiBITM connector is a new medical device used for vital capacity inhaled induction with sevoflurane. It allows efficient preoxygenation of patients and reduces waste anesthetic gases in the operation room during induction.

LETTERS TO THE EDITOR:

Stephanie Armstrong, W. John Russell, and Gregory C. Allen

The Onset of MH • Response
Anesth Analg 2000 91: 1560. [Full Text]  

David L. Hepner, Craig M. Palmer, Wallace M. Nogami, Gretchen Van Maren, and Diane M. Alves

Neuraxial Opioids and Respiratory Depression • Response
Anesth Analg 2000 91: 1560-1561. [Full Text]  

Egbert Huettemann and Gregory A. Nuttall

Hetastarch and Hydroxyethyl Starch Are Not the Same • Response
Anesth Analg 2000 91: 1561. [Full Text]  

Irene P. Osborn

The Intubating Laryngeal Mask Airway (ILMA) is Assisted by an Old Device
Anesth Analg 2000 91: 1561-1562. [Full Text]  

George Mychaskiw, II, Bobby J. Heath, Gregory B. Hammer, Khanh Ngo, and Alex Macario

Regional Anesthesia and Pediatric Cardiac Surgery • Response
Anesth Analg 2000 91: 1562. [Full Text]  

Richard I. Mazze

Novel CO₂ Absorbents and Low-Flow Sevoflurane
Anesth Analg 2000 91: 1562-1563. [Full Text]  

Luis G. Michelsen, Peter Elliott, and Rajinder K. Mirakhur

Hemodynamic Effects of Remifentanil in Patients Undergoing Cardiac Surgery • Response
Anesth Analg 2000 91: 1563. [Full Text]  

Sylvia Y. Dolinski and Leanne Groban

Look Before You Leap
Anesth Analg 2000 91: 1563-1564. [Full Text]  

Ajeet D. Sharma and Thomas F. Slaughter

Utilization of a Retrograde Cardioplegia Catheter for Rapid Central Venous Infusion
Anesth Analg 2000 91: 1564. [Full Text]  

Jaideep J. Pandit

Potential Hazards of Radiolucent Body Art in the Tongue
Anesth Analg 2000 91: 1564-1565. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

Robert Friedman, L. Jill Krasnor, M. Joanne Douglas, Peter G. Duncan, Terrence C. Bogard, and Norig Ellison

Anesthesiology and the Academic Medical Center: Place and Promise at the Start of the New Millenium. Vol. 38, No. 2 of International Anesthesiology Clinics. • Textbook of Obstetric Anesthesia • Evidence Based Resource in Anaesthesia and Analgesia • Ostheimer’s Manual of Obstetric Anesthesia, 3^rd ed. • Blind Eye: How the Medical Establishment Let a Doctor Get Away With Murder • Books and Multimedia Received
Anesth Analg 2000 91: 1566-1568. [Full Text]  

GUEST REVIEWS:

GUEST REVIEWERS LIST— APRIL 2000 TO SEPTEMBER 2000
Anesth Analg 2000 91: 1569-1573. [Full Text]  

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