EDITORIALS:

Paul F. White and James G. Bovill

From SIVA to ISAP!—A Logical Evolution
Anesth Analg 2001 92: 1-2. [Full Text] [PDF] [Request Permissions]  

John C. Rowlingson

How Can Local Anesthetic in the Wound Not Help?
Anesth Analg 2001 92: 3-4. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Anders Thorén, Mikael Elam, and Sven-Erik Ricksten

Jejunal Mucosal Perfusion Is Well Maintained During Mild Hypothermic Cardiopulmonary Bypass in Humans
Anesth Analg 2001 92: 5-11. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Jejunal mucosal perfusion increases during mild hypothermic cardiopulmonary bypass (CPB). Intestinal laser Doppler flowmetry, gastric tonometry, and measurements of splanchnic lactate extraction could not reveal a local or global splanchnic ischemia during or after CPB. A mismatch between splanchnic oxygen delivery and demand was seen, particularly during rewarming and warm CPB.

Michael B. Howie, Roger Dzwonczyk, and Thomas D. McSweeney

An Evaluation of a New Two-Electrode Myocardial Electrical Impedance Monitor for Detecting Myocardial Ischemia
Anesth Analg 2001 92: 12-18. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We used dogs to determine if we could measure myocardial ischemia using a device that measures impedance and demonstrated that a two-electrode myocardial electrical impedance monitor reliably reflected changes induced by myocardial ischemia.

Kishor G. Lathi, Peter R. Vale, Douglas W. Losordo, Rafael M. Cespedes, James F. Symes, Darryl D. Esakof, Michael Maysky, and Jeffrey M. Isner

Gene Therapy with Vascular Endothelial Growth Factor for Inoperable Coronary Artery Disease: Anesthetic Management and Results
Anesth Analg 2001 92: 19-25. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Previously revascularized patients now judged "inoperable," continue to present with chronic, recurrent angina. Our study describes the anesthetic considerations and management of such patients treated with a novel approach by using gene therapy to stimulate angiogenesis and improve perfusion to ischemic myocardium.

Michèle Bertrand, Gilles Godet, Karolin Meersschaert, Luc Brun, Eduardo Salcedo, and Pierre Coriat

Should the Angiotensin II Antagonists be Discontinued Before Surgery?
Anesth Analg 2001 92: 26-30. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This prospective randomized study demonstrated that more severe hypotensive episodes, requiring vasoconstrictor treatment, occur after induction of general anesthesia in patients chronically treated with AIIA and receiving this drug on the morning before operation, in comparison with those in whom AIIA were discontinued on the day before operation. Recommendations to discontinue these drugs on the day before the surgery may be justified.

Ngai Liu, Guy Kuhlman, Nicolas Dalibon, Marc Moutafis, Jean-Claude Levron, and Marc Fischler

A Randomized, Double-Blinded Comparison of Intrathecal Morphine, Sufentanil and their Combination versus IV Morphine Patient-Controlled Analgesia for Postthoracotomy Pain
Anesth Analg 2001 92: 31-36. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: As compared with IV patient-controlled analgesia, intrathecal morphine or combined sufentanil and morphine provided superior postoperative pain relief both at rest (11 h) and on coughing (8 h) than did IV patient-controlled analgesia morphine alone. IV morphine requirement was decreased during the first postoperative day after posterolateral thoracotomy.

Leanne Groban, Dwight D. Deal, Jason C. Vernon, Robert L. James, and John Butterworth

Cardiac Resuscitation After Incremental Overdosage with Lidocaine, Bupivacaine, Levobupivacaine, and Ropivacaine in Anesthetized Dogs
Anesth Analg 2001 92: 37-43. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: There were consistent differences among the local anesthetics, the sum of which suggests that larger doses and blood concentrations of ropivacaine (ROP) and lidocaine will be tolerated as compared with bupivacaine (BUP) and levobupivacaine (LBUP). Lidocaine intoxication results in myocardial depression from which resuscitation is consistently successful but will require continuing drug support. After BUP, LBUP, or ROP, resuscitation is not always successful, and the administration of epinephrine may lead to severe arrhythmias. The unbound plasma concentrations at collapse were larger for ROP compared with BUP, whereas the concentrations of LBUP and BUP were not significantly different from each other. Furthermore, larger plasma concentrations of ROP than BUP are present after resuscitation, suggesting a wider margin of safety when large volumes and large concentrations are used to establish upper or lower extremity nerve blocks for surgical anesthesia and during long-term infusions for pain management.

Jerome F. O’Hara, Jr, Wayne A. Colburn, John E. Tetzlaff, Andrew C. Novick, Kenneth W. Angermeier, and Armin Schubert

Hemoglobin and Methemoglobin Concentrations After Large-Dose Infusions of Diaspirin Cross-Linked Hemoglobin
Anesth Analg 2001 92: 44-48. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The dose of diaspirin cross-linked hemoglobin (DCLHb) (936 {+/-} 276 mg/kg) used in this study was one of the largest reported in humans to date. The DCLHb mean half-life was 10 h. The half-life observed was 2-4 times that found at smaller doses in previous studies. Whole blood methemoglobin fraction increased during DCLHb infusion but did not reach a range associated with complications.

Matthias J. Koessler, Renato Fabiani, Hendrik Hamer, and Rocco P. Pitto

The Clinical Relevance of Embolic Events Detected by Transesophageal Echocardiography During Cemented Total Hip Arthroplasty: A Randomized Clinical Trial
Anesth Analg 2001 92: 49-55. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Use of conventional cementing techniques is associated with echocardiographic evidence of embolism in 93% of patients and with a significant increase in pulmonary shunting. The incidence of embolism and change in shunting are reduced with a modified cementing technique that limits increases in intramedullary pressure.

PEDIATRIC ANESTHESIA:

Lisa Fazi, Ellen C. Jantzen, John B. Rose, C. Dean Kurth, and Mehernoor F. Watcha

A Comparison of Oral Clonidine and Oral Midazolam as Preanesthetic Medications in the Pediatric Tonsillectomy Patient
Anesth Analg 2001 92: 56-61. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We compared preanesthetic sedation and postoperative recovery after oral clonidine (4 {micro}g/kg) and midazolam (0.5 mg/kg) in children during tonsillectomy. The clonidine group had greater preoperative anxiety and shorter surgery and anesthesia times, but required more postoperative analgesia. Delayed recovery and discharge times did not differ. Midazolam was superior to clonidine as oral preanesthetic medication for these patients.

Peter Marhofer, Helga Freitag, Anette Höchtl, Manfred Greher, Wolfgang Erlacher, and Margot Semsroth

S(+)-Ketamine for Rectal Premedication in Children
Anesth Analg 2001 92: 62-65. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In contrast to racemic ketamine, neither plain S(+)-ketamine (1.5 mg/kg) nor the addition of S(+)-ketamine (0.75 mg/kg) with midazolam shows advantages compared with plain midazolam for rectal premedication in children for anesthetic potencies or facilitation of induction of anesthesia via face mask.

Wulf Dietrich, Siegmund Braun, Michael Spannagl, and Joseph A. Richter

Low Preoperative Antithrombin Activity Causes Reduced Response to Heparin in Adult but not in Infant Cardiac-Surgical Patients
Anesth Analg 2001 92: 66-71. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In patients less than one year of age, low antithrombin (AT) activity is caused by the immature coagulation system. Despite low AT activity, these young patients demonstrate a normal or increased response to heparin anticoagulation before cardiopulmonary bypass (CPB). In contrast, in patients older than one year of age and adult patients decreased preoperative AT activity is mainly caused by preoperative heparin therapy and causes insufficient response to heparin anticoagulation with a standard heparin dosage. Measurement of preoperative AT activity identifies patients at risk of inadequate anticoagulation during CPB.

Wenjing Xiao and Xiaoming Deng

The Minimum Alveolar Concentration of Enflurane for Laryngeal Mask Airway Extubation in Deeply Anesthetized Children
Anesth Analg 2001 92: 72-75. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: There may be fewer problems associated with the laryngeal mask airway extubation when patients are deeply anesthetized. The purpose of this study was to determine the minimum concentration of enflurane for successful removal of the laryngeal mask in children.

Stephen A. Stayer, Dean B. Andropoulos, Sabrina T. Bent, E. Dean McKenzie, and Charles D. Fraser

Volume Ventilation of Infants with Congenital Heart Disease: A Comparison of Dräger, NAD 6000 and Siemens, Servo 900C Ventilators
Anesth Analg 2001 92: 76-79. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We compared two ventilators for use in infants. Twenty infants undergoing surgery for congenital heart defects were randomized to receive ventilation first with one ventilator, then with the other. Although there were differences in observed ventilatory variables, both machines provided adequate ventilation when set in the volume control mode.

AMBULATORY ANESTHESIA:

Philip E. Greilich, Cesar D. Virella, James M. Rich, Mangala Kurada, Kevin Roberts, James F. Warren, and William V. Harford

Remifentanil Versus Meperidine For Monitored Anesthesia Care: A Comparison Study in Older Patients Undergoing Ambulatory Colonoscopy
Anesth Analg 2001 92: 80-84. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Remifentanil infusions and meperidine boluses are equally well tolerated in older patients undergoing ambulatory colonoscopy when administered by an anesthesia provider.

Margarita Coloma, Larry L. Duffy, Paul F. White, W. Kendall Tongier, and Philip J. Huber, Jr.

Dexamethasone Facilitates Discharge After Outpatient Anorectal Surgery
Anesth Analg 2001 92: 85-88. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: A single dose of dexamethasone (4 mg IV) decreased the time to "home readiness" without increasing the incidence of postoperative wound complications in an outpatient population undergoing anorectal surgery.

Hannah J. Blanshard, Frances Chung, Pirjo H. Manninen, Michael D. Taylor, and Mark Bernstein

Awake Craniotomy for Removal of Intracranial Tumor: Considerations for Early Discharge
Anesth Analg 2001 92: 89-94. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: It may be feasible to perform awake craniotomies for removal of intracranial tumor as an ambulatory procedure; however, caution is advised. Patient selection must be stringent with respect to the patient's preoperative functional status, tumor depth, surrounding edema, patient support at home, and ease of access to hospital for readmission.

Jun Tang, Paul F. White, Ronald H. Wender, Robert Naruse, Robert Kariger, Alexander Sloninsky, Mitchell S. Karlan, Robert Y. Uyeda, Scott R. Karlan, Carol Reichman, and Brian Whetstone

Fast-Track Office-Based Anesthesia: A Comparison of Propofol Versus Desflurane with Antiemetic Prophylaxis In Spontaneously Breathing Patients (Brief Report)
Anesth Analg 2001 92: 95-99. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Compared to propofol, maintenance of anesthesia with desflurane provided significantly better intraoperative conditions during office-based surgery. In addition, desflurane with routine antiemetic prophylaxis was associated with a faster early recovery and similar incidence of postoperative side effects.

ANESTHETIC PHARMACOLOGY:

Atsushi Tsuda, Osamu Shibata, Masataka Saito, Shigeru Hashimoto, Shu Iwanaga, Tetsuji Makita, and Koji Sumikawa

A Dose-Response Study of Anticholinesterase Drugs on Contractile and Phosphatidylinositol Responses of Rat Trachea
Anesth Analg 2001 92: 100-105. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Neostigmine and pyridostigmine, but not edrophonium, have dual effects on the tension and phosphatidylinositol responses of rat trachea. Large doses of anticholinesterase drugs cause airway smooth muscle relaxation, which may be seen in patients with myasthenia gravis who have received excessive anticholinesterase therapy.

Thomas M. Hemmerling, Joachim Schmidt, Tobias Wolf, Christian Hanusa, Ernst Siebzehnruebl, and Hubert Schmitt

Intramuscular Versus Surface Electromyography of the Diaphragm for Determining Neuromuscular Blockade
Anesth Analg 2001 92: 106-111. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The novel method of monitoring the diaphragmatic neuromuscular blockade (NMB) at the patient's back showed good correlation and good comparability with the IM NMB derived from an endoscopically inserted wire electrode and might be clinically used. The simultaneous determination of the NMB at the orbicularis oculi and the corrugator supercilii muscle did not show that either of these muscles was a good indicator of the diaphragmatic response.

Veronika Goll, Ozan Akça, Robert Greif, Helga Freitag, Cem F. Arkiliç, Thomas Scheck, Agnes Zoeggeler, Andrea Kurz, Gabriella Krieger, Rainer Lenhardt, and Daniel I. Sessler

Ondansetron is no More Effective than Supplemental Intraoperative Oxygen for Prevention of Postoperative Nausea and Vomiting
Anesth Analg 2001 92: 112-117. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Supplemental oxygen reduces the risk of postoperative nausea and vomiting (PONV) as well or better than 8 mg of ondansetron. Because oxygen is inexpensive and essentially risk-free, supplemental oxygen is a preferable method of reducing PONV.

Gunther Wiesner, Klaus Hoerauf, Klaus Schroegendorfer, Pawel Sobczynski, Marion Harth, and Hugo W. Ruediger

High-Level, but Not Low-Level, Occupational Exposure to Inhaled Anesthetics Is Associated with Genotoxicity in the Micronucleus Assay
Anesth Analg 2001 92: 118-122. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: A high level of occupational exposure to inhaled anesthetics is associated with genotoxicity (as defined by formation of micronucleated lymphocytes), whereas a low-level exposure (within National Institute of Occupational Safety and Health limits) is not.

Yi Zhang, Susan Wu, Edmond I Eger, II, and James M. Sonner

Neither GABA_A nor Strychnine-Sensitive Glycine Receptors Are the Sole Mediators of MAC for Isoflurane
Anesth Analg 2001 92: 123-127. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: {gamma}-amino-n-butyric acid and glycine receptors may in part be responsible for the immobilizing action of isoflurane. They are not, however, the only receptors that contribute to isoflurane-induced immobility (i.e., that determine the MAC of isoflurane).

Makoto Shiga, Kahoru Nishina, Katsuya Mikawa, and Hidefumi Obara

The Effects of Lidocaine on Nitric Oxide Production from an Activated Murine Macrophage Cell Line
Anesth Analg 2001 92: 128-133. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Lidocaine dose-dependently inhibited nitric oxide production by activated macrophages, presumably at levels after transcription. The attenuating effect of lidocaine on organ injuries previously reported may be explained by the ability of the drug to suppress this inflammatory mediator.

Eiji Masaki, Koji Yamazaki, Yuji Ohno, Haruhisa Nishi, Yasunori Matsumoto, and Masahiro Kawamura

The Anesthetic Interaction Between Adenosine Triphosphate and N-methyl-D-Aspartate Receptor Antagonists in the Rat
Anesth Analg 2001 92: 134-139. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Because P2X and N-methyl-D-aspartate receptors mediate a fast neurotransmission, we examined the anesthetic interaction between antagonists of these receptors. P2 and N-methyl-D-aspartate receptor antagonists showed additive anesthetic interaction.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Fujio Karasawa, Tomohisa Mori, Tomohiro Okuda, and Tetsuo Satoh

Profile Soft-Seal Cuff, a New Endotracheal Tube, Effectively Inhibits an Increase in the Cuff Pressure Through High Compliance Rather than Low Diffusion of Nitrous Oxide
Anesth Analg 2001 92: 140-144. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: A new material with nitrous oxide (N2O) gas barrier properties produces a thin and highly compliant cuff without increasing N2O diffusion, thereby reducing the increase of intracuff pressure and postoperative sore throat. Because the increase in the cuff pressure is time dependent, the Profile Soft-Seal Cuff (Sims Portex, Kent, UK) might be better than the Profile Cuff (Sims Portex) for anesthesia of a long duration.

Fujio Karasawa, Tomohisa Mori, Yasushi Kawatani, Takashi Ohshima, and Tetsuo Satoh

Deflationary Phenomenon of the Nitrous Oxide-Filled Endotracheal Tube Cuff After Cessation of Nitrous Oxide Administration
Anesth Analg 2001 92: 145-148. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: A recently developed method for maintaining stable cuff pressure (N2O-filled cuffs) enables us to assess the decrease in cuff pressure after cessation of N2O administration. Our results confirm the limitations of N2O-filled cuffs when N2O-inspired concentrations are reduced.

Keith J. Girling, Jennifer L. Spendlove, Muhammad S. Quraishi, and Ravi P. Mahajan

Video Imaging to Assess Neuromuscular Blockade at the Larynx
Anesth Analg 2001 92: 149-153. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Assessment of neuromuscular blockade at the larynx is possible by using a video imaging technique. By using this technique, the time to onset of neuromuscular blockade at the larynx is similar to that at the hand after the administration of succinylcholine; this finding is different from previously published data obtained by using a cuff pressure measurement technique.

Robert D. Fitzgerald, Claus Lamm, Wolfgang Oczenski, Thomas Stimpfl, Walter Vycudilik, and Herbert Bauer

Direct Current Auditory Evoked Potentials During Wakefulness, Anesthesia, and Emergence from Anesthesia
Anesth Analg 2001 92: 154-160. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This study demonstrates the potential of direct current auditory evoked potentials for monitoring depth of anesthesia in humans.

CRITICAL CARE AND TRAUMA:

Hiroaki Tokioka, Toshiaki Tanaka, Tomoko Ishizu, Tomihiro Fukushima, Toshio Iwaki, Yuko Nakamura, and Yoshinori Kosogabe

The Effect of Breath Termination Criterion on Breathing Patterns and the Work of Breathing During Pressure Support Ventilation
Anesth Analg 2001 92: 161-165. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Although termination criterion (TC) is usually nonadjustable, it influences the effectiveness of pressure support ventilation for mechanical ventilation. The proper adjustment of TC is crucial to improve patient-ventilator synchrony and decrease work of breathing. TC 5% of the peak inspiratory flow may be the optimal value for patients with acute respiratory distress syndrome or acute lung injury.

NEUROSURGICAL ANESTHESIA:

Sabine Himmelseher, Ernst Pfenninger, and Christian Werner

Intraoperative Monitoring in Neuroanesthesia: A National Comparison Between Two Surveys in Germany in 1991 and 1997
Anesth Analg 2001 92: 166-171. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Standards of anesthetic monitoring were surveyed in neuroanesthesia in Germany in 1991 and 1997. Central nervous system monitoring was not the standard of practice.

James R. Munis, Sanjay Bhatia, and Leonardo J. Lozada

Peripheral Venous Pressure as a Hemodynamic Variable in Neurosurgical Patients
Anesth Analg 2001 92: 172-179. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In patients undergoing either elective craniotomy or complex spine surgery, peripheral venous pressure (PVP) trends correlated with central venous pressure (CVP) trends with a mean offset of 3 mm Hg (PVP > CVP). PVP trends provided equivalent physiological information to CVP trends in this subset of patients, especially during periods of hemodynamic instability. In addition, measurements made during a planned circulatory arrest support the hypothesis that PVP approximates mean systemic pressure (systemic arrest pressure), which is a direct index of patient volume status independent of cardiac or respiratory activity.

OBSTETRIC ANESTHESIA:

Richard Debon, Bernard Allaouchiche, Frédéric Duflo, Emmanuel Boselli, and Dominique Chassard

The Analgesic Effect of Sufentanil Combined with Ropivacaine 0.2% for Labor Analgesia: A Comparison of Three Sufentanil Doses
Anesth Analg 2001 92: 180-183. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We studied the effect of adding one of three possible sufentanil doses to epidural ropivacaine 0.2% for labor analgesia. Adding sufentanil increased the duration of analgesia but there was no advantage in adding more than 5 {micro}g of sufentanil.

Jean-Marc Bernard, Daniel Le Roux, Alexandre Barthe, Olivier Jourdain, Louis Vizquel, and Claude Michel

The Dose-Range Effects of Sufentanil Added to 0.125% Bupivacaine on the Quality of Patient-Controlled Epidural Analgesia During Labor
Anesth Analg 2001 92: 184-188. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Adding a small concentration of sufentanil to 0.125% bupivacaine for patient-controlled epidural analgesia during labor improved the quality of analgesia but did not modify the bupivacaine requirement. Reducing the sufentanil concentrations to 0.156 {micro}g/mL decreased the pruritus intensity without reducing analgesia.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

Brian Fredman, Edna Zohar, Alex Tarabykin, Arie Shapiro, Ami Mayo, Ehud Klein, and Robert Jedeikin

Bupivacaine Wound Instillation via an Electronic Patient-Controlled Analgesia Device and a Double-Catheter System Does Not Decrease Postoperative Pain or Opioid Requirements After Major Abdominal Surgery
Anesth Analg 2001 92: 189-193. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: After major abdominal surgery performed through a 20-cm incision, repeated 0.25% bupivacaine wound instillation via an electronic patient-controlled analgesia device and a double-catheter system does not decrease postoperative pain or opioid requirements.

Michel Carles, Alphonse Pulcini, Philippe Macchi, Patrick Duflos, Marc Raucoules-Aime, and Dominique Grimaud

An Evaluation of the Brachial Plexus Block at the Humeral Canal Using a Neurostimulator (1417 Patients): The Efficacy, Safety, and Predictive Criteria of Failure
Anesth Analg 2001 92: 194-198. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We prospectively evaluated the feasability and the factors causing failure of a peripheral nerve block technique (humeral block) using neurostimulation in a large number of patients. The importance of the level of stimulation for the success of the block was evaluated for the first time.

Xavier Culebras, Elisabeth Van Gessel, Pierre Hoffmeyer, and Zdravko Gamulin

Clonidine Combined with a Long Acting Local Anesthetic Does Not Prolong Postoperative Analgesia after Brachial Plexus Block but Does Induce Hemodynamic Changes
Anesth Analg 2001 92: 199-204. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Clonidine in brachial plexus block does not improve postoperative analgesia when mixed with a long-lasting anesthetic. Nevertheless, with or without clonidine, bupivacaine in interscalene block provides a long-lasting analgesia of approximately 15 h.

Andrea Casati, Guido Fanelli, Luca Magistris, Paolo Beccaria, Marco Berti, and Giorgio Torri

Minimum Local Anesthetic Volume Blocking the Femoral Nerve in 50% of Cases: A Double-Blinded Comparison Between 0.5% Ropivacaine and 0.5% Bupivacaine
Anesth Analg 2001 92: 205-208. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Considering the risk for drug-related systemic toxicity, the equipotency ratio between ropivacaine and bupivacaine is crucial for daily practice. Despite the 40% reduction in the analgesic potency of ropivacaine reported during epidural analgesia for labor pain, results of this prospective, randomized, double-blinded study demonstrated that the same volume of 0.5% ropivacaine or 0.5% bupivacaine is required to produce an effective block of the femoral nerve in 50% of cases.

Iurie Acalovschi, Tudor Cristea, Simona Margarit, and Rodica Gavrus

Tramadol Added to Lidocaine for Intravenous Regional Anesthesia
Anesth Analg 2001 92: 209-214. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Tramadol, a centrally acting analgesic, might have local anesthetic properties, as do some opioid drugs. We demonstrated that 0.25% tramadol solution containing 100 mg tramadol is not effective as a sole drug, but may improve the action of 0.5% lidocaine for intravenous regional anesthesia. The increased incidence of side effects may limit the clinical use of tramadol.

Jerry D. Vloka, Admir Hadzic, Ernest April, and Daniel M. Thys

The Division of the Sciatic Nerve in the Popliteal Fossa: Anatomical Implications for Popliteal Nerve Blockade
Anesth Analg 2001 92: 215-217. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: When performing popliteal block, insertion of the needle at 100 mm above the popliteal crease is more likely to result in placement of the needle proximal to the division of the sciatic nerve than placement at 50 or 70 mm, according to the classical teaching.

Alain Borgeat, Fabian Kalberer, Hilaire Jacob, Yvan A. Ruetsch, and Christian Gerber

Patient-Controlled Interscalene Analgesia With Ropivacaine 0.2% versus Bupivacaine 0.15% After Major Open Shoulder Surgery: The Effects on Hand Motor Function
Anesth Analg 2001 92: 218-223. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We compared the patient-controlled interscalene analgesia technique with ropivacaine 0.2% and bupivacaine 0.15% after major open shoulder surgery. For similar pain control ropivacaine is associated with better preservation of strength in the hand and less paresthesia in the fingers.

Phoon Ping Chen, Po Tong Chui, Marlene Ma, and Tony Gin

A Prospective Survey of Patients after Cessation of Patient-Controlled Analgesia
Anesth Analg 2001 92: 224-227. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We surveyed patients 24 h after cessation of IV patient-controlled analgesia (PCA). This survey revealed that the usual clinical reasons to stop IV PCA might not be the most appropriate. Patients have different reasons why they wish to restart or not restart IV PCA. The cessation of PCA should be individualized.

Ping-Heng Tan, Kang Liu, Chih-Hsien Peng, Ling-Cheng Yang, Chung-Ren Lin, and Cheng-Yuan Lu

The Effect of Dexamethasone on Postoperative Pain and Emesis After Intrathecal Neostigmine
Anesth Analg 2001 92: 228-232. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The results of our evaluation of the effect of IV dexamethasone versus saline control on analgesia and nausea and vomiting after intrathecal neostigmine and tetracaine suggest that IV dexamethasone did not enhance the analgesic effect of neostigmine or reduce the incidence of emesis after intrathecal administration.

Keiichi Omote, Tomoyuki Kawamata, Yoshito Nakayama, Mikito Kawamata, Koji Hazama, and Akiyoshi Namiki

The Effects of Peripheral Administration of a Novel Selective Antagonist for Prostaglandin E Receptor Subtype EP₁, ONO-8711, in a Rat Model of Postoperative Pain
Anesth Analg 2001 92: 233-238. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The peripheral administration of an antagonist for EP1 receptor that is a subtype of prostaglandin E receptors can inhibit the mechanical hyperalgesia induced by a surgical incision.

Vesna Pirec, Charles E. Laurito, Ying Lu, and David C. Yeomans

The Combined Effects of N-type Calcium Channel Blockers and Morphine on A Versus C Fiber Mediated Nociception
Anesth Analg 2001 92: 239-243. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This study demonstrates that combined spinal administration of mu opioids and N-type calcium channel blockers may be useful in providing analgesia for A{delta} mediated (first, sharp) pain while minimizing the side effects of both drugs.

Craig M. Palmer

Continuous Intrathecal Sufentanil for Postoperative Analgesia (Case Report)
Anesth Analg 2001 92: 244-245. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Intrathecal sufentanil via continuous infusion can be effectively used for postoperative analgesia.

Takashi Asai, Kei Yamamoto, Takuji Hirose, Hitoshi Taguchi, and Koh Shingu

Breakage of Epidural Catheters: A Comparison of an Arrow Reinforced Catheter and Other Nonreinforced Catheters (Case Report)
Anesth Analg 2001 92: 246-248. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Although breakage of an epidural catheter is rare, our ex vivo study suggests that compared with three other epidural catheters, the Arrow catheter is more likely to stretch and break. The segment between the 7- and 8-cm marks may be an area especially vulnerable to breakage.

James R. Hebl, Terese T. Horlocker, and Douglas J. Pritchard

Diffuse Brachial Plexopathy After Interscalene Blockade in a Patient Receiving Cisplatin Chemotherapy: The Pharmacologic Double Crush Syndrome (Case Report)
Anesth Analg 2001 92: 249-251. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Sensory peripheral neuropathy is a common toxic side effect in patients undergoing cisplatin chemotherapy. The peripheral nerve fibers of these patients may therefore be more susceptible to the toxic effects of local anesthetics. As a result, regional anesthetic techniques should be used with caution within this patient population to avoid potentially devastating and irreversible neurologic sequelae.

MEDICAL INTELLIGENCE:

John B. Pollard

Cardiac Arrest During Spinal Anesthesia: Common Mechanisms and Strategies for Prevention
Anesth Analg 2001 92: 252-256. [Full Text] [PDF] [Request Permissions]  

GENERAL ARTICLES:

Konrad R. G. Schwarzkopf, Hansjoerg Hoff, Michael Hartmann, and Harald G. Fritz

A Comparison Between Meperidine, Clonidine and Urapidil in the Treatment of Postanesthetic Shivering
Anesth Analg 2001 92: 257-260. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Patients shivering during recovery from general anesthesia were treated in a randomized double-blinded fashion with meperidine, clonidine, or urapidil. Meperidine and clonidine were both very effective, whereas urapidil was only effective in 60% of patients treated.

Akiko Taguchi, Cem F. Arkilic, Arundhathi Ahluwalia, Daniel I. Sessler, and Andrea Kurz

Negative Pressure Rewarming vs. Forced Air Warming in Hypothermic Postanesthetic Volunteers
Anesth Analg 2001 92: 261-266. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In this study we show that calories from a negative pressure rewarming device are largely constrained to the forearm, and that heat does not flow to the core thermal compartment. Consequently, this warming concept is not more effective than passive insulation in hypothermic postanesthetic subjects. In contrast, rewarming is very effective with convective warming.

E. Andrew Ochroch and Richard M. Levitan

A Videographic Analysis of Laryngeal Exposure Comparing the Articulating Laryngoscope and External Laryngeal Manipulation
Anesth Analg 2001 92: 267-270. [Abstract] [Full Text] [PDF] [Request Permissions]  

CASE REPORTS:

Rosendo F. Mortero, Zamira Orahovac, Kentaro Tsueda, and and Jeffrey M. Bumpous

Severe Laryngospasm at Tracheal Extubation in a Patient with Superior Laryngeal Nerve Injury
Anesth Analg 2001 92: 271-272. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Episodes of severe laryngospasm at tracheal extubation, paroxysmal coughs with choking spells after thyroidectomy, and laryngoscopic findings of superior laryngeal nerve injury are consistent with episodic laryngospasm. Laryngeal hypersensitivity should be considered in patients exhibiting episodic symptoms of laryngeal obstruction and sensory abnormality after surgery.

Alain François Broccard, Lucas Liaudet, John-David Aubert, Pierre Schnyder, and Marie-Denise Schaller

Negative Pressure Post-Tracheal Extubation Alveolar Hemorrhage
Anesth Analg 2001 92: 273-275. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: General anesthesia often requires placing a tube into the trachea to maintain adequate breathing. At the end of the surgical procedure, the endotracheal tube is removed, and this, as reported here, may sometimes result in the development of pulmonary hemorrhage. We documented the regional distribution by computed tomography of the hemorrhage and its alveolar origin by bronchoscopy and suggest that small lung vessel damage best explains those findings.

Ken-ichi Satoh, Nozomu Sakamoto, Yutaka Shinohe, Maki Satoh, and Shigeharu Joh

Indigo Carmine-Induced Bradycardia in a Patient During General Anesthesia
Anesth Analg 2001 92: 276-277. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Indigo carmine is very often used to confirm if catheters for delivering anticancer drugs are placed in the appropriate vicinity of tumors. This report demonstrates that severe bradycardia can occur after intraarterial administration of indigo carmine.

LETTERS:

Malachy O. Columb, Linda S. Polley, and David C. Campbell

Potencies and Probabilities: One-Sided P Values Suggest a One-Sided Story!
Anesth Analg 2001 92: 278-279. [Full Text] [PDF] [Request Permissions]  

Lawrence C. Tsen

The Mask Avenger?
Anesth Analg 2001 92: 279. [Full Text] [PDF] [Request Permissions]  

Ingrid M. Browne, David J. Birnbach, Sylvia Y. Dolinski, and J. C. Gerancher

Unmasked Mischief
Anesth Analg 2001 92: 279-281. [Full Text] [PDF] [Request Permissions]  

Paul S. Myles, Jennifer O. Hunt, and Helen Fletcher

Measuring Health Status (Quality of Recovery?) after Anesthesia and Surgery
Anesth Analg 2001 92: 281. [Full Text] [PDF] [Request Permissions]  

Mohamed Naguib, Noriaki Kanaya, and Akiyoshi Namiki

The Three-Dimensional Computed Tomography Imaging and Prediction of Unanticipated Difficult Tracheal Intubation
Anesth Analg 2001 92: 281-282. [Full Text] [PDF] [Request Permissions]  

Alan David Kaye, Sanjiv Vig, Raj Sabar, Nigel Bedforth, Jonathan Grant Hardman, and Michael Nathanson

Cerebral Hemodynamic Response to the Introduction of Desflurane: A Comparison with Sevoflurane
Anesth Analg 2001 92: 282-283. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Jeffrey A. Rosenthal, F. J. Singelyn, P. Lavand'homme, M. De Kock, F. Roelants, F. Veyckmans, Emyne Pelyn Karaca, Johanna Schwarzenberger, and Dimitry Baranov

Atlas of Pain Management Injection Techniques • Regional Anesthesia; Volume 18, Number 2 of Anesthesiology Clinics of North America • Practical Echocardiography: The Heart of the Matter. Part 1, Basics • Textbook of Neuroanaesthesia and Critical Care • Books and Multimedia Received
Anesth Analg 2001 92: 284-6. [Full Text] [PDF] [Request Permissions]  

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