EDITORIALS:

Markus C. Schneider and David J. Birnbach

Lidocaine Neurotoxicity in the Obstetric Patient: Is the Water Safe?
Anesth Analg 2001 92: 287-290. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Francis Bernard, André Denault, Denis Babin, Caroline Goyer, Pierre Couture, André Couturier, and Jean Buithieu

Diastolic Dysfunction is Predictive of Difficult Weaning from Cardiopulmonary Bypass
Anesth Analg 2001 92: 291-298. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Abnormal diastolic filling patterns are frequently observed during cardiac surgery. The data support routine evaluation of diastolic function during echocardiographic cardiac assessment of patients undergoing cardiac surgery.

Eric R. Gross, Meir Gare, Wolfgang G. Toller, Judy R. Kersten, David C. Warltier, and Paul S. Pagel

Ethanol Enhances the Functional Recovery of Stunned Myocardium Independent of K_ATP Channels in Dogs
Anesth Analg 2001 92: 299-305. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Small amounts of ethanol improve the functional recovery of postischemic, reperfused myocardium in barbiturate-anesthetized dogs. These beneficial effects are not related to adenosine triphosphate-dependent potassium channels.

Andrew Maslow, Gary Stearns, Arthur Bert, William Feng, David Price, Carl Schwartz, Scott MacKinnon, Fred Rotenberg, Richard Hopkins, George Cooper, Arun Singh, and Stephen H. Loring

Monitoring End-Tidal Carbon Dioxide During Weaning from Cardiopulmonary Bypass in Patients Without Significant Lung Disease
Anesth Analg 2001 92: 306-313. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In normothermic patients without pulmonary disease, acute changes in PETCO2 during separation from cardiopulmonary bypass were reflective of changes in pulmonary artery blood flow. Specific PETCO2 values were predictive of cardiac output values under the clinical conditions of the study.

Vance G. Nielsen, Valerie E. Armstead, Brian T. Geary, and Irina L. Opentanova

PentaLyte® Does Not Decrease Heparinoid Release but Does Decrease Circulating Thrombotic Mediator Activity Associated with Aortic Occlusion-Reperfusion in Rabbits
Anesth Analg 2001 92: 314-319. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: PentaLyte(R) administration does not decrease the heparinoid release associated with aortic occlusion-reperfusion but does decrease the elaboration of a thrombotic mediator. This study serves as a rational basis to determine whether coadministration of PentaLyte(R) with a heparin antagonist (e.g., protamine or heparinase) may maintain hemostasis after aortic occlusion-reperfusion.

Vance G. Nielsen

Nitric Oxide Decreases Coagulation Protein Function in Rabbits as Assessed by Thromboelastography
Anesth Analg 2001 92: 320-323. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In rabbit whole blood, nitric oxide (NO) decreases hemostatic function by decreasing both coagulation protein function and platelet function. Coagulation protein function may be similarly affected in clinical situations involving the administration of NO or NO donors.

Mark R. Forrest, Adrian H. Chester, and David Royston

The Effects of Diaspirin Cross-Linked Hemoglobin on the Tone of Human Saphenous Vein
Anesth Analg 2001 92: 324-328. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Hemoglobin solutions are used as alternatives to blood transfusion. In animals, they cause vasoconstriction by binding nitric oxide. This is an in vitro study of the effects of one hemoglobin solution in human blood vessels. It shows that this hemoglobin solution alone had no effect in human tissue but antagonized other agents used to alter vessel tone.

Palaniandy Sekaran, Marek Ehrlich, Christian Hagl, Marc L. Leavitt, Roger Jacobs, Jock N. McCullough, and Elliott Bennett-Guerrero

A Comparison of Complete Blood Replacement With Varying Hematocrit Levels on Neurological Recovery in a Porcine Model of Profound Hypothermic (<5°C) Circulatory Arrest
Anesth Analg 2001 92: 329-334. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In a porcine model of profound hypothermia (<5{degrees}C) and circulatory arrest, complete blood replacement resulted in superior neurological outcome. This finding suggests that at ultralow temperatures, the presence of erythrocytes or some other blood component may be deleterious.

Michael Zaugg, Mario L. Lachat, Thomas Pfammatter, Gieri Cathomas, and Edith R. Schmid

Sudden Respiratory Arrest Resulting From Brainstem Embolism in a Patient Undergoing Endovascular Abdominal Aortic Aneurysm Repair (Case Report)
Anesth Analg 2001 92: 335-337. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Surgery on the aorta is a great challenge for the anesthesiologist, even with newly developed and less invasive stent-graft procedures. The case of a fatal cerebral embolism during endovascular repair of an abdominal aortic aneurysm is reported, and the potential mechanisms underlying this unexpected complication are discussed.

Kent H. Rehfeldt and David J. Cook

Transesophageal Echocardiographic Imaging of a New Aortic Cannula for Differential Perfusion During Cardiopulmonary Bypass (Technical Communication)
Anesth Analg 2001 92: 338-340. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We describe the use of echocardiographic imaging to assist in the placement of an aortic cannula that provides differential perfusion of the arch and descending aorta during cardiac surgery in adults.

Michael Booke, Hugo Van Aken, Martin Storm, Florian Fritzsche, Stefan Wirtz, and Frank Hinder

Fat Elimination from Autologous Blood (Technical Communication)
Anesth Analg 2001 92: 341-343. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Bowl-based autotransfusion devices reduce the amount of fat found in shed blood, but cannot completely eliminate fat particles. When fat is seen on the surface of the processed blood, this blood should be filtered with a leukocyte removal filter before retransfusion.

Yang Sun, Philip E. Greilich, Steve I. O. Wilson, Mark R. Jackson, and Charles W. Whitten

The Use of Lepirudin for Anticoagulation in Patients with Heparin-Induced Thrombocytopenia During Major Vascular Surgery (Case Report)
Anesth Analg 2001 92: 344-346. [Abstract] [Full Text] [PDF] [Request Permissions]  

AMBULATORY ANESTHESIA:

Narinder Rawal, Renée Allvin, Anders Amilon, Torbjörn Ohlsson, and Jan Hallén

Postoperative Analgesia at Home After Ambulatory Hand Surgery: A Controlled Comparison of Tramadol, Metamizol, and Paracetamol
Anesth Analg 2001 92: 347-351. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Despite pain medication, up to 40% of patients experienced pain at home after ambulatory hand surgery. Of the three analgesic drugs evaluated in this double-blinded study, tramadol was the most effective but was also associated with most patient dissatisfaction because of an increased incidence of nausea and dizziness. Metamizol provided somewhat better analgesia than acetaminophen. There is a need for better oral pain medication at home.

Margarita Coloma, Jen W. Chiu, Paul F. White, and Steven C. Armbruster

The Use of Esmolol as an Alternative to Remifentanil During Desflurane Anesthesia for Fast-Track Outpatient Gynecologic Laparoscopic Surgery
Anesth Analg 2001 92: 352-357. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Adjunctive use of a variable-rate infusion of esmolol during outpatient anesthesia with desflurane-nitrous oxide was associated with less postoperative nausea and vomiting than a remifentanil infusion. However, both adjuvants facilitated fast-tracking and lead to early discharge after laparoscopic tubal ligation surgery.

PEDIATRIC ANESTHESIA:

Lionel Davis and Nick Ross

Bilateral Vocal Cord Palsy After Ventricular Drainage in a Child (Case Report)
Anesth Analg 2001 92: 358-361. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Vocal cord palsies are caused by high intracranial pressure and normally improve with treatment. Our case report implies that stridor after drainage of a hydrocephalus, in susceptible patients, can be a result of worsening of vocal cord palsies.

ANESTHETIC PHARMACOLOGY:

Atsushi Nagata, Shin-ichi Nakao, Nobuyasu Nishizawa, Munehiro Masuzawa, Takefumi Inada, Kohei Murao, Etsuko Miyamoto, and Koh Shingu

Xenon Inhibits but N₂O Enhances Ketamine-Induced c-Fos Expression in the Rat Posterior Cingulate and Retrosplenial Cortices
Anesth Analg 2001 92: 362-368. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Xenon may suppress adverse neuronal effects of ketamine. Conversely, combined use of N2O and ketamine may increase the risk of neuronal adverse effects, such as psychotomimetic effects.

Burkhard Gustorff, Peter Felleiter, Gabriele Nahlik, Werner Brannath, Klaus H. Hoerauf, Anna Spacek, and Hans G. Kress

The Effect of Remifentanil on the Heat Pain Threshold in Volunteers
Anesth Analg 2001 92: 369-374. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This study investigated remifentanil as a single infused drug to determine its analgetic property. A dose-dependent effect was found in a human heat pain threshold assessment.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Koichi Tanigawa, Taku Takeda, Eiichi Goto, and Keiichi Tanaka

The Efficacy of Esophageal Detector Devices in Verifying Tracheal Tube Placement: A Randomized Cross-over Study of Out-Of-Hospital Cardiac Arrest Patients
Anesth Analg 2001 92: 375-378. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The esophageal detector device (EDD) failed to confirm endotracheal tube (ETT) placement in more than 25% of tracheal intubations in this study. One must not rely too heavily on the results of the EDD alone, and proper clinical judgment in conjunction with all available modalities should be used to confirm ETT placement in out-of-hospital cardiac arrest patients.

Arjang Khorasani, Kenneth D. Candido, Ahmed H. Ghaleb, Simin Saatee, and Samuel K. Appavu

Canister Tip Orientation and Residual Volume Have Significant Impact on the Dose of Benzocaine Delivered by Hurricaine® Spray
Anesth Analg 2001 92: 379-383. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: There is substantial variability in dose of benzocaine administered by nonmetered Hurricaine(R) spray. Canister orientation and residual volume of anesthetic significantly affect output of benzocaine and are clinically uncontrollable. Methemoglobinemia may occur even after the manufacturer's suggested spraying guidelines. We saw no correlation between dose and spraying time or number of sprays.

Stephen E. McNulty, Benjamin Kline, Joseph Welsh, and Richard Bartkowski

Radiofrequency Transmission to Monitoring Devices in the Operating Room: A Simulation Study
Anesth Analg 2001 92: 384-388. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Circuit simulations were used to evaluate radiofrequency transmission from the electrosurgical unit (ESU) to monitoring devices in the operating room. A connection between the dispersive electrode and a medical device can occur outside the body, as simulated by current passing through an electrolyte fluid medium; or through higher resistance pathways such as body tissue, as simulated by current passing through water. The variability in voltage and spark intensity among the monitoring devices that we investigated suggests different relative risks for an ESU-induced thermal injury.

Josef Rieder, Peter Prazeller, Michael Boehler, Philipp Lirk, Werner Lindinger, and Anton Amann

Online Monitoring of Air Quality at the Postanesthetic Care Unit by Proton-Transfer-Reaction Mass Spectrometry
Anesth Analg 2001 92: 389-392. [Abstract] [Full Text] [PDF] [Request Permissions]  

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

Tong J. Gan, Frank Sloan, Guy de L Dear, Habib E. El-Moalem, and David A. Lubarsky

How Much Are Patients Willing to Pay to Avoid Postoperative Nausea and Vomiting?
Anesth Analg 2001 92: 393-400. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We have established a cost-benefit analysis for an antiemetic therapy. Patients highly value avoiding postoperative nausea and vomiting. The amount they are willing to pay for a totally effective antiemetic is US$61-$US113..

OBSTETRIC ANESTHESIA:

Marie T. Aouad, Sahar S. Siddik, Maya I. Jalbout, and Anis S. Baraka

Does Pregnancy Protect Against Intrathecal Lidocaine-Induced Transient Neurologic Symptoms?
Anesth Analg 2001 92: 401-404. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Transient neurologic symptom (TNS) can follow spinal anesthesia and manifests as back pain radiating to the legs, resolving spontaneously. Spinal anesthesia for cesarean delivery was performed with either hyperbaric lidocaine 5% (n = 100) or hyperbaric bupivacaine 0.75% (n = 100). TNS was not noted in any patient.

John Philip, Shiv K. Sharma, Vijaya N. R. Gottumukkala, Beverly J. Perez, Elizabeth A. Slaymaker, and Jackie Wiley

Transient Neurologic Symptoms After Spinal Anesthesia with Lidocaine in Obstetric Patients
Anesth Analg 2001 92: 405-409. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The occurrence of transient neurologic symptoms with intrathecal lidocaine among obstetric patients in the supine surgical position appears to be infrequent and without serious sequelae. However, larger randomized studies conducted under similar controlled conditions are warranted to conclusively ascertain the incidence of transient neurologic symptoms with lidocaine in a similar population.

Andrew P. Robinson, Gordon R. Lyons, Rowan C. Wilson, Heather J. Gorton, and Malachy O. Columb

Levobupivacaine for Epidural Analgesia in Labor: The Sparing Effect of Epidural Fentanyl
Anesth Analg 2001 92: 410-414. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Determination of minimum local analgesic concentrations by the technique of sequential allocation allows the interaction between epidural opioids and local anesthetics to be quantified. This study demonstrates that the addition of fentanyl significantly reduces levobupivacaine requirements for epidural analgesia.

NEUROSURGICAL ANESTHESIA:

Robert A. Bowie, Paddy J. O’Connor, Jonathan G. Hardman, and Ravi P. Mahajan

The Effect of Continuous Positive Airway Pressure on Cerebral Blood Flow Velocity in Awake Volunteers
Anesth Analg 2001 92: 415-417. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Our study implies that the application of continuous positive airway pressure (CPAP) does not affect transcranial Doppler monitoring of the middle cerebral artery blood flow velocity and that the effect of CPAP on cerebral hemodynamics is less than had been previously suggested.

Mishiya Matsumoto, Kazunobu Ohtake, Hiroya Wakamatsu, Satoe Oka, Takashi Kiyoshima, Kazuhiko Nakakimura, and Takefumi Sakabe

The Time Course of Acquisition of Ischemic Tolerance and Induction of Heat Shock Protein 70 after a Brief Period of Ischemia in the Spinal Cord in Rabbits
Anesth Analg 2001 92: 418-423. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Ischemic tolerance in the spinal cord is induced in 4 days, not yet induced in 2 days but gone by 7 days, after ischemic pretreatment. The amount of heat shock protein 70 (HSP70) in the cytoplasm does not explain this temporal profile, but HSP70 in the nucleus might play a role in the acquisition of ischemic tolerance.

Robert Watson and Kate Leslie

Nerve Blocks Versus Subcutaneous Infiltration for Stereotactic Frame Placement
Anesth Analg 2001 92: 424-427. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Supraorbital and greater occipital nerve blocks represent an effective alternative to subcutaneous infiltration for placement of a stereotactic head-frame. With the techniques used in our study, nerve blocks were less painful than subcutaneous infiltration.

CRITICAL CARE AND TRAUMA:

Hideaki Imanaka, Motomu Shimaoka, Nariaki Matsuura, Masaji Nishimura, Noriyuki Ohta, and Hiroshi Kiyono

Ventilator-Induced Lung Injury Is Associated with Neutrophil Infiltration, Macrophage Activation, and TGF-ß1 mRNA Upregulation in Rat Lungs
Anesth Analg 2001 92: 428-436. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: High-pressure ventilation demonstrated, in the early phase, not only proinflammatory processes, including neutrophil infiltration and adhesion molecules upregulation on macrophages, but profibriogenetic processes, including transforming growth factor-{beta}1 mRNA expression in the lung tissue. These immunological alterations may be involved in the progress of ventilator-induced lung injury.

Takefumi Inada, Shoichiro Taniuchi, Koh Shingu, Yohnosuke Kobayashi, Junichi Fujisawa, and Shin-ichi Nakao

Propofol Depressed Neutrophil Hydrogen Peroxide Production More Than Midazolam, Whereas Adhesion Molecule Expression was Minimally Affected by both Anesthetics in Rats with Abdominal Sepsis
Anesth Analg 2001 92: 437-441. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: In septic patients, mechanical ventilation of the lungs is sometimes needed, and propofol and midazolam are widely used for sedation. Midazolam was less inhibitory for neutrophil function than propofol during sepsis; thus, midazolam may be preferable to propofol for sedation during sepsis for preserving the neutrophil function to combat sepsis.

Frederic Duflo, Bernard Allaouchiche, Richard Debon, Fabienne Bordet, and Dominique Chassard

An Evaluation of the Gram Stain in Protected Bronchoalveolar Lavage Fluid for the Early Diagnosis of Ventilator-Associated Pneumonia
Anesth Analg 2001 92: 442-447. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We investigated the reliability of direct examination versus quantitative cultures in the early diagnosis of ventilator-associated pneumonia using the protected bronchoalveolar lavage in 104 patients. Regarding detection of bacteria using the Gram stain, we found low sensitivity and negative predictive value and high specificity and positive predictive value.

REGIONAL ANESTHESIA AND PAIN MEDICINE:

Anupama Wadhwa, David Clarke, Colin S. Goodchild, and David Young

Large-Dose Oral Dextromethorphan as an Adjunct to Patient-Controlled Analgesia with Morphine after Knee Surgery
Anesth Analg 2001 92: 448-454. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Although dextromethorphan is an N-methyl-d-aspartate antagonist in animals, this property may not be realizable in human postoperative pain states.

François J. Singelyn, Patrick E. Vanderelst, and Jean-Marie A. Gouverneur

Extended Femoral Nerve Sheath Block After Total Hip Arthroplasty: Continuous Versus Patient-Controlled Techniques
Anesth Analg 2001 92: 455-459. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This study demonstrated that, after total hip arthroplasty, an extended femoral nerve sheath block consisting of patient-controlled analgesia boluses (5 mL per 30 min) of 0.125% bupivacaine with clonidine 1 {micro}g/mL and sufentanil 0.1 {micro}g/mL provides efficient postoperative analgesia and significantly minimizes local anesthetic consumption.

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

Anterior Approach to the Sciatic Nerve Block: The Effects of Leg Rotation
Anesth Analg 2001 92: 460-462. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Interior rotation of the leg facilitates needle insertion in the anterior approach to sciatic nerve block.

Masataka Yokoyama, Yoshitaro Itano, Satoshi Mizobuchi, Hideki Nakatsuka, Ryuji Kaku, Takeaki Takashima, and Masahisa Hirakawa

The Effects of Epidural Block on the Distribution of Lymphocyte Subsets and Natural-Killer Cell Activity in Patients with and without Pain
Anesth Analg 2001 92: 463-469. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Epidural block causes a transient and significant alteration of lymphocyte subsets and natural-killer cell activity regardless of pain status. Our results indicate that local sympathetic nerve block may be important in modulating an immune response.

Masataka Yokoyama, Satoshi Mizobuchi, Osamu Nagano, Hiromi Fujii, Masami Yamashita, and Masahisa Hirakawa

The Effects of Epidural Insertion Site and Surgical Procedure on Plasma Lidocaine Concentration
Anesth Analg 2001 92: 470-475. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The site of infusion and the surgical procedure, with the exception of liver surgery, do not affect plasma lidocaine concentrations under continuous epidural infusion at a rate of 1.5 mg{middle dot}kg-1 {middle dot}h-1. Caution should be used when patients receive epidural infusion of lidocaine during hepatectomy.

Wade S. Kingery, Geeta S. Agashe, Shigehito Sawamura, M. Frances Davies, J. David Clark, and Mervyn Maze

Glucocorticoid Inhibition of Neuropathic Hyperalgesia and Spinal Fos Expression
Anesth Analg 2001 92: 476-482. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Chronic continuous infusion of the glucocorticoid, methylprednisolone, relieved pain in a rodent model of nerve injury, and this effect persisted after discontinuing the drug. Methylprednisolone may be a curative treatment for some types of neuropathic pain when administered in divided daily doses over several weeks.

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

The Effect of Montage on the Analgesic Response to Percutaneous Neuromodulation Therapy
Anesth Analg 2001 92: 483-487. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: With electroanalgesic techniques such as percutaneous neuromodulation therapy, the pattern of the electrical stimulation can influence the acute analgesic response even when identical stimuli are administered at the same dermatomal levels.

Henning Harke, Peter Gretenkort, Hans U. Ladleif, Salah Rahman, and Ole Harke

The Response of Neuropathic Pain and Pain in Complex Regional Pain Syndrome I to Carbamazepine and Sustained-Release Morphine in Patients Pretreated with Spinal Cord Stimulation: A Double-Blinded Randomized Study
Anesth Analg 2001 92: 488-495. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: This study included patients with neuropathic pain suppressed by spinal cord stimulation (SCS). After deactivation of SCS, different drug effects were evaluated. In contrast to morphine, carbamazepine showed significant pain relief compared with placebo.

Gisele Zapata-Sudo, Margarete M. Trachez, Roberto T. Sudo, and Thomas E. Nelson

Is Comparative Cardiotoxicity of S(-) and R(+) Bupivacaine Related to Enantiomer-Selective Inhibition of L-Type Ca²⁺ Channels?
Anesth Analg 2001 92: 496-501. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Accidental intravascular injection of bupivacaine can induce toxic effects on the heart. We investigated the sensitivity of different bupivacaine structures' actions on the Ca2+ conducting channels in rat ventricular cells and concluded that the increased toxicity of R(+) bupivacaine is not explained by actions on the Ca2+ channels' inhibition.

Shilpa Kaushik, Allen H. Hord, Donald D. Denson, Devin V. McAllister, Sudhasinee Smitra, Mark G. Allen, and Mark R. Prausnitz

Lack of Pain Associated with Microfabricated Microneedles (Brief Report)
Anesth Analg 2001 92: 502-504. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Microscopic needles previously shown capable of transdermal delivery of drugs and proteins are demonstrated to be painless when pressed into the skin of human subjects.

Paul F. White, Shitong Li, and Jen W. Chiu

Electroanalgesia: Its Role in Acute and Chronic Pain Management (Medical Intelligence)
Anesth Analg 2001 92: 505-513. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Interest in nonpharmacologic alternatives to conventional analgesic drugs for the management of acute and chronic pain has lead to an evaluation of the use of electroanalgesic therapies.

Paul J. O’Connor, Gerald L. Moysa, and Brendan T Finucane

Thoracic Epidural Anesthesia for Bilateral Reduction Mammoplasty in a Patient with Klippel-Feil Syndrome (Case Report)
Anesth Analg 2001 92: 514-516. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: General anesthesia is best avoided in cases of Klippel-Feil syndrome where tracheal intubation is potentially difficult. The syndrome features severe abnormalities of the neck and upper thoracic spine, which may also lead to difficulties with neuraxial blockade. We describe the use of epidural anesthesia for bilateral reduction mammoplasty in a patient with this condition.

GENERAL ARTICLES:

Thomas Heidegger, Hans J. Gerig, Brigitte Ulrich, and Georg Kreienbühl

Validation of a Simple Algorithm for Tracheal Intubation: Daily Practice Is the Key to Success in Emergencies— An Analysis of 13,248 Intubations
Anesth Analg 2001 92: 517-522. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The aim of this investigation was to validate a simple tracheal intubation algorithm used in daily practice for years as a quality control exercise. With the exception of the guidewire, the only airway management instrument used was the fiberoptic bronchoscope. Of 13,248 intubations evaluated (90.6% of all intubations), only six patients (0.045%) could not be intubated by following our algorithm. The high proportion of primary fiberoptic intubations (12.1% of all intubations) has resulted in a corresponding degree of practice and experience with this method, with the consequence that the number of unanticipated failed intubations is very small. Daily practice is the key to success in the emergency situation.

Arissara Iamaroon, Siriporn Pitimana-aree, Chatchai Prechawai, Jutarat Anusit, Kanchana Somcharoen, and Onanong Chaiyaroj

Endotracheal Intubation with Thiopental/Succinylcholine or Sevoflurane-Nitrous Oxide Anesthesia in Adults: A Comparative Study
Anesth Analg 2001 92: 523-528. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: The three vital capacity inhaled anesthetic techniques with 8% sevoflurane and 66% N2O in O2 to receive 6% end-tidal sevoflurane may be an alternative for endotracheal intubation in adults who are at high risk from succinylcholine.

Åsa Österlund Modalen, Eva Arlander, Lars I. Eriksson, and Sten G. E. Lindahl

The Effects on Hypercarbic Ventilatory Response of Sameridine Compared to Morphine and Placebo
Anesth Analg 2001 92: 529-534. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: A novel molecule, sameridine, produces both a local anesthetic blockade and a partial {micro}-agonist action. In large doses, the ventilatory CO2 response was depressed, which was not the case when the recommended clinical dose was used.

Asikiya Walcourt, Robert L. Scott, and Howard A. Nash

Blockage of One Class of Potassium Channel Alters the Effectiveness of Halothane in a Brain Circuit of Drosophila
Anesth Analg 2001 92: 535-541. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Shaker channels are important elements during halothane inhibition of a specific reflex in Drosophila. Neurons that express these channels, which are irregularly distributed in the brain of flies, provide promising leads to identifying anesthetic-sensitive components.

Chin-Sheng Tang, Shou-Zen Fan, and Chang-Chuan Chan

Smoking Status and Body Size Increase Carbon Monoxide Concentrations in the Breathing Circuit During Low-Flow Anesthesia
Anesth Analg 2001 92: 542-547. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We found that smoking status, preoperative smoking, body weight and gas flow rates were major factors of affecting peak and mean carbon monoxide concentrations in low-flow anesthesia. Our direct measurement system is useful for monitoring real time exposures to CO during continuous clinical anesthesia.

Shu-Ming Wang and Zeev N. Kain

Auricular Acupuncture: A Potential Treatment for Anxiety
Anesth Analg 2001 92: 548-553. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: Auricular acupuncture at the "relaxation" point can decrease anxiety in healthy volunteers.

CASE REPORTS:

Dennis P. Dimaculangan, Banu S. Lokhandwala, David J. Wlody, and Robert M. Gross

Difficult Airway in a Patient with Coffin-Siris Syndrome
Anesth Analg 2001 92: 554-555. [Abstract] [Full Text] [PDF] [Request Permissions]  

Implications: We report on a patient with Coffin-Siris syndrome and consider a potential association between this condition and difficult intubation. Although this inherited condition is extremely rare, anesthesiologists should be aware of its existence and prepare for potential airway management problems whenever it is encountered.

LETTERS:

Scott S. Reuben and Michael F. Mulroy

Ambulatory Anesthesia for Knee Arthroscopy
Anesth Analg 2001 92: 556. [Full Text] [PDF] [Request Permissions]  

Fumi Yanagidate, Yoshihiro Hamaya, and Shuji Dohi

Vaginal Indigo Carmine-Induced Severe Hypotension
Anesth Analg 2001 92: 556. [Full Text] [PDF] [Request Permissions]  

Fouad Atallah, Thérèse Bastside-Heulin, Kamran Samii, and Pierre Plante

Nefopam Analgesia as a Substitute of Neurolept Analgesia for Extracorporeal Shock Wave Lithotripsy
Anesth Analg 2001 92: 557. [Full Text] [PDF] [Request Permissions]  

Andreas Lehmann, Joachim Boldt, Peter Elliott, and RK Mirakhur

Remifentanil in Cardiac Surgery
Anesth Analg 2001 92: 557-558. [Full Text] [PDF] [Request Permissions]  

Toshiyuki Saito

Characteristics of Extended Unilateral (Paravertebral) Anesthesia
Anesth Analg 2001 92: 558. [Full Text] [PDF] [Request Permissions]  

E. Andrew Ochroch, Rebecca A. Barnett, and Mitchell David Tobias

A Complication of Venous Double Cannulation
Anesth Analg 2001 92: 558-559. [Full Text] [PDF] [Request Permissions]  

Amr Abouleish, Mark L. Blas, and Emilio Lobato

Postoperative Management of Intraoperative Anaphylaxis
Anesth Analg 2001 92: 559. [Full Text] [PDF] [Request Permissions]  

Brian M. Parker, Samuel A. Irefin, Christopher J. O’Connor, and Kenneth J. Tuman

Antifibrinolytic Therapy and Pulmonary Thromboembolism During Orthotopic Liver Transplantation
Anesth Analg 2001 92: 559-560. [Full Text] [PDF] [Request Permissions]  

Gary L. Fanning

Hyaluronidase in Ophthalmic Anesthesia
Anesth Analg 2001 92: 560. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Dell R. Burkey, Franco Carli, Alex N. Chapochnikov, and MD Mark A. Chaney

Practical Management of Pain, 3rd Edition • Perioperative Medicine; Volume 18, Number 3 of Anesthesiology Clinics of North America • Transoesophageal Echocardiography in Anesthesia • Books and Multimedia Received
Anesth Analg 2001 92: 561-562. [Full Text] [PDF] [Request Permissions]  

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