EDITORIALS:

Edmond I Eger, II

Good News, Bad News
Anesth Analg 2002 94: 239-240. [Full Text] [PDF] [Request Permissions]  

Donald D. Koblin

Urethane: Help or Hindrance?
Anesth Analg 2002 94: 241-242. [Full Text] [PDF] [Request Permissions]  

PEDIATRIC ANESTHESIA:

Dolores B. Njoku, Robert S. Greenberg, Mohammed Bourdi, Craig B. Borkowf, Elizabeth M. Dake, Jackie L. Martin, and Lance R. Pohl

Autoantibodies Associated with Volatile Anesthetic Hepatitis Found in the Sera of a Large Cohort of Pediatric Anesthesiologists
Anesth Analg 2002 94: 243-249. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Environmental exposure of anesthesiology personnel to certain inhaled anesthetics can induce the formation of autoantibodies that have been associated with anesthetic hepatitis. Female anesthesiologists have high levels of these autoantibodies; however, the majority of these individuals do not develop hepatitis, suggesting that autoantibodies may not have a pathological role in volatile anesthetic-induced hepatitis.

Susan T. Verghese, Ajay Nath, David Zenger, Ramesh I. Patel, Richard F. Kaplan, and Kantilal M. Patel

The Effects of the Simulated Valsalva Maneuver, Liver Compression, and/or Trendelenburg Position on the Cross-Sectional Area of the Internal Jugular Vein in Infants and Young Children
Anesth Analg 2002 94: 250-254. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The combinations of simulated Valsalva, liver compression, and Trendelenburg maneuvers produce the maximal mean increase in the size of the internal jugular vein in infants and young children, with the Valsalva maneuver being the most effective single maneuver. This increase is significant in young children, but negligible in infants.

Egbert Huettemann, Christoph Terborg, Samir G. Sakka, Gritta Petrat, Felix Schier, and Konrad Reinhart

Preserved CO₂ Reactivity and Increase in Middle Cerebral Arterial Blood Flow Velocity During Laparoscopic Surgery in Children
Anesth Analg 2002 94: 255-258. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Laparoscopic surgery is performed frequently in pediatric patients. Cerebral blood flow velocities increase during insufflation of the intraperitoneal cavity for minimally invasive surgery in children. The vasoreactivity as part of the cerebral autoregulation remains unaffected.

Manoj K. Karmakar, Cindy S. T. Aun, Eliza L. Y. Wong, April S. Y. Wong, Simon K. C. Chan, and Chung K. Yeung

Ropivacaine Undergoes Slower Systemic Absorption from the Caudal Epidural Space in Children than Bupivacaine
Anesth Analg 2002 94: 259-265. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared the systemic absorption of ropivacaine (0.2%) and bupivacaine (0.2%) after caudal epidural injection of 2 mg/kg in children aged 1-7 yr. Our results show that ropivacaine undergoes slower systemic absorption from the caudal epidural space in children than does bupivacaine.

Richard M. Dsida, Melissa Wheeler, Patrick K. Birmingham, Zhao Wang, Corri L. Heffner, Charles J. Coté, and Michael J. Avram

Age-Stratified Pharmacokinetics of Ketorolac Tromethamine in Pediatric Surgical Patients
Anesth Analg 2002 94: 266-270. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The literature suggests that ketorolac disposition differs between children and adults. We characterized ketorolac pharmacokinetics in 36 children. Body weight-normalized two-compartment pharmacokinetic variables did not differ among pediatric patients <17 yr old and were similar to adult values.

Toshiya Tomioka, Yutaka Awaya, Kenji Nihei, Hiroshi Sekiyama, Shigehito Sawamura, and Kazuo Hanaoka

Anesthesia for Patients with Congenital Insensitivity to Pain and Anhidrosis: A Questionnaire Study in Japan
Anesth Analg 2002 94: 271-274. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the anesthetic management of patients with congenital insensitivity to pain and anhidrosis. We clarified the following three important points: anesthesia is necessary, temperature management must be maintained, and there must be sufficient perioperative sedation in the anesthetic management of patients with congenital insensitivity to pain and anhidrosis.

CARDIOVASCULAR ANESTHESIA:

Mark C. Priestley, Louise Cope, Richard Halliwell, Peter Gibson, Richard B. Chard, Michael Skinner, and Peter L. Klineberg

Thoracic Epidural Anesthesia for Cardiac Surgery: The Effects on Tracheal Intubation Time and Length of Hospital Stay
Anesth Analg 2002 94: 275-282. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We found that epidural analgesia was more effective than IV morphine for cardiac surgery. Epidural anesthesia also allowed earlier weaning from mechanical ventilation, but it did not affect hospital discharge time.

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

A Study of a Weight-Adjusted Aprotinin Dosing Schedule During Cardiac Surgery
Anesth Analg 2002 94: 283-289. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The current dosing schedule for aprotinin results in a large variation in aprotinin plasma concentrations between patients and a large variation within each patient over time. A new weight-based dosing schedule reduced variation of aprotinin concentration over time, but was unable to reduce between-patient variability in aprotinin concentration.

Timothy O. Stanley, G. Burkhard Mackensen, Hilary P. Grocott, William D. White, James A. Blumenthal, Daniel T. Laskowitz, Kevin P. Landolfo, Joseph G. Reves, Joseph P. Mathew, Mark F. Newman, The Neurologic Outcome Research Group, and The CARE Investigators of the Duke Heart Center

The Impact of Postoperative Atrial Fibrillation on Neurocognitive Outcome After Coronary Artery Bypass Graft Surgery
Anesth Analg 2002 94: 290-295. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Neurocognitive dysfunction is common after coronary artery bypass graft surgery. The relationship between atrial fibrillation and neurocognitive dysfunction has not been examined. Our study shows that postoperative atrial fibrillation is associated with neurocognitive decline.

Masayuki Miyabe, Kennichi Yanagi, Norio Ohshima, Shigehito Sato, Taeko Fukuda, and Hidenori Toyooka

Sodium Nitroprusside Decreases Leukocyte Adhesion and Emigration After Hemorrhagic Shock
Anesth Analg 2002 94: 296-301. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The IV infusion of 0.1 {micro}g {middle dot} kg-1 {middle dot} min-1 of sodium nitroprusside, a dose that does not exert a significant vasodilator effect, reduces leukocyte adhesion and emigration after hemorrhagic shock.

Joseph P. Mathew, Manuel L. Fontes, Susan Garwood, Elizabeth Davis, William D. White, Gerard McCloskey, Jane C.K. Fitch, Sherif Afifi, David L. Lee, Phillip Kraker, Terence D. Rafferty, Paul G. Barash, Linda Gillam, and Edward Prokop

Transesophageal Echocardiography Interpretation: A Comparative Analysis Between Cardiac Anesthesiologists and Primary Echocardiographers
Anesth Analg 2002 94: 302-309. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Interpretation of intraoperative transesophageal echocardiograms can be reliably performed by cardiac anesthesiologists.

Minako Ashidagawa, Maria Ohara, and Yasuhiro Koide

An Intraoperative Diagnosis of Dynamic Left Ventricular Outflow Tract Obstruction Using Transesophageal Echocardiography Leads to the Treatment with Intravenous Disopyramide (Case Report)
Anesth Analg 2002 94: 310-312. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During surgery, dynamic left ventricular outflow obstruction (LVOT) can potentially occur frequently, but diagnosis may be less frequent. When circulatory disturbance occurs with suspicion of LVOT obstruction, transesophageal echocardiography can provide exact proof of diagnosis and basis for immediate treatment.

ANESTHETIC PHARMACOLOGY:

Koji Hara and R. Adron Harris

The Anesthetic Mechanism of Urethane: The Effects on Neurotransmitter-Gated Ion Channels
Anesth Analg 2002 94: 313-318. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Urethane modestly affects multiple neurotransmitter systems at an anesthetic concentration. Our findings suggest that these degenerate effects of urethane can produce anesthesia and that urethane has a potential to influence neuronal measurements made in in vivo preparations.

Inas A. M. Radwan, Shigeru Saito, and Fumio Goto

The Neurotoxicity of Local Anesthetics on Growing Neurons: A Comparative Study of Lidocaine, Bupivacaine, Mepivacaine, and Ropivacaine
Anesth Analg 2002 94: 319-324. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Local anesthetics induce growth cone collapse and neurite degeneration in the growing neurons. Mepivacaine was safer than lidocaine, bupivacaine, and ropivacaine for the primary cultured chick neurons.

Nobuyasu Nishizawa, Tetsuya Shirasaki, Shinichi Nakao, Hiroko Matsuda, and Koh Shingu

The Inhibition of the N-Methyl-D-Aspartate Receptor Channel by Local Anesthetics in Mouse CA1 Pyramidal Neurons
Anesth Analg 2002 94: 325-330. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined the effects of four local anesthetics (procaine, tetracaine, bupivacaine, and lidocaine) on NMDA-induced currents by using a whole-cell patch-clamp technique in dissociated mouse hippocampal pyramidal neurons. Both procaine and tetracaine produced a reversible and concentration-dependent inhibition of the NMDA-induced currents.

Henry U. Weigt, Michael Georgieff, Cordian Beyer, and Karl J. Föhr

Activation of Neuronal N-Methyl-D-Aspartate Receptor Channels by Lipid Emulsions
Anesth Analg 2002 94: 331-337. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lipid emulsions are widely used as carriers for hypnotics such as propofol, etomidate, or diazepam. We tested nine commercially available lipid emulsions and demonstrate that three of them—Intralipid, Structolipid, and Abbolipid—activate NMDA receptor channels in the membranes of cortical neuronal cells.

Michael Hanania and Eric Kitain

Melatonin for Treatment and Prevention of Postoperative Delirium (Case Report)
Anesth Analg 2002 94: 338-339. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Postoperative delirium or confusion after surgery is a common problem associated with complications and death. Delirium has been linked to sleep-wake cycle disruption. Melatonin levels, which play an important role in regulating the sleep-wake cycle, are decreased after surgery. Two cases are presented where melatonin was used to treat and prevent postoperative delirium.

Brigitte Fauroux, Jeremy Cordingley, Nicholas Hart, Annick Clément, John Moxham, Frédéric Lofaso, and Michael I. Polkey

Depression of Diaphragm Contractility by Nitrous Oxide in Humans (Case Report)
Anesth Analg 2002 94: 340-345. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated whether nitrous oxide (a common component of gas anesthesia) reduces diaphragm strength in humans. Diaphragm strength is reduced by nitrous oxide but the effect wears off within 20 min of administration. Caution is advised when using nitrous oxide without anesthesiologist supervision in patients at risk of ventilatory failure

AMBULATORY ANESTHESIA:

Pamela H. Lennox, Himat Vaghadia, Cynthia Henderson, Lynn Martin, and G. W. E. Mitchell

Small-Dose Selective Spinal Anesthesia for Short-Duration Outpatient Laparoscopy: Recovery Characteristics Compared with Desflurane Anesthesia
Anesth Analg 2002 94: 346-350. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study compared the use of a desflurane general anesthetic to a small-dose spinal anesthetic in ambulatory gynecological laparoscopy. Using the spinal technique, patients can walk from the operating room table to a stretcher on completion of surgery. Their recovery time was similar to that of the desflurane group.

Livia S. Marica, Terry O’Day, Janine E. Janosky, and Elisabet U. M. Nystrom

Chloroprocaine is Less Painful than Lidocaine for Skin Infiltration Anesthesia
Anesth Analg 2002 94: 351-354. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using 2-chloroprocaine can diminish pain caused by the intradermal injection of lidocaine. pH variations of the solution did not relate to the pain profile of the local anesthetic.

Michel A. Terheggen, Frank Wille, Inne H. Borel Rinkes, Trian I. Ionescu, and Johannes T. Knape

Paravertebral Blockade for Minor Breast Surgery
Anesth Analg 2002 94: 355-359. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study confirms the previously reported superior pain relief after paravertebral blockade (PVB) for breast surgery. However, considering the relatively mild postoperative pain and therefore the limited advantage of PVB for these patients, the risk/benefit ratio does not favor the routine use of PVB for minor breast surgery.

Andrew G. Kadar, Caleb H. Ing, Paul F. White, Cynthia A. Wakefield, Barry A. Kramer, and Kerri Clark

Anesthesia for Electroconvulsive Therapy in Obese Patients
Anesth Analg 2002 94: 360-361. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Obese patients have successfully undergone over 650 consecutive uncomplicated ECT treatments without any special precautions at two major U.S. medical centers.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Robert G. Loeb and W. Tecumseh Fitch

A Laboratory Evaluation of an Auditory Display Designed to Enhance Intraoperative Monitoring
Anesth Analg 2002 94: 362-368. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We developed and tested an auditory display of multivariable clinical data. With little training, clinicians successfully used the display to detect and diagnose simulated critical events. This suggests that a multivariable auditory display could enhance intraoperative monitoring.

Thomas M. Hemmerling and Pierre Harvey

Electrocardiographic Electrodes Provide the Same Results as Expensive Special Sensors in the Routine Monitoring of Anesthetic Depth (Technical Communication)
Anesth Analg 2002 94: 369-371. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The Bispectral Index (BIS) monitor adequately monitors depth of anesthesia. The routine use of this monitor has been hampered by the benefit-cost equation because only special expensive electrodes can be used. We examined the agreement of BIS values obtained by original sensor electrodes and commercial electrocardiogram (ECG) electrodes. These ECG electrodes can replace more expensive BIS sensors.

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

Anna Lee and Tony Gin

Applying the Results of Quantitative Systematic Reviews to Clinical Practice
Anesth Analg 2002 94: 372-377. [Full Text] [PDF] [Request Permissions]  

CRITICAL CARE AND TRAUMA:

Joachim Boldt, G. Haisch, S. Suttner, B. Kumle, and F. Schellhase

Are Lactated Ringer’s Solution and Normal Saline Solution Equal with Regard to Coagulation?
Anesth Analg 2002 94: 378-384. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In 42 patients undergoing major abdominal surgery, either lactated Ringer's solution or 0.9% saline solution were exclusively used for volume therapy for 48 h. Activated thrombelastography revealed some mild hypercoagulability after surgery. No differences in coagulation were seen between the two intravascular volume replacement strategies.

Kahoru Nishina, Katsuya Mikawa, Osamu Morikawa, Hidefumi Obara, and R. J. Mason

The Effects of Intravenous Anesthetics and Lidocaine on Proliferation of Cultured Type II Pneumocytes and Lung Fibroblasts (Brief Report)
Anesth Analg 2002 94: 385-388. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Midazolam, ketamine, thiopental, propofol, or lidocaine did not inhibit proliferation of cultured rat type II pneumocytes. Our findings suggest that these anesthetics do not impede alveolar reepithelization after acute lung injury.

NEUROSURGICAL ANESTHESIA:

Hernán R. Muñoz, Gastón E. Núñez, José E. de la Fuente, and Manuel G. Campos

The Effect of Nitrous Oxide on Jugular Bulb Oxygen Saturation During Remifentanil Plus Target-Controlled Infusion Propofol or Sevoflurane in Patients with Brain Tumors
Anesth Analg 2002 94: 389-392. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study demonstrates that nitrous oxide can increase jugular bulb venous oxygen saturation when added to sevoflurane/remifentanil anesthesia, but not to propofol/remifentanil anesthesia, in patients with brain tumors.

Shailendra Joshi, Houng Duong, Sundeep Mangla, Mei Wang, Adam D. Libow, Sulli J. Popilskis, Noeleen D. Ostapkovich, Theodore S. Wang, William L. Young, and John Pile-Spellman

In Nonhuman Primates Intracarotid Adenosine, but Not Sodium Nitroprusside, Increases Cerebral Blood Flow
Anesth Analg 2002 94: 393-399. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intraarterial 133Xe cerebral blood flow (CBF) measurements suggest that intracarotid adenosine, in a dose that lacks significant systemic side effects, profoundly increases CBF, whereas nitroprusside has no effect.(5-12)

Hubert J. Schmitt and Thomas M. Hemmerling

Venous Air Emboli Occur During Release of Positive End-Expiratory Pressure and Repositioning After Sitting Position Surgery
Anesth Analg 2002 94: 400-403. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that venous air embolism (VAE) occurs not only during surgery in the sitting position but also during positive end-expiratory pressure release and repositioning of the patient into the supine position. Continuous monitoring for VAE should be performed until the patient is returned to the supine position.

OBSTETRIC ANESTHESIA:

Mark Kubli, Mark J. Scrutton, Paul T. Seed, and Geraldine O’ Sullivan

An Evaluation of Isotonic "Sport Drinks" During Labor
Anesth Analg 2002 94: 404-408. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Solid foods may endanger a woman's life if consumed during labor. Isotonic sport fluids were evaluated as a nutritional alternative. Results demonstrate that mothers who have not received parenteral opioids can safely drink isotonic drinks in active labor.

Ernst-Peter Horn, Frank Schroeder, Andrè Gottschalk, Daniel I. Sessler, Natascha Hiltmeyer, Thomas Standl, and Jochen Schulte am Esch

Active Warming During Cesarean Delivery
Anesth Analg 2002 94: 409-414. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Perioperative forced-air warming of women undergoing cesarean delivery with epidural anesthesia prevents maternal and fetal hypothermia, reduces maternal shivering, and improves umbilical vein pH.

Zahid H. Bajwa, Charles Ho, Artem Grush, Jonathan Kleefield, and Carol A. Warfield

Discitis Associated with Pregnancy and Spinal Anesthesia (Case Report)
Anesth Analg 2002 94: 415-416. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This is a case report of a disk infection (discitis) caused by the bacteria, Streptococcus bovis after spinal anesthesia for cesarean delivery. S. bovis rarely causes discitis, and spinal anesthesia for labor and delivery has not been reported as a cause of discitis.

PAIN MEDICINE:

Stuart A. Dunbar, P. Manikantan, and J. Philip

Epidural Infusion Pressure in Degenerative Spinal Disease Before and After Epidural Steroid Therapy
Anesth Analg 2002 94: 417-420. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During injection into the epidural space we observed increased resistance in patients with degenerative spinal disease. This resistance was significantly less when measured 3 wk after an epidural steroid injection. This change in pressure may indicate efficacy from epidural steroid injection.

Yoram Shir, James N. Campbell, Srinivasa N. Raja, and Ze’ev Seltzer

The Correlation Between Dietary Soy Phytoestrogens and Neuropathic Pain Behavior in Rats After Partial Denervation
Anesth Analg 2002 94: 421-426. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dietary soy suppresses neuropathic pain in rats after partial sciatic nerve ligation. Some of the pain-suppression properties of soy can be attributed to phytoestrogens, isoflavones abundantly found in soy products. Average, but not low or high, plasma levels of phytoestrogens are associated with analgesia.

Caroline E. Heughan, Gary V. Allen, Teena D. Chase, and Jana Sawynok

Peripheral Amitriptyline Suppresses Formalin-Induced Fos Expression in the Rat Spinal Cord
Anesth Analg 2002 94: 427-431. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In the formalin test, amitriptyline produces different effects on pain behaviors after systemic, spinal administration and peripheral administration. Fos protein, an indicator of neuronal activity after noxious stimulation, is upregulated after formalin injection. We examined the effects of amitriptyline on such expression and observed a reduction in expression with peripheral administration.

REGIONAL ANESTHESIA:

José L. Mojica, Héctor J. Meléndez, and Leonelo E. Bautista

The Timing of Intravenous Crystalloid Administration and Incidence of Cardiovascular Side Effects During Spinal Anesthesia: The Results from a Randomized Controlled Trial
Anesth Analg 2002 94: 432-437. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Crystalloids are frequently administered to nonobstetric patients minutes before spinal anesthesia to prevent cardiovascular side effects (CVSE). This randomized controlled trial shows that although crystalloids administered before spinal block result in no clinical benefit, they significantly reduce the risk of CVSE when administered at the time of spinal block.

John A. C. Murdoch, Ursula K. Dickson, Paul A. Wilson, Jonathan S. Berman, Rita R. Gad-Elrab, and Nicholas B. Scott

The Efficacy and Safety of Three Concentrations of Levobupivacaine Administered as a Continuous Epidural Infusion in Patients Undergoing Orthopedic Surgery
Anesth Analg 2002 94: 438-444. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Postoperative epidural infusion of levobupivacaine can provide safe and effective analgesia for patients having hip or knee joint replacement. Of the three concentrations we infused at a constant rate, 0.25% provided significantly better pain relief.

Hervé Bouaziz, Florence Vial, Denis Jochum, Dioukamaly Macalou, Michel Heck, Pascal Meuret, Marc Braun, and Marie-Claire Laxenaire

An Evaluation of the Cutaneous Distribution After Obturator Nerve Block
Anesth Analg 2002 94: 445-449. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Previous studies reporting an incidence of obturator nerve block after three-in-one block may have mistaken a femoral nerve block for an obturator nerve block in 100% of cases when the cutaneous distribution of the obturator nerve was assessed on the medial aspect of the thigh. The only way to effectively evaluate obturator nerve function is to assess adductor strength.

Konrad Maurer, Georgios Ekatodramis, Katharina Rentsch, and Alain Borgeat

Interscalene and Infraclavicular Block for Bilateral Distal Radius Fracture (Case Report)
Anesth Analg 2002 94: 450-452. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report presents the performance of a simultaneous blockade of both upper extremities in a patient who sustained a bilateral distal radius fracture. The patient was known to be difficult to intubate and to have a severe hypersensitivity to opioids.

GENERAL ARTICLES:

Peter Kranke, Leopold H. Eberhart, Norbert Roewer, and Martin R. Tramèr

Pharmacological Treatment of Postoperative Shivering: A Quantitative Systematic Review of Randomized Controlled Trials
Anesth Analg 2002 94: 453-460. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Less than two shivering patients need to be treated with meperidine 25 mg, clonidine 150 {micro}g, or doxapram 100 mg for one to stop shivering within 5 min who would have continued to shiver had they all received a placebo.

Charles Cerf, Martine Mesguish, Inanna Gabriel, Serge Amselem, and Philippe Duvaldestin

Screening Patients with Prolonged Neuromuscular Blockade After Succinylcholine and Mivacurium
Anesth Analg 2002 94: 461-466. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Systematic screening for the pseudocholinesterase atypical variant by biochemical and DNA analysis after a prolonged neuromuscular blocking effect of succinylcholine or mivacurium shows that molecular biology could improve the diagnosis in approximately one third of patients, but with few clinical implications, compared with biochemical testing.

Charles Beattie

The Modified Nasal Trumpet Maneuver (Technical Communication)
Anesth Analg 2002 94: 467-469. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A simple technique is proposed that can be used to rescue patients who are in a condition of cannot intubate/cannot ventilate. The described maneuver may save patients from requiring a surgical airway.

Virendra K. Arya, Amitabh Dutta, Pramila Chari, and Ramesh K. Sharma

Difficult Retrograde Endotracheal Intubation: The Utility of a Pharyngeal Loop (Case Report)
Anesth Analg 2002 94: 470-473. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A 30-yr-old woman presented for redo-release of bilateral temporomandibular joint ankylosis under general anesthesia. During the previous anesthetic for primary release of ankylosis, tracheostomy was done, as conventional blind nasotracheal and retrograde intubation attempts failed several times. This case report describes the method for overcoming the difficulties of a retrograde intubation procedure in removing the guiding catheter nasally by using a pharyngeal loop assembly.

LETTERS TO THE EDITOR:

Konstantinos Raymondos, Bernhard Panning, Gideon Paret, Zvi Vaknin, Danny Lotan, and Zohar Barzilay

Deleterious Airway Administration of Adrenaline • Response
Anesth Analg 2002 94: 474. [Full Text] [PDF] [Request Permissions]  

S. Mérat, J-P. Lévecque, Y. Le Gulluche, Y. Diraison, J-M. Delmas, T. Faillot, and L. Brinquin

Paraplegia After Sitting Position
Anesth Analg 2002 94: 474-475. [Full Text] [PDF] [Request Permissions]  

Georgios Ekatodramis, John M. Bonvini, Alain Borgeat, Andrea Casati, and Guido Fanelli

The Effects of Single or Multiple Injections on the Volume of 0.5% Ropivacaine Required for Femoral Nerve Blockade • Response
Anesth Analg 2002 94: 475-476. [Full Text] [PDF] [Request Permissions]  

Mummadi Sanjeeva Reddy, Pyati Srinivas, Ole Andersen, Søren Elkjaer, and Lene Bruun

Hepatic Failure After Rectal Acetaminophen • Response
Anesth Analg 2002 94: 476. [Full Text] [PDF] [Request Permissions]  

Mazen A. Karraz, Denis L. Bourke, and Juraj Sprung

Primary Score Predicting the Difficulty of Neuraxial Block • Response
Anesth Analg 2002 94: 476-477. [Full Text] [PDF] [Request Permissions]  

Yushi U. Adachi, Maiko Satomoto, and Hideyuki Higuchi

Fiberoptic Orotracheal Intubation in the Left Semilateral Position
Anesth Analg 2002 94: 477-478. [Full Text] [PDF] [Request Permissions]  

Hsiu-chin Chou, Tzu-lang Wu, Noriaki Kanaya, and Akiyoshi Namiki

Long and Narrow Pharyngolaryngeal Passage in Difficult Airway • Response
Anesth Analg 2002 94: 478-479. [Full Text] [PDF] [Request Permissions]  

C. Chamorro, J. A. Silva, M. A. Romera, J. Márquez, C. Pardo, W. R. Hasibeder, M. W. Dünser, and A. J. Mayr

Vasopressin Effect on Pulmonary Arterial Pressure • Response
Anesth Analg 2002 94: 479. [Full Text] [PDF] [Request Permissions]  

Guy Weinberg, Shigeo Ohmura, and Masayuki Kawada

Local Anesthetic Toxicity: Different Mechanisms for Different End Points • Response
Anesth Analg 2002 94: 479-480. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Thoracic Anesthesia; Volume 19, Number 3 of Anesthesiology Clinics of North America • Prehospital Trauma Care • Anesthesia and Neurosurgery, 4th edition • Books and Multimedia Received
Anesth Analg 2002 94: 481-482. [Full Text] [PDF] [Request Permissions]  

ERRATA:

Erratum
Anesth Analg 2002 94: 254. [Full Text] [PDF] [Request Permissions]  

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