EDITORIALS:

Scott R. Schulman

Rapacuronium Redux
Anesth Analg 2002 94: 483-484. [Full Text]  

Armin Schubert

Cerebral Hyperemia, Systemic Hypertension, and Perioperative Intracranial Morbidity: Is There a Smoking Gun?
Anesth Analg 2002 94: 485-487. [Full Text]  

PEDIATRIC ANESTHESIA:

Donna M. Rajchert, Caroline A. Pasquariello, Mehernoor F. Watcha, and Mark S. Schreiner

Rapacuronium and the Risk of Bronchospasm in Pediatric Patients
Anesth Analg 2002 94: 488-493. [Abstract] [Full Text]  

IMPLICATIONS: In a retrospective cohort study, significant risk factors for the development of bronchospasm with the administration of rapacuronium on induction of anesthesia included rapid sequence induction and prior history of reactive airways disease. In a case-control study, children with bronchospasm during induction of anesthesia were several times more likely to have received rapacuronium compared with other muscle relaxants.

Sonja Meier, Jeremy Geiduschek, Reto Paganoni, Frauke Fuehrmeyer, and Adrian Reber

The Effect of Chin Lift, Jaw Thrust, and Continuous Positive Airway Pressure on the Size of the Glottic Opening and on Stridor Score in Anesthetized, Spontaneously Breathing Children
Anesth Analg 2002 94: 494-499. [Abstract] [Full Text]  

IMPLICATIONS: Chin lift and jaw thrust maneuvers combined with continuous positive airway pressure improve the view of the glottic opening as viewed by flexible nasal laryngoscopy and decrease stridor in anesthetized, spontaneously breathing children.

Eric E. C. de Waal, Jaap W. de Vries, Cas L. J. J. Kruitwagen, and Cor J. Kalkman

The Effects of Low-Pressure Carbon Dioxide Pneumoperitoneum on Cerebral Oxygenation and Cerebral Blood Volume in Children
Anesth Analg 2002 94: 500-505. [Abstract] [Full Text]  

IMPLICATIONS: Peritoneal CO2 absorption during laparoscopic surgery causes hypercapnia and CO2-mediated cerebral hemodynamic effects. Hyperventilation and the head-up position before CO2 insufflation is not sufficient to counteract these effects of low-pressure pneumoperitoneum (5-8 mm Hg) in children.

John W. Berkenbosch, Christopher R. Fichter, and Joseph D. Tobias

The Correlation of the Bispectral Index Monitor with Clinical Sedation Scores During Mechanical Ventilation in the Pediatric Intensive Care Unit
Anesth Analg 2002 94: 506-511. [Abstract] [Full Text]  

IMPLICATIONS: We demonstrate the usefulness of the bispectral index monitor for assessing sedation in pediatric intensive care unit patients. The bispectral index monitor correlated with clinically assessed sedation levels and was useful for differentiating adequate from inadequate sedation, which would be of value when the clinical examination is unavailable.

Ellen D. Iannoli and Ronald S. Litman

Tension Pneumothorax During Flexible Fiberoptic Bronchoscopy in a Newborn (Case Report)
Anesth Analg 2002 94: 512-513. [Abstract] [Full Text]  

IMPLICATIONS:A newborn undergoing flexible fiberoptic bronchoscopy before repair of a tracheoesophageal fistula developed a life-threatening tension pneumothorax. The mechanisms of this complication are discussed and recommendations are made for preventing this complication.

CARDIOVASCULAR ANESTHESIA:

John Butterworth, Yonggu A. Lin, Richard Prielipp, Judy Bennett, and Robert James

The Pharmacokinetics and Cardiovascular Effects of a Single Intravenous Dose of Protamine in Normal Volunteers
Anesth Analg 2002 94: 514-522. [Abstract] [Full Text]  

IMPLICATIONS: We developed a method for measurement of protamine in human blood. In volunteers, protamine concentrations decreased rapidly after administration. The rapid disappearance of protamine from the circulation, as defined by a median half-life of 7.4 min, could contribute to cases of "heparin rebound" after initial adequate reversal of heparin.

Mark B. Bloch, Robert A. Dyer, Sylvia A. Heijke, and Michael F. James

Tramadol Infusion for Postthoracotomy Pain Relief: A Placebo-Controlled Comparison with Epidural Morphine
Anesth Analg 2002 94: 523-528. [Abstract] [Full Text]  

IMPLICATIONS: A prospective, randomized, double-blinded, placebo-controlled study of postthoracotomy pain relief showed that IV tramadol in the form of a bolus followed by continuous infusion was as effective as epidural morphine. The use of tramadol avoids the necessity of placing a thoracic epidural catheter.

Jean-François Baron, Maximilien Gourdin, Michèle Bertrand, Anne Mercadier, Josée Delort, Edouard Kieffer, and Pierre Coriat

The Effect of Universal Leukodepletion of Packed Red Blood Cells on Postoperative Infections in High-Risk Patients Undergoing Abdominal Aortic Surgery
Anesth Analg 2002 94: 529-537. [Abstract] [Full Text]  

IMPLICATIONS: We evaluated the influence of leukocyte reduction by filtration of packed red blood cells (RBC) on postoperative infections and adverse outcomes in patients undergoing elective major aortic surgery by comparing two epochs with and without filtration. Data from this study suggest that the effect of using filtered RBC on postoperative infections is not of obvious importance.

Nicholas J. Wilkes, Rex L. Woolf, Michael C. Powanda, Tong J. Gan, Sam J. Machin, Andrew Webb, Marjorie Mutch, Elliott Bennett-Guerrero, and Michael Mythen

Hydroxyethyl Starch in Balanced Electrolyte Solution (Hextend^®)—Pharmacokinetic and Pharmacodynamic Profiles in Healthy Volunteers
Anesth Analg 2002 94: 538-544. [Abstract] [Full Text]  

IMPLICATIONS: Hextend(R) is a new plasma volume expander containing 6% hydroxyethyl starch in a physiologically balanced medium. This open-label volunteer study demonstrated that it has pharmacokinetic and pharmacodynamic profiles similar to those of established HES.

Benedikt Preckel, Dirk Ebel, Jost Müllenheim, Jan Fräßdorf, Volker Thämer, and Wolfgang Schlack

The Direct Myocardial Effects of Xenon in the Dog Heart In Vivo
Anesth Analg 2002 94: 545-551. [Abstract] [Full Text]  

IMPLICATIONS: Regional administration of xenon direct to the left anterior descending-perfused myocardium resulted in a small but consistent negative inotropic effect of the noble gas in the dog heart in vivo.

Akira Kudoh, Emiko Kudoh, Hiroshi Katagai, and Tomoko Takazawa

Ketamine Suppresses Norepinephrine-Induced Inositol 1,4,5-Trisphosphate Formation Via Pathways Involving Protein Kinase C
Anesth Analg 2002 94: 552-557. [Abstract] [Full Text]  

IMPLICATIONS: Ketamine inhibits norepinephrine-induced inositol 1,4,5-triphosphate formation in a dose-dependent manner via pathways that involve protein kinase C and a decrease in intracellular Ca2+ concentrations.

William Murtha and Craig Guenther

Dynamic Left Ventricular Outflow Tract Obstruction Complicating Bilateral Lung Transplantation (Case Report)
Anesth Analg 2002 94: 558-559. [Abstract] [Full Text]  

IMPLICATIONS: Dynamic left ventricular outflow tract obstruction is not an uncommon phenomenon, but it is often unrecognized. Its rapid recognition and effective treatment was only possible with transesophageal echocardiography (TEE). This contributes to the support for TEE being routinely available for assessment of hemodynamic instability.

AMBULATORY ANESTHESIA:

Brian Fredman, Offer Sheffer, Edna Zohar, Irena Paruta, Santiago Richter, Robert Jedeikin, and Paul F. White

Fast-Track Eligibility of Geriatric Patients Undergoing Short Urologic Surgery Procedures
Anesth Analg 2002 94: 560-564. [Abstract] [Full Text]  

IMPLICATIONS: Geriatric outpatients undergoing brief urologic procedures more rapidly achieve fast-tracking discharge criteria after desflurane (versus isoflurane and propofol) anesthesia. Use of isoflurane was also associated with an increased need for nursing interventions in the early recovery period compared with desflurane and propofol.

Pamela H. Lennox, Colin Chilvers, and Himat Vaghadia

Selective Spinal Anesthesia Versus Desflurane Anesthesia in Short Duration Outpatient Gynecological Laparoscopy: A Pharmacoeconomic Comparison
Anesth Analg 2002 94: 565-568. [Abstract] [Full Text]  

IMPLICATIONS: Small-dose spinal anesthesia is an effective alternative to a desflurane general anesthetic in terms of cost and recovery profiles in ambulatory gynecological laparoscopy.

Adia Paraskeva, Konstantinos Papilas, Argyro Fassoulaki, Aikaterini Melemeni, and Georgios Papadopoulos

Physostigmine Does Not Antagonize Sevoflurane Anesthesia Assessed by Bispectral Index or Enhances Recovery
Anesth Analg 2002 94: 569-572. [Abstract] [Full Text]  

IMPLICATIONS: This double-blinded, randomized study investigated the impact of physostigmine of BIS values during 0.6% sevoflurane anesthesia as well as in the postoperative recovery, when sevoflurane is administered as a sole anesthetic. Physostigmine has no effect on BIS values or on the tests assessing recovery.

Thomas Mencke, Jan-Uwe Schreiber, Christine Becker, Marion Bolte, and Thomas Fuchs-Buder

Pretreatment Before Succinylcholine for Outpatient Anesthesia? (Brief Report)
Anesth Analg 2002 94: 573-576. [Abstract] [Full Text]  

IMPLICATIONS: This study demonstrated that pretreatment of succinylcholine with rocuronium failed to decrease the incidence or the severity of postoperative myalgia. However, in most patients, pretreatment was associated with muscle weakness before loss of consciousness. Thus, there is no convincing evidence supporting routine pretreatment with succinylcholine.

Paul F. White

The Role of Non-Opioid Analgesic Techniques in the Management of Pain After Ambulatory Surgery (Review Article)
Anesth Analg 2002 94: 577-585. [Full Text]  

TECHNOLOGY, COMPUTING, AND SIMULATION:

Kenji Yoshitani, Masahiko Kawaguchi, Kazuyuki Tatsumi, Katsuyasu Kitaguchi, and Hitoshi Furuya

A Comparison of the INVOS 4100 and the NIRO 300 Near-Infrared Spectrophotometers
Anesth Analg 2002 94: 586-590. [Abstract] [Full Text]  

IMPLICATIONS: Near-infrared spectroscopy (NIRS) has been proposed as a noninvasive clinical method for assessing cerebral oxygenation. The acceptable reliability and validity of NIRS values have not been established despite their widespread use. The INVOS 4100 and the NIRO 300 can display cerebral oxygen saturation as regional cerebral oxygen saturation and tissue oxygenation index, but they produce differing results.

Ashraf A. Dahaba, Fedor von Klobucar, Peter H. Rehak, and Werner F. List

The Neuromuscular Transmission Module Versus the Relaxometer Mechanomyograph for Neuromuscular Block Monitoring
Anesth Analg 2002 94: 591-596. [Abstract] [Full Text]  

IMPLICATIONS:Compared with the Relaxometer mechanomyograph, the neuromuscular transmission module could equally indicate time to tracheal intubation and full recovery from 0.6 mg/kg rocuronium neuromuscular block. Its small quick-fit sensor has the advantage, in an often crowded and busy operating room, of being incorporated in the AS/3TM anesthesia workstation.

ANESTHETIC PHARMACOLOGY:

Matthias Paul, Christoph H. Kindler, Ralf M. Fokt, Mark J. Dresser, Natalie C. J. Dipp, and C. Spencer Yost

The Potency of New Muscle Relaxants on Recombinant Muscle-Type Acetylcholine Receptors
Anesth Analg 2002 94: 597-603. [Abstract] [Full Text]  

IMPLICATIONS: Potencies of nondepolarizing muscle relaxants, studied at muscle nicotinic acetylcholine receptors expressed in a recombinant expression system, correlate highly with the clinical doses needed in adults to produce 50% twitch depression at the adductor pollicis muscle.

Robert Greif, Scott Greenwald, Ekkehard Schweitzer, Sonja Laciny, Angela Rajek, James E. Caldwell, and Daniel I. Sessler

Muscle Relaxation Does Not Alter Hypnotic Level During Propofol Anesthesia
Anesth Analg 2002 94: 604-608. [Abstract] [Full Text]  

IMPLICATIONS: Neuromuscular block level did not alter Bispectral Index (BIS) during propofol anesthesia, either by reducing electromyographic artifact or by decreasing afferent neuronal input. The BIS will thus comparably estimate sedation in deeply unconscious patients who are paralyzed, partially paralyzed, or unparalyzed.

Hideyuki Higuchi, Yushi Adachi, Shinya Arimura, Mie Ogata, and Tetsuo Satoh

Oral Clonidine Premedication Reduces the Awakening Concentration of Propofol
Anesth Analg 2002 94: 609-614. [Abstract] [Full Text] Data Supplement  

IMPLICATIONS: Preanesthetic medication with 5 {micro}g/kg oral clonidine, but not 2.5 {micro}g/kg clonidine, is associated with prolonged recovery from propofol/fentanyl anesthesia.

Marco P. Zalunardo, Daniel Serafino, Patricia Szelloe, Fabia Weisser, Andreas Zollinger, Burkhardt Seifert, and Thomas Pasch

Preoperative Clonidine Blunts Hyperadrenergic and Hyperdynamic Responses to Prolonged Tourniquet Pressure During General Anesthesia
Anesth Analg 2002 94: 615-618. [Abstract] [Full Text]  

IMPLICATIONS: Tourniquet inflation is associated with a continuous increase in arterial blood pressure and sympathetic outflow. This study shows that IV clonidine effectively blunts increases of both arterial blood pressure and plasma norepinephrine concentrations.

Etsuko Nagaoka, Kouichiro Minami, Yohsuke Shiga, Yasuhito Uezono, Munehiro Shiraishi, Kazuyoshi Aoyama, and Akio Shigematsu

Tramadol Has No Effect on Cortical Renal Blood Flow—Despite Increased Serum Catecholamine Levels—in Anesthetized Rats: Implications for Analgesia in Renal Insufficiency
Anesth Analg 2002 94: 619-625. [Abstract] [Full Text]  

IMPLICATIONS: A bolus and continuous injection of tramadol does not alter renal blood flow (RBF) in normal rats. A bolus injection of tramadol has little effect on RBF in rats with experimentally induced renal insufficiency. These results suggest that tramadol would be a safe analgesic for maintaining RBF during the postoperative period.

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

The Effects of Urapidil on Thermoregulatory Thresholds in Volunteers
Anesth Analg 2002 94: 626-630. [Abstract] [Full Text]  

IMPLICATIONS: In this study we show that the antihypertensive drug urapidil stops cold-induced shivering and decreases normal thermoregulatory responses, i.e., the thresholds for vasoconstriction and shivering, in awake volunteers.

Robert C. Dutton, Anya J. Maurer, James M. Sonner, Michael S. Fanselow, Michael J. Laster, and Edmond I Eger, II

Short-Term Memory Resists the Depressant Effect of the Nonimmobilizer 1-2-Dichlorohexafluorocyclobutane (2N) More than Long-Term Memory
Anesth Analg 2002 94: 631-639. [Abstract] [Full Text]  

IMPLICATIONS: The nonimmobilizer 1,2-dichlorohexafluorocyclobutane has a greater depressant effect on long-term memory than short-term memory, suggesting that it impairs the processes responsible for the retention of memory more than for the formation of memory itself.

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

Richard H. Epstein and Franklin Dexter

Statistical Power Analysis to Estimate How Many Months of Data Are Required to Identify Operating Room Staffing Solutions to Reduce Labor Costs and Increase Productivity
Anesth Analg 2002 94: 640-643. [Abstract] [Full Text]  

IMPLICATIONS: With 30 workdays of operating room or anesthesia group data, the optimization method can propose staffing solutions that significantly decrease costs and increase productivity compared with existing staffing solutions. We recommend that, when the statistical method is applied routinely for adjusting staffing (e.g., on a quarterly basis), 9 to 12 mo of data be used.

Wilton A. van Klei, Karel G.M. Moons, Charles L.G. Rutten, Anke Schuurhuis, Johannes T.A. Knape, Cornelis J. Kalkman, and Diederick E. Grobbee

The Effect of Outpatient Preoperative Evaluation of Hospital Inpatients on Cancellation of Surgery and Length of Hospital Stay
Anesth Analg 2002 94: 644-649. [Abstract] [Full Text]  

IMPLICATIONS: An observational study was conducted to compare various outcomes before and after the introduction of outpatient preoperative evaluation (OPE). Although smaller than anticipated, OPE for potential inpatients leads to a significant reduction of canceled cases and of length of admission.

NEUROSURGICAL ANESTHESIA:

Nicolas Bruder, Daniel Pellissier, Philippe Grillot, and François Gouin

Cerebral Hyperemia During Recovery from General Anesthesia in Neurosurgical Patients
Anesth Analg 2002 94: 650-654. [Abstract] [Full Text]  

IMPLICATIONS: Cerebral hyperemia occurs during emergence from general anesthesia. It might be one mechanism of cerebral complications in the early postoperative period.

Sihua Qi, Ren-Zhi Zhan, Chaoran Wu, Hideyoshi Fujihara, Kiichiro Taga, and Koki Shimoji

The Effects of Thiopental and Propofol on Cell Swelling Induced by Oxygen/Glucose Deprivation in the CA1 Pyramidal Cell Layer of Rat Hippocampal Slices
Anesth Analg 2002 94: 655-660. [Abstract] [Full Text]  

IMPLICATIONS: We demonstrated that thiopental, but not propofol, attenuates ischemic neuronal swelling induced by oxygen/glucose deprivation in an in vitro ischemic model.

Aleksa Cenic, Rosemary A. Craen, Ting-Yim Lee, and Adrian W. Gelb

Cerebral Blood Volume and Blood Flow Responses to Hyperventilation in Brain Tumors During Isoflurane or Propofol Anesthesia
Anesth Analg 2002 94: 661-666. [Abstract] [Full Text]  

IMPLICATIONS: In rabbits with brain tumors, brain blood flow and volume were significantly larger in all regions (tumor, peri-tumor, and contralateral normal tissue) with isoflurane than with propofol during normocapnia, and remained responsive to a reduction in PaCO2. Consequently, during hypocapnia, brain blood flow and volume values with isoflurane were similar to values with propofol.

Yoshitaka Inoue, Kazunori Koga, and Akio Shigematsu

A Comparison of Two Tracheal Intubation Techniques with Trachlight^TM and Fastrach^TM in Patients with Cervical Spine Disorders
Anesth Analg 2002 94: 667-671. [Abstract] [Full Text]  

IMPLICATIONS: The TrachlightTM may be more advantageous for orotracheal intubation in patients with cervical spine disorders than the FastrachTM with respect to reliability, rapidity and safety.

Johnathan J. Edwards and Voytek Bosek

Extravasation Injury of the Upper Extremity by Intravenous Phenytoin (Case Report)
Anesth Analg 2002 94: 672-673. [Abstract] [Full Text]  

IMPLICATIONS: Extravasation or IV injury attributable to phenytoin can cause severe soft tissue damage. Anesthesiologists are likely to encounter this problem and should recognize it and the potential complications. With increased awareness, the occurrence may be minimized.

OBSTETRIC ANESTHESIA:

Shaul Cohen, Carol B. Pantuck, David Amar, Elizabeth Burley, and Eugene J. Pantuck

The Primary Action of Epidural Fentanyl After Cesarean Delivery is Via a Spinal Mechanism
Anesth Analg 2002 94: 674-679. [Abstract] [Full Text]  

IMPLICATIONS: Fentanyl administered epidurally to parturients after cesarean delivery has a primarily spinal mechanism of action and this effect is enhanced by very small dose epidural bupivacaine and epinephrine.

Kim S. Khaw, Warwick D. Ngan Kee, Mabel Wong, Floria Ng, and Anna Lee

Spinal Ropivacaine for Cesarean Delivery: A Comparison of Hyperbaric and Plain Solutions
Anesth Analg 2002 94: 680-685. [Abstract] [Full Text]  

IMPLICATIONS: We compared hyperbaric and plain ropivacaine for combined spinal/epidural analgesia in the lateral position in patients undergoing elective cesarean delivery. Hyperbaric ropivacaine produced more rapid block with faster recovery and less requirement for epidural supplementation compared with plain ropivacaine.

Tony Gin, Matthew T.V. Chan, Ka Lai Chan, and Pong Mo Yuen

Prolonged Neuromuscular Block After Rocuronium In Postpartum Patients (Brief Report)
Anesth Analg 2002 94: 686-689. [Abstract] [Full Text]  

IMPLICATIONS: Neuromuscular block is prolonged in the postpartum period after standard doses of rocuronium. Drug administration according to lean body mass will produce a more consistent duration of block.

David L. Hepner, Miriam Harnett, Scott Segal, William Camann, Angela M. Bader, and Lawrence C. Tsen

Herbal Medicine Use in Parturients (Special Article)
Anesth Analg 2002 94: 690-693. [Abstract] [Full Text]  

IMPLICATIONS: Herbal medicine use may be less prevalent in the parturient population, however, some health care providers may be promoting their use during pregnancy.

PAIN MEDICINE:

Henning Harke, Peter Gretenkort, Hans Ulrich Ladleif, Peter Koester, and Salah Rahman

Spinal Cord Stimulation in Postherpetic Neuralgia and in Acute Herpes Zoster Pain
Anesth Analg 2002 94: 694-700. [Abstract] [Full Text]  

IMPLICATIONS: In many patients with postherpetic neuralgia and acute herpes zoster pain is not satisfactorily alleviated with pharmacological approaches. We report on 23 of 28 patients with postherpetic neuralgia and 4 of 4 with acute herpes zoster whose chronic pain was improved by electrical spinal cord stimulation.

Chung- Ren Lin, Cheng-Haung Wang, P.- C. Wu, Zhi-Hong Wen, Hartmut Buerkle, and Lin-Cheng Yang

Apraclonidine Attenuates the Increases in Spinal Excitatory Amino Acid Release in Rats with Adjuvant-Induced Inflammation
Anesth Analg 2002 94: 701-705. [Abstract] [Full Text]  

IMPLICATIONS: This study showed a novel finding that the hypersensitivity state seems to be dependent on increased release of spinal excitatory amino acids (EAAs), and the significant modulatory effect of the {alpha}2-adrenergic agonist apraclonidine on the release of spinal EAAs accounts for its analgesic properties in adjuvant-induced inflammation.

REGIONAL ANESTHESIA:

Lukas Kirchmair, Tanja Entner, Stephan Kapral, and Gottfried Mitterschiffthaler

Ultrasound Guidance for the Psoas Compartment Block: An Imaging Study
Anesth Analg 2002 94: 706-710. [Abstract] [Full Text]  

IMPLICATIONS: We developed an ultrasound-guided approach to the psoas compartment at the levels L2-3, L3-4, and L4-5. Feasibility and accuracy were tested on embalmed cadavers and verified by means of computed tomography. Ultrasound guidance proved to be feasible and accurate for the performance of psoas compartment blocks.

Robert J. McCarthy, James M. Kerns, Heather A. Nath, Morton Shulman, and Anthony D. Ivankovich

The Antinociceptive and Histologic Effect of Sciatic Nerve Blocks with 5% Butamben Suspension in Rats
Anesth Analg 2002 94: 711-716. [Abstract] [Full Text]  

IMPLICATIONS: Butamben 5% nerve blocks produced a prolonged antinociceptive effect to formalin-induced nociception and heat hyperalgesia, without significant motor effect or evidence of substantial histologic changes.

Shinji Takahashi, Makoto Tanaka, and Hidenori Toyooka

The Efficacy of Hemodynamic and T-Wave Criteria for Detecting Intravascular Injection of Epinephrine Test Dose in Propofol-Anesthetized Adults
Anesth Analg 2002 94: 717-722. [Abstract] [Full Text]  

IMPLICATIONS: Accidental migration of an epidural catheter into a blood vessel is often detected by hemodynamic changes after injecting an epidural test dose containing epinephrine. Our results suggest that 5 {micro}g of epinephrine is not adequate to reliably produce hemodynamic and T-wave alterations in adult patients during propofol anesthesia.

Mária Némethy, Leonardo Paroli, Pamela G. Williams-Russo, and Thomas J. J. Blanck

Assessing Sedation with Regional Anesthesia: Inter-Rater Agreement on a Modified Wilson Sedation Scale
Anesth Analg 2002 94: 723-728. [Abstract] [Full Text]  

IMPLICATIONS: We evaluated the interrater reliability of the Wilson scale for measuring sedation during regional anesthesia. Paired anesthesia care providers' ratings of patient sedation indicated very good interrater reliability in both the original scale and a modified version. The modified Wilson scale provides a quick noninvasive means of monitoring sedation during regional anesthesia.

Istvan Bátai, Monika Kerényi, Judit Falvai, and Gyorgy Szabó

Bacterial Growth in Ropivacaine Hydrochloride (Brief Report)
Anesth Analg 2002 94: 729-731. [Abstract] [Full Text]  

IMPLICATIONS: Drugs affecting bacterial growth may influence the occurrence of postoperative infections. Ropivacaine 10 mg/mL killed Staphylococcus aureus and Escherichia coli; ropivacaine 2 mg/mL supported the growth of E. coli.

GENERAL ARTICLES:

Jay B. Brodsky, Harry J. M. Lemmens, John G. Brock-Utne, Mark Vierra, and Lawrence J. Saidman

Morbid Obesity and Tracheal Intubation
Anesth Analg 2002 94: 732-736. [Abstract] [Full Text]  

IMPLICATIONS: In 100 morbidly obese patients, neither obesity nor body mass index predicted problems with tracheal intubation. However, a high Mallampati score (>=3) and large neck circumference may increase the potential for difficult laryngoscopy and intubation.

Christian Keller, Joseph Brimacombe, Axel Kleinsasser, and Lawrence Brimacombe

The Laryngeal Mask Airway ProSeal^TM as a Temporary Ventilatory Device in Grossly and Morbidly Obese Patients Before Laryngoscope-Guided Tracheal Intubation
Anesth Analg 2002 94: 737-740. [Abstract] [Full Text]  

IMPLICATIONS: The laryngeal mask airway ProSealTM is an effective temporary ventilatory device in grossly and morbidly obese patients before laryngoscope-guided tracheal intubation.

José O. C. Auler, Jr., Erika Miyoshi, Cláudia R. Fernandes, Fábio E. Benseñor, Luciana Elias, and Jorge Bonassa

The Effects of Abdominal Opening on Respiratory Mechanics During General Anesthesia in Normal and Morbidly Obese Patients: A Comparative Study
Anesth Analg 2002 94: 741-748. [Abstract] [Full Text]  

Jhi-Joung Wang, Jann-Inn Tzeng, Shung-Tai Ho, Jen-Yin Chen, Chin-Chen Chu, and Edmund C. So

The Prophylactic Effect of Tropisetron on Epidural Morphine-Related Nausea and Vomiting: A Comparison of Dexamethasone with Saline
Anesth Analg 2002 94: 749-753. [Abstract] [Full Text]  

IMPLICATIONS: We compared the prophylactic IV administration of tropisetron 5 mg to prevent postoperative nausea and vomiting (PONV) associated with epidural morphine with dexamethasone 5 mg and saline in women undergoing hysterectomy. We found that tropisetron 5 mg did not significantly reduce the occurrence of PONV associated with epidural morphine. Dexamethasone 5 mg was effective for this purpose.

Giampiero Patriarca, Eleonora Nucera, Alessandro Buonomo, Massimiliano Del Ninno, Chiara Roncallo, Emanuela Pollastrini, Tiziana De Pasquale, Alessandro Milani, and Domenico Schiavino

Latex Allergy Desensitization by Exposure Protocol: Five Case Reports
Anesth Analg 2002 94: 754-758. [Abstract] [Full Text]  

IMPLICATIONS: We present five patients with latex allergy who underwent desensitization by a new cutaneous exposure protocol. This study provides evidence that a safe therapeutic approach to latex allergy is possible.

Donald M. Miller and Margie Lavelle

A Streamlined Pharynx Airway Liner: A Pilot Study in 22 Patients in Controlled and Spontaneous Ventilation
Anesth Analg 2002 94: 759-761. [Abstract] [Full Text]  

LETTERS TO THE EDITOR:

John G. Brock-Utne, Alexander Ng, and Graham Smith

Gastroesophageal Reflux and Aspiration of Gastric Contents • Response
Anesth Analg 2002 94: 762-763. [Full Text]  

Charles W. Whitten, John Feiner, Ronald D. Miller, and Robert Hickey

Clinical Productivity Metrics • Response
Anesth Analg 2002 94: 763. [Full Text]  

Cornelius J. O’Connor, Jr. and Michael S. Stix

Place the Bubble Solution with Your Fingertip
Anesth Analg 2002 94: 763-764. [Full Text]  

W. Marchant

Epidural Catheter Placement Using Electrical Stimulation Test
Anesth Analg 2002 94: 764. [Full Text]  

A.F. David Cole, N. D. A. Scawn, and G. N. Russell

Intrapleural—Another Approach to Sensory Phrenic Nerve Block • Response
Anesth Analg 2002 94: 764-765. [Full Text]  

Rumiko Uda, Masahiko Onaka, Takashi Okuno, Hidemaro Mori, Xing-Guo Sun, and Chingmuh Lee

The Second Gas Effect is Not Statistically Valid • Response
Anesth Analg 2002 94: 765-766. [Full Text]  

Hiroshi Goto and Burt J. McKeag

Continuous Patient Oxygenation During Endotracheal Intubation Through the LMA-Fastrack^TM
Anesth Analg 2002 94: 766-767. [Full Text]  

Cedric Prys-Roberts and Gilles Godet

Withdrawal of Antihypertensive Drugs Before Anesthesia • Response
Anesth Analg 2002 94: 767-768. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

Conducting Research in Anesthesia and Intensive Care Medicine • Acute Pain Management: A Practical Guide, 2nd Edition • Pediatric Emergencies; Volume 19, Number 2 (June 2001) of Anesthesia Clinics of North America • Books and Multimedia Received
Anesth Analg 2002 94: 769-770. [Full Text]  

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