EDITORIALS:

Tracie A. Saunders and Peter S.A. Glass

A Trial of Labor For Remifentanil
Anesth Analg 2002 94: 771-773. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Stephan Mierdl, Christian Byhahn, Selami Dogan, Tayfun Aybek, Gerhard Wimmer-Greinecker, Paul Kessler, Dirk Meininger, and Klaus Westphal

Segmental Wall Motion Abnormalities During Telerobotic Totally Endoscopic Coronary Artery Bypass Grafting
Anesth Analg 2002 94: 774-780. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Segmental myocardial wall motion was evaluated with transesophageal echocardiography during robot-assisted totally endoscopic coronary artery bypass grafting. Significant biventricular segmental wall motion abnormalities occurred before cardiopulmonary bypass under single-lung ventilation and carbon dioxide insufflation. The changes in myocardial wall motion were of limited clinical relevance.

Hironori Ishihara, Hirobumi Okawa, Tsutomu Iwakawa, Noriko Umegaki, Toshihito Tsubo, and Akitomo Matsuki

Does Indocyanine Green Accurately Measure Plasma Volume Early After Cardiac Surgery?
Anesth Analg 2002 94: 781-786. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Overestimation of indocyanine green-derived plasma volume can occur in the presence of generalized capillary protein leakage. This overestimation was examined early after cardiac surgery by using the simultaneous measurement of the initial distribution volume of glucose. We suggest that overestimation of the traditional dye dilution method is negligible, but apparent over- or underestimation of pulse dye densitometry-derived plasma volume cannot be negligible.

Michael Broomé, M. Haney, B. Österlund, S. Häggmark, G. Johansson, and B. Biber

The Cardiac Effects of Intracoronary Angiotensin II Infusion
Anesth Analg 2002 94: 787-793. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The positive inotropic and chronotropic effects of angiotension II (Ang II) seen in previous studies seem to be mediated via extracardiac actions of Ang II. Coronary vascular tone is not affected by local Ang II infusion in anesthetized pigs.

J. Margreiter, C. Keller, and J. Brimacombe

The Feasibility of Transesophageal Echocardiograph-Guided Right and Left Ventricular Oximetry in Hemodynamically Stable Patients Undergoing Coronary Artery Bypass Grafting
Anesth Analg 2002 94: 794-798. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Transesophageal echocardiograph-guided left and right ventricular oximetry is feasible in hemodynamically stable anesthetized patients and provides similar readings to arterial and mixed venous blood samples.

Juraj Sprung, James D. Kindscher, Joyce A. Wahr, Jerrold H. Levy, Terri G. Monk, Mark W. Moritz, and Patrick J. O’Hara

The Use of Bovine Hemoglobin Glutamer-250 (Hemopure^®) in Surgical Patients: Results of a Multicenter, Randomized, Single-Blinded Trial
Anesth Analg 2002 94: 799-808. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The intraoperative use of hemoglobin glutamer-250 (bovine) (HBOC-201, Hemopure(R)) was generally well tolerated. The administration of HBOC-201 was associated with a delayed increase in the plasma methemoglobin concentrations.

Robert J. Frumento, Linda Mongero, Yoshifumi Naka, and Elliott Bennett-Guerrero

Preserved Gastric Tonometric Variables in Cardiac Surgical Patients Administered Intravenous Perflubron Emulsion
Anesth Analg 2002 94: 809-814. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study suggests that the administration of perflubron emulsion prevents gastrointestinal tract ischemia in cardiac surgical patients and may preserve postoperative gastrointestinal tract function.

Claude Couvret, Stéphanie Tricoche, Annick Baud, Brigitte Dabo, Sylvie Buchet, Michel Palud, and Jacques Fusciardi

The Reduction of Preoperative Autologous Blood Donation for Primary Total Hip or Knee Arthroplasty: The Effect on Subsequent Transfusion Rates
Anesth Analg 2002 94: 815-823. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared two transfusion policies for primary total hip or knee arthroplasties: first, a standard preoperative autologous donation with a liberal autologous transfusion policy; and second, a more restrictive indication for autologous donation that was based on patients' individual factors, with identical criteria for autologous and allogeneic transfusion. We found that this change of policy reduced autologous donation and transfusion with no increase in allogeneic transfusion.

Heike Koelzow, Jacqueline A. Gedney, Janos Baumann, Nicola J. Snook, and Mark C. Bellamy

The Effect of Methylene Blue on the Hemodynamic Changes During Ischemia Reperfusion Injury in Orthotopic Liver Transplantation
Anesth Analg 2002 94: 824-829. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Methylene blue attenuates the hemodynamic changes of the ischemia reperfusion syndrome in liver transplantation, and this effect involves guanylate cyclase inhibition.

Marc Moutafis, Nicolas Dalibon, Ngai Liu, Guy Kuhlman, and Marc Fischler

The Effects of Intravenous Almitrine on Oxygenation and Hemodynamics During One-Lung Ventilation
Anesth Analg 2002 94: 830-834. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Eight {micro}g {middle dot} kg-1 {middle dot} min-1 IV almitrine limits one-lung ventilation-induced decrease in PaO2 without causing any hemodynamic modification in patients without pulmonary hypertension.

Karoline Meersschaert, Luc Brun, Maximilien Gourdin, Stéphane Mouren, Michèle Bertrand, Bruno Riou, and Pierre Coriat

Terlipressin-Ephedrine Versus Ephedrine to Treat Hypotension at the Induction of Anesthesia in Patients Chronically Treated with Angiotensin Converting-Enzyme Inhibitors: A Prospective, Randomized, Double-Blinded, Crossover Study
Anesth Analg 2002 94: 835-840. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Vascular surgical patients chronically treated with drugs that inhibit the functioning of the renin-angiotensin system may experience hypotension unresponsive to conventional therapy. This double-blinded, cross-over study demonstrated that in these patients the use of a vasopressin analog, terlipressin given with ephedrine, was effective in reversing intraoperative systemic hypotension refractory to ephedrine.

Paul S. Pagel, John G. Krolikowski, Franz Kehl, Boris Mraovic, Judy R. Kersten, and David C. Warltier

The Role of Mitochondrial and Sarcolemmal K_ATP Channels in Canine Ethanol-Induced Preconditioning In Vivo
Anesth Analg 2002 94: 841-848. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Mitochondrial and sarcolemmal KATP channels mediate ethanol-induced preconditioning independent of alterations in systemic hemodynamics or coronary collateral perfusion in vivo.

Guochang Hu, Jakob Vinten-Johansen, M. Ramez Salem, Zhi-Qing Zhao, and George J. Crystal

Isoflurane Inhibits Neutrophil-Endothelium Interactions in the Coronary Circulation: Lack of a Role for Adenosine Triphosphate-Sensitive Potassium Channels
Anesth Analg 2002 94: 849-856. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Isoflurane inhibited neutrophil-endothelium interactions and the inflammatory response in vitrovia a pathway independent of the adenosine triphosphate-sensitive potassium channels. This action could be involved in the cardioprotection by isoflurane observed in vivo.

Kent H. Rehfeldt and Roger L. Click

Prosthetic Valve Malfunction Masked by Intraoperative Pressure Measurements (Case Report)
Anesth Analg 2002 94: 857-858. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe a case in which intraoperative echocardiography recorded an abnormally high pressure gradient across a newly implanted mechanical heart valve. However, inserting pressure-transducing needles on each side of this prosthesis did not confirm the echocardiographic findings. The prosthesis was later confirmed to be malfunctioning and was replaced.

PEDIATRIC ANESTHESIA:

Santhanam Suresh, Sandra L. Barcelona, Nancy M. Young, Ilana Seligman, Corri L. Heffner, and Charles J. Coté

Postoperative Pain Relief in Children Undergoing Tympanomastoid Surgery: Is a Regional Block Better than Opioids?
Anesth Analg 2002 94: 859-862. [Abstract] [Full Text] [PDF] [VIDEO FILE]  [Request Permissions]  

IMPLICATIONS: We prospectively compared the use of a great auricular nerve block versus IV morphine sulfate in a randomized double-blinded study in children undergoing tympanomastoid surgery. Analgesia was comparable between groups but nearly half the Block group never required additional analgesics and the number of vomiting events was nearly 66% less.

Yuichi Yaguchi, Shinichi Inomata, Shin-ichi Kihara, Yasuyuki Baba, Yukinao Kohda, and Hidenori Toyooka

The Reduction in Minimum Alveolar Concentration for Tracheal Extubation After Clonidine Premedication in Children
Anesth Analg 2002 94: 863-866. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oral clonidine premedication decreased MAC for tracheal extubation for sevoflurane dose dependency and did not prolong emergence from anesthesia.

John B. Rose, Jeffrey L. Galinkin, Ellen C. Jantzen, and Rosetta M. Chiavacci

A Study of Lidocaine Iontophoresis for Pediatric Venipuncture
Anesth Analg 2002 94: 867-871. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this randomized, double-blinded, placebo-controlled study, we found that dermal anesthesia with lidocaine HCl 2% combined with epinephrine 1:100,000 administered via iontophoresis in children is achieved in 8.8 {+/-} 2.1 min, reduces discomfort associated with venipuncture, is safe, and increases satisfaction when compared with the placebo.

AMBULATORY ANESTHESIA:

Michael Boehler, Gottfried Mitterschiffthaler, and Andreas Schlager

Korean Hand Acupressure Reduces Postoperative Nausea and Vomiting After Gynecological Laparoscopic Surgery
Anesth Analg 2002 94: 872-875. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This randomized study was performed to investigate the antiemetic effect of the Korean hand acupuncture point K-K9. Acupressure of K-K9 reduces the incidence of postoperative nausea and vomiting in female patients after minor gynecological laparoscopic surgery.

Bernard F. Vanacker, Ester Geerts, Steve Coppens, and Mathijs van Iersel

A Comparison of Neuromuscular Effects, Tracheal Intubating Conditions, and Reversibility of Rapacuronium Versus Mivacurium in Female Patients (Brief Report)
Anesth Analg 2002 94: 876-878. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Rapacuronium is a new, rapid-onset, short-duration, nondepolarizing neuromuscular blocking drug. We evaluated the intubating conditions at maximum block after the administration of rapacuronium or mivacurium in female patients undergoing laparoscopy. We also evaluated the neostigmine-induced reversibility of neuromuscular block after this single dose of rapacuronium or mivacurium.

ANESTHETIC PHARMACOLOGY:

Laszlo Gyermek, Chingmuh Lee, Young-Moon Cho, N. Nguyen, and S. K. Tsai

Neuromuscular Pharmacology of TAAC3, a New Nondepolarizing Muscle Relaxant with Rapid Onset and Ultrashort Duration of Action
Anesth Analg 2002 94: 879-885. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We developed a new nondepolarizing muscle relaxant, TAAC3, and investigated it in several animal models. TAAC3 has shown a very rapid onset and an ultrashort duration of neuromuscular blocking action. A minor degree of cardiac vagal block was observed. TAAC3 is promising for further studies.

Hideyuki Higuchi, Yushi Adachi, Albert Dahan, Erik Olofsen, Shinya Arimura, Tomohisa Mori, and Tetsuo Satoh

The Interaction Between Propofol and Clonidine for Loss of Consciousness
Anesth Analg 2002 94: 886-891. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oral clonidine 2.5 and 5.0 {micro}g/kg premedication decreases the propofol concentration required for loss of consciousness.

Mitsuaki Yamazaki, Tamotsu Nagakawa, Noboru Hatakeyama, Nobuko Shibuya, and Thomas A. Stekiel

The Effects of Propofol on Neural and Endothelial Control of In Situ Rat Mesenteric Vascular Smooth Muscle Transmembrane Potentials
Anesth Analg 2002 94: 892-897. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Vascular smooth muscle (VSM) contractile force responses to the IV anesthetic, propofol, were indirectly assessed by VSM membrane potential changes to clarify the mechanisms underlying attenuation of peripheral vascular control of arterial blood pressure. Results indicate that propofol-induced VSM membrane hyperpolarization and coupled reduction of VSM contractile force underlie such attenuation.

Roger Schmid, Gideon Koren, Julia Klein, and Joel Katz

The Stability of a Ketamine-Morphine Solution
Anesth Analg 2002 94: 898-900. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Small-dose ketamine is used with increasing frequency in the acute postoperative setting as an adjunct to traditional opioid analgesics. We show that a racemic ketamine and morphine solution at a clinically relevant concentration seems to be stable at room temperature at a wide range of pH values for at least 4 days.

Kenichiro Sagata, Kouichiro Minami, Nobuyuki Yanagihara, Munehiro Shiraishi, Yumiko Toyohira, Susumu Ueno, and Akio Shigematsu

Tramadol Inhibits Norepinephrine Transporter Function at Desipramine-Binding Sites in Cultured Bovine Adrenal Medullary Cells
Anesth Analg 2002 94: 901-906. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Tramadol competitively inhibits norepinephrine transporter function at desipramine-binding sites in the adrenal medullary cells and probably the noradrenergic neurons of the descending inhibitory system.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Kai-Michael Scheufler and Josef Zentner

Motor-Evoked Potential Facilitation During Progressive Cortical Suppression by Propofol
Anesth Analg 2002 94: 907-912. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the effect of different transcranial magnetoelectric stimulation paradigms on motor-evoked potentials during different levels of cortical suppression by propofol. The most effective stimulation frequency seems to change from 100 to 200 Hz during progressive propofol dose escalation, possibly because of specific interaction with cortical interneurons.

OBSTETRIC ANESTHESIA:

Petri Volmanen, Ethem I. Akural, Tytti Raudaskoski, and Seppo Alahuhta

Remifentanil in Obstetric Analgesia: A Dose-Finding Study
Anesth Analg 2002 94: 913-917. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We determined the minimum effective dose of patient-controlled IV remifentanil for labor analgesia. There was wide individual variation in the dose required for effective labor analgesia. Potentially serious side effects, which were observed frequently during remifentanil analgesia, may limit its use in obstetrics.

Medge D. Owen, Michael J. Poss, Laura S. Dean, and Margaret A. Harper

Prolonged Intravenous Remifentanil Infusion for Labor Analgesia (Case Report)
Anesth Analg 2002 94: 918-919. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A 34-h remifentanil infusion was administered for labor analgesia in a patient with thrombocytopenia and renal insufficiency. Compared with other opioids, remifentanil may produce fewer cumulative effects during prolonged infusion because of its unique metabolism.

Anna Lee, Warwick D. Ngan Kee, and Tony Gin

A Quantitative, Systematic Review of Randomized Controlled Trials of Ephedrine Versus Phenylephrine for the Management of Hypotension During Spinal Anesthesia for Cesarean Delivery (Case Report)
Anesth Analg 2002 94: 920-926. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:Phenylephrine and ephedrine to manage hypotension during spinal anesthesia for elective cesarean delivery were compared in this systematic review. Women given ephedrine had neonates with lower umbilical cord blood pH values compared with those given phenylephrine. However, no differences in the incidence of fetal acidosis (pH value of <7.2) or neonatal Apgar scores were found.

Yaakov Beilin, Ashalatha Nair, Ittamar Arnold, Howard H. Bernstein, Jeffrey Zahn, Sabera Hossain, and Carol A. Bodian

A Comparison of Epidural Infusions in the Combined Spinal/Epidural Technique for Labor Analgesia (Case Report)
Anesth Analg 2002 94: 927-932. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this prospective, randomized, and double-blinded study we found that initiating an epidural infusion of bupivacaine 0.125% with fentanyl 2 {micro}g/mL at 10 mL/h 15 min after subarachnoid fentanyl 25 {micro}g with 1 mL of bupivacaine 0.25%, followed by an epidural test dose of 3 mL of bupivacaine 0.25%, maintained the analgesia for longer but with more motor block than with either bupivacaine 0.04% or bupivacaine 0.0625%.

ECONOMICS AND HEALTH SYSTEMS RESEARCH:

Franklin Dexter and Rodney D. Traub

How to Schedule Elective Surgical Cases into Specific Operating Rooms to Maximize the Efficiency of Use of Operating Room Time
Anesth Analg 2002 94: 933-942. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We showed how elective cases should be scheduled to maximize the efficiency of use of operating room time. The analysis applies to surgical suites at which surgeons and patients have access to operating room time every workday.

CRITICAL CARE AND TRAUMA:

Alka B. Patel, June Sokolowski, Bruce A. Davidson, Paul R. Knight, and Bruce A. Holm

Halothane Potentiation of Hydrogen Peroxide-Induced Inhibition of Surfactant Synthesis: The Role of Type II Cell Energy Status
Anesth Analg 2002 94: 943-947. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A mediator of inflammation (hydrogen peroxide) and an inhaled anesthetic (halothane) interact to decrease cell energy and secretion of a substance (surfactant) required for healthy lung function from cells that line gas-exchange compartments. This interaction represents a possible mechanism by which inflammatory lung disease may become more severe intraoperatively.

NEUROSURGICAL ANESTHESIA:

Sean R.R. Hall, Louie Wang, Brian Milne, Sally Ford, and Murray Hong

Intrathecal Lidocaine Prevents Cardiovascular Collapse and Neurogenic Pulmonary Edema in a Rat Model of Acute Intracranial Hypertension
Anesth Analg 2002 94: 948-953. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:In a rat model of intracranial balloon inflation, intrathecal lidocaine prevented cardiovascular collapse and neurogenic pulmonary edema. Descending neural pathways are involved in the development of cardiopulmonary complications associated with acute intracranial hypertension.

Kiyoshi Nagase, Hiroki Iida, and Shuji Dohi

L-Arginine and Nitroglycerin Restore Hypercapnia-Induced Cerebral Vasodilation in Rabbits After its Attenuation by Ketamine
Anesth Analg 2002 94: 954-958. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The attenuation of cerebral vasodilation to hypercapnia seen under ketamine anesthesia is reversed by L-arginine or nitroglycerin infusion.

Katsuyuki Terajima, Yoshiyuki Oi, Akira Ogura, Naoyuki Sakai, Mao Takei, Tomonori Tamaki, and Ryo Ogawa

Blood Patch Therapy for Spontaneous Intracranial Hypotension: Safe Performance After Epidurography in an Unconscious Patient (Case Report)
Anesth Analg 2002 94: 959-961. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Epidurography was useful for identifying the epidural space and determining the likely spread of an epidural blood patch in an unconscious patient with spontaneous intracranial hypotension.

PAIN MEDICINE:

Tatsuo Yamamoto and Natsuko Nozaki-Taguchi

The Role of Cyclooxygenase-1 and -2 in the Rat Formalin Test
Anesth Analg 2002 94: 962-967. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our data suggest that a COX-2 selective inhibitor, but not a COX-1 selective inhibitor, may produce a good analgesic effect on the inflammatory pain state in a clinical situation.

Natsuko Nozaki-Taguchi and Tony L. Yaksh

Spinal and Peripheral µ Opioids and the Development of Secondary Tactile Allodynia After Thermal Injury
Anesth Analg 2002 94: 968-974. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Sensitivity to touch observed in areas adjacent to injury is blocked by opioids applied before, but not after, injury. This suggests that injury-activated opioid-sensitive fibers are responsible for sensitization and reveals a cascade that is diminished by pretreatment but not posttreatment, providing a rationale for adequate analgesia before injury (surgery) has occurred.

Caroline E. Heughan and Jana Sawynok

The Interaction Between Gabapentin and Amitriptyline in the Rat Formalin Test After Systemic Administration
Anesth Analg 2002 94: 975-980. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: By use of the rat formalin test, a model of persistent pain, we examined the effect of a combination of amitriptyline and gabapentin, which are used to treat chronic pain in humans. The drug combination produced additive analgesia against one outcome, but another outcome was more ambiguous.

Wolfgang Jaksch, Stefan Lang, Robert Reichhalter, Gerald Raab, Klaus Dann, and Sylvia Fitzal

Perioperative Small-Dose S(+)-Ketamine Has No Incremental Beneficial Effects on Postoperative Pain When Standard-Practice Opioid Infusions Are Used
Anesth Analg 2002 94: 981-986. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Small-dose S(+)-ketamine had no positive effect on postoperative analgesia when administered perioperatively for elective arthroscopic anterior cruciate ligament repair. Unlike investigations of the racemic mixture of ketamine, our study methods included timely standard-practice perioperative opioid analgesia, which seems to make supplemental analgesia unnecessary.

REGIONAL ANESTHESIA:

Andrea Casati, Battista Borghi, Guido Fanelli, Elisa Cerchierini, Roberta Santorsola, Valeria Sassoli, Crispino Grispigni, and Giorgio Torri

A Double-Blinded, Randomized Comparison of Either 0.5% Levobupivacaine or 0.5% Ropivacaine for Sciatic Nerve Block
Anesth Analg 2002 94: 987-990. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: No studies have compared the clinical properties of levobupivacaine with those of ropivacaine when providing sciatic nerve block for hallux valgus repair. Results from this prospective, randomized, double-blinded study demonstrate that 20 mL of either 0.5% levobupivacaine or 0.5% ropivacaine provide comparable surgical block with prolonged postoperative analgesia.

Miguel Angel Reina, Oscar De Leon Casasola, Andrés López, José Antonio De Andrés, Miguel Mora, and Agustín Fernández

The Origin of the Spinal Subdural Space: Ultrastructure Findings
Anesth Analg 2002 94: 991-995. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The subdural space was not seen under transmission electron microscopy in samples of human spinal meninges where surgical manipulation was avoided. Scanning electron microscopy in other samples showed the presence of broken neurothelial cells giving up fissures that extended along the dura-arachnoid interface. These findings may explain the origin of a real subdural space.

Pia di Benedetto, Andrea Casati, Laura Bertini, Guido Fanelli, and Jaques E. Chelly

Postoperative Analgesia with Continuous Sciatic Nerve Block After Foot Surgery: A Prospective, Randomized Comparison Between the Popliteal and Subgluteal Approaches
Anesth Analg 2002 94: 996-1000. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Comparing two different approaches for continuous sciatic nerve block after orthopedic foot surgery, this prospective, randomized study demonstrated that the subgluteal approach is as effective and safe as the previously described posterior popliteal approach, and can be considered a useful alternative to anesthesia and acute postoperative analgesia after foot procedures.

Xavier Capdevila, Philippe Biboulet, Didier Morau, Nathalie Bernard, Jacques Deschodt, Sandrine Lopez, and Françoise d’Athis

Continuous Three-in-One Block for Postoperative Pain After Lower Limb Orthopedic Surgery: Where Do the Catheters Go?
Anesth Analg 2002 94: 1001-1006. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The course of a continuous three-in-one block catheter is unpredictable. Only 23% of the catheters lie near the lumbar plexus. The success of sensory and motor blocks, as well as postoperative analgesia, depend on the position of the catheter under the fascia iliaca.

Baljit Singh and Puneet Sharma

Subdural Block Complicating Spinal Anesthesia? (Case Report)
Anesth Analg 2002 94: 1007-1009. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:Features suggestive of subdural block appeared after an apparently normal subarachnoid block. The long bevel of the reusable Quincke-type spinal needle may have contributed to the development of this complication. We propose that spinal needles should have a smaller bevel to minimize the possibility of such a complication.

Gregory A. Liguori, George F. Chimento, Leslie Borow, and Mark Figgie

Possible Bupivacaine Toxicity After Intraarticular Injection for Postarthroscopic Analgesia of the Knee: Implications of the Surgical Procedure (Case Report)
Anesth Analg 2002 94: 1010-1013. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case of possible bupivacaine toxicity after intraarticular injection during knee arthroscopy. The importance of the specific type of surgical procedure performed during arthroscopy and its relationship to potential local anesthetic toxicity are highlighted.

GENERAL ARTICLES:

Pierre A. Diemunsch, Thomas Van Dorsselaer, Klaus D. Torp, Roland Schaeffer, and Bernard Geny

Calibrated Pneumoperitoneal Venting to Prevent N₂O Accumulation in the CO₂ Pneumoperitoneum During Laparoscopy with Inhaled Anesthesia: An Experimental Study in Pigs
Anesth Analg 2002 94: 1014-1018. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: External venting calibrated at four or eight initial pneumoperitoneal volumes per hour with compensation by fresh CO2 is sufficient to prevent nitrous oxide buildup of more than 10% in the pneumoperitoneum during laparoscopy with inhaled general anesthesia if venting is constant.

Robert Greif, Sonja Laciny, Angela Rajek, Anthony G. Doufas, and Daniel I. Sessler

The Threshold and Gain of Thermoregulatory Vasoconstriction Differs During Anesthesia in the Dependent and Upper Arms in the Lateral Position
Anesth Analg 2002 94: 1019-1022. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The threshold for cold-induced vasoconstriction is reduced in the dependent arm, but the gain of vasoconstriction is increased. Consequently, the core temperature triggering intense vasoconstriction was similar in each arm, suggesting that the thermoregulatory system compensates for the hydrostatic effects of the lateral position.

S. Kihara, Y. Yaguchi, J. Brimacombe, S. Watanabe, N. Taguchi, and N. Hosoya

Intubating Laryngeal Mask Airway Size Selection: A Randomized Triple Crossover Study in Paralyzed, Anesthetized Male and Female Adult Patients
Anesth Analg 2002 94: 1023-1027. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: For men, the Size 4 and 5 intubating laryngeal mask airways are better than the Size 3 for ventilation and blind tracheal intubation. For women, the Size 4 and 5 are better than the Size 3 for ventilation, but there is no difference among sizes for blind intubation. The length the tracheal tube must protrude from the distal aperture of the intubating laryngeal mask airway to ensure that the cuff is completely through the vocal cords is 8-13 cm, depending on the size of the mask and tracheal tube and on the sex and height of the patient.

Christoph H. Kindler, Thierry Girard, Diane Gong, and Albert Urwyler

The Differential Effect of Halothane and 1,2-Dichlorohexafluorocyclobutane on In VitroMuscle Contractures of Patients Susceptible to Malignant Hyperthermia
Anesth Analg 2002 94: 1028-1033. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using in vitro contracture tests, we showed that halothane and the nonimmobilizer 1,2-dichlorohexafluorocyclobutane differ in their effects on contractures of muscle bundles from individuals susceptible to malignant hyperthermia (MH) as a result of their differing action on MH ryanodine receptors. These findings render this receptor a possible molecular target for volatile anesthetic action.

Claude Lentschener, Abdelmalek Ghimouz, Philippe Bonnichon, Christine Parc, and Yves Ozier

Acute Postoperative Glaucoma After Nonocular Surgery Remains a Diagnostic Challenge (Case Report)
Anesth Analg 2002 94: 1034-1035. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthesia may acutely reveal angle-closure glaucoma. This complication is an ophthalmologic emergency. However, symptoms of acute glaucoma may be overlooked or misinterpreted in a sedated or comatose patient, and this may result in delayed treatment. Immediate diagnosis and appropriate treatment should be done to prevent visual loss.

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

Esophageal Insufflation with Normal Fiberoptic Positioning of the ProSeal^TM Laryngeal Mask Airway (Case Report)
Anesth Analg 2002 94: 1036-1039. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Esophageal insufflation can occur simultaneously with venting from the drain tube during positive pressure ventilation with the ProSealTM laryngeal mask airway.

LETTERS TO THE EDITOR:

Michael Beriault, Roger Maltby, and Hwan Joo

When is an Airway Not an Airway? • Response
Anesth Analg 2002 94: 1040. [Full Text] [PDF] [Request Permissions]  

Gökcen Basaranoglu, Veysel Erden, and Hamdi Delatioglu

Reduction of Pain on Injection of Propofol: A Comparison of Fentanyl with Remifentanil
Anesth Analg 2002 94: 1040-1041. [Full Text] [PDF] [Request Permissions]  

Tetsu Uejima, Santhanam Suresh, and Giovanni Cucchiaro

Is 0.375% Bupivacaine Safe in Caudal Anesthesia in Neonates and Young Infants? • Response
Anesth Analg 2002 94: 1041. [Full Text] [PDF] [Request Permissions]  

I. Garutti, L. Olmedilla, and C. D. Spies

Searching the Preferred Anesthetic Technique During One-Lung-Ventilation • Response
Anesth Analg 2002 94: 1041-1042. [Full Text] [PDF] [Request Permissions]  

Paul F. White

Propofol Formulation and Pain on Injection
Anesth Analg 2002 94: 1042. [Full Text] [PDF] [Request Permissions]  

Carl J. Borromeo, David Canes, Michael S. Stix, and Michael E. Glick

Hiccupping and Regurgitation via the Drain Tube of the ProSeal Laryngeal Mask
Anesth Analg 2002 94: 1042-1043. [Full Text] [PDF] [Request Permissions]  

Jonathan V. Roth

Warming Blankets Should Not Be Placed Over Transdermal Medications
Anesth Analg 2002 94: 1043. [Full Text] [PDF] [Request Permissions]  

Jan Poelaert, André Denault, Francis Bernard, and Pierre Couture

Diagnosis of Diastolic Dysfunction: Importance of Spectral Doppler Imaging • Response
Anesth Analg 2002 94: 1043-1045. [Full Text] [PDF] [Request Permissions]  

David L. Hepner and Tomoki Nishiyama

Propofol-Induced Bronchoconstriction: Asthma or Allergy? • Response
Anesth Analg 2002 94: 1045. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Tumescent Technique: Tumescent Anesthesia & Microcannular Liposuction • Medical Ethics; Volume 39 Number 3 (Summer 2001) of International Anesthesiology Clinics • Clinical Anesthesia Practice, 2nd Edition • Books and Multimedia Received
Anesth Analg 2002 94: 1046-1047. [Full Text] [PDF] [Request Permissions]  

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