EDITORIALS:

Gilbert Park

Rescue Is Stressful
Anesth Analg 2002 95: 263-265. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Yuji Kadoi, Shigeru Saito, Daisuke Yoshikawa, Fumio Goto, Nao Fujita, and Fumio Kunimoto

Increasing Mean Arterial Blood Pressure Has No Effect on Jugular Venous Oxygen Saturation in Insulin-Dependent Patients During Tepid Cardiopulmonary Bypass
Anesth Analg 2002 95: 266-272. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined the effects of increasing mean arterial blood pressure (MAP) by the administration of phenylephrine on internal jugular venous oxygen saturation (SjvO2) during tepid cardiopulmonary bypass in diabetic patients and found that increasing MAP had no effect on the SjvO2 value in insulin-dependent patients.

David L. Reich, Elliott Bennett-Guerrero, Carol A. Bodian, Sabera Hossain, Wanda Winfree, and Marina Krol

Intraoperative Tachycardia and Hypertension Are Independently Associated with Adverse Outcome in Noncardiac Surgery of Long Duration
Anesth Analg 2002 95: 273-277. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intraoperative tachycardia and hypertension were associated with negative postoperative outcomes after major noncardiac surgery of long duration. These results imply that intraoperative tachycardia and hypertension may have independent effects on outcome over and above the risk imparted by underlying medical conditions.

Nobuhiro Okano, Sotaro Miyoshi, Ryoichi Owada, Nao Fujita, Yuji Kadoi, Shigeru Saito, Fumio Goto, and Toshihiro Morita

Impairment of Hepatosplanchnic Oxygenation and Increase of Serum Hyaluronate During Normothermic and Mild Hypothermic Cardiopulmonary Bypass
Anesth Analg 2002 95: 278-286. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Hepatic sinusoidal endothelial cells (SECs) are pivotal in the regulation of sinusoidal blood flow. This study showed that SEC function might be impaired during and after cardiopulmonary bypass, irrespective of the temperature management.

Charles Marc Samama, Olivier Langeron, Nadia Rosencher, Xavier Capdevila, Patricia Rouche, Michel Pegoix, Josée Bernière, and Pierre Coriat

Aprotinin Versus Placebo in Major Orthopedic Surgery: A Randomized, Double-Blinded, Dose-Ranging Study
Anesth Analg 2002 95: 287-293. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Large doses of aprotinin decrease blood loss and transfusion amount in major orthopedic surgery.

Arzu Takil, Zeynep Eti, Pinar Irmak, and F. Yilmaz Gögüs

Early Postoperative Respiratory Acidosis After Large Intravascular Volume Infusion of Lactated Ringer’s Solution During Major Spine Surgery
Anesth Analg 2002 95: 294-298. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The infusion of large-volume lactated Ringer's solution does not cause hyperchloremic metabolic acidosis as does 0.9% saline during major surgery, but leads to postoperative mild hyponatremia and respiratory acidosis.

Go-Shine Huang, Hung-Jui Wang, Chi-Hou Chen, Shung-Tai Ho, and Chih-Shung Wong

Pulmonary Artery Rupture After Attempted Removal of a Pulmonary Artery Catheter (Case Report)
Anesth Analg 2002 95: 299-301. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Withdrawal of a pulmonary catheter before initiation of cardiopulmonary bypass may prevent suturing the catheter to the pulmonary trunk and avoid the fatal complication of pulmonary artery rupture.

Gerard R. Manecke, Jr, Jason C. Brown, Allan A. Landau, David P. Kapelanski, Carla M. St. Laurent, and William R. Auger

An Unusual Case of Pulmonary Artery Catheter Malfunction (Case Report)
Anesth Analg 2002 95: 302-304. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Sudden loss of thermodilution or temperature-monitoring capabilities of an indwelling pulmonary artery catheter may indicate significant damage to the catheter, possibly leading to electrical hazard and infection risk. Blood appearing at the electrical connection port confirms the diagnosis. The catheter, if easily removed, should be replaced as soon as possible.

Ruben J. Azocar, Punam Narang, Daniel Talmor, Alan Lisbon, and A. Murat Kaynar

Persistent Left Superior Vena Cava Identified After Cannulation of the Right Subclavian Vein (Case Report)
Anesth Analg 2002 95: 305-307. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report the case of a patient with a chest radiograph suggestive of intraarterial placement of a central venous catheter. On investigation, the catheter was located in a previously undiagnosed persistent left superior vena cava.

Muhammad A. Munir and Shelby Q. Chien

An In Situ Technique to Retrieve an Entrapped J-Tip Guidewire from an Inferior Vena Cava Filter (Case Report)
Anesth Analg 2002 95: 308-309. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Entrapment of a guidewire in the vena cava filter during central venous catheter placement is a newly recognized complication. Complex techniques have been described to free the guidewire. We describe a simple in situ technique that may free the guidewire without the application of complex techniques.

Ali Al-Khafaji, Howard L. Corwin, Gur C. Adhar, and Mark L. Greenberg

Bidirectional Tachycardia: Two Cases and a Review (Case Report)
Anesth Analg 2002 95: 310-315. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bidirectional tachycardia is an uncommon and unique arrhythmia. It typically occurs in patients with digitalis toxicity, but it can also be associated with other causes. There has been controversy regarding the origin and the mechanism of bidirectional tachycardia. Treatment of bidirectional tachycardia involves the correction of reversible factors and the use of some antiarrhythmic medication.

Sibylle Ruesch and Jerrold H. Levy

Treatment of Persistent Tachycardia with Dexmedetomidine During Off-Pump Cardiac Surgery (Case Report)
Anesth Analg 2002 95: 316-318. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: After unsuccessful treatment of intraoperative tachycardia with esmolol during off-pump revascularization, heart rate was successfully reduced with a bolus and infusion of dexmedetomidine.

Emmanuel Marret, Olivier Pruszkowski, Arnaud Deleuze, and Francis Bonnet

Accelerated Idioventricular Rhythm Associated with Desflurane Administration (Case Report)
Anesth Analg 2002 95: 319-321. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The rapid administration of desflurane results in transient hypertension and tachycardia, especially in the presence of sympathetic imbalance. We report a case in which rapid administration of desflurane precipitated an accelerated idioventricular rhythm in a patient. This may have been related to a period of inadequate anesthesia.

Thomas M. Hemmerling and Joanne D. Fortier

Falsely Increased Bispectral Index Values in a Series of Patients Undergoing Cardiac Surgery Using Forced-Air-Warming Therapy of the Head (Case Report)
Anesth Analg 2002 95: 322-323. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Falsely increased bispectral index (BIS) values of >70 occur during forced-warm-air therapy in patients undergoing cardiac surgery. When forced-warm-air therapy for the head is used (as in ultra-fast-tracking cardiac patients), BIS interpretation needs careful examination. Falsely increased BIS values can easily be recognized when the warm-air flow is stopped. Within 2-3 min, BIS returns to a much lower, "true" value.

G. Knichwitz, M. Zahl, H. Van Aken, A. Semjonow, and M. Booke

Intraoperative Washing of Long-Stored Packed Red Blood Cells by Using an Autotransfusion Device Prevents Hyperkalemia (Case Report)
Anesth Analg 2002 95: 324-325. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:Long-stored packed red blood cells (PRBCs) have a large potassium load. In patients with end-stage renal failure, the transfusion of such PRBCs may cause a critical increase in plasma potassium levels. Washing PRBCs with an autotransfusion device allows for a marked decrease in potassium load, thus preventing hyperkalemia.

PEDIATRIC ANESTHESIA:

Ban C. H. Tsui, R. Seal, and J. Koller

Thoracic Epidural Catheter Placement Via the Caudal Approach in Infants by Using Electrocardiographic Guidance
Anesth Analg 2002 95: 326-330. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Epidural electrocardiography may be used to guide the positioning of the thoracic epidural catheter tip via the caudal approach to the appropriate dermatome for optimum analgesia.

Ah Young Oh, Yang Hyun Kim, Bo Kyung Kim, Hee-Soo Kim, and Chong Sung Kim

Unexpected Tracheomalacia in Marfan Syndrome During General Anesthesia for Correction of Scoliosis (Case Report)
Anesth Analg 2002 95: 331-332. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:We experienced an unexpected tracheomalacia exhibiting CO2 retention and an increased peak inspiratory pressure after beginning an operation; it was confirmed with fiberoptic bronchoscopy. If there are no problems in the circuit or tube when the patient shows CO2 retention and increases in peak inspiratory pressure, the fiberoptic bronchoscope is helpful

Clarisse Peuch, Serge Malbezin, Carole Saizou, Vincent Couloigner, Monique Elmaleh, Yves Nivoche, Pascal de Lagausie, and Vincent Laudenbach

Separate-Lung Ventilation Strategy for Reimplantation of Esophageal Bronchus (Case Report)
Anesth Analg 2002 95: 333-335. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe an original ventilation method designed to optimize lung recruitment and gas exchanges during surgery in a newborn with congenital esophageal atresia and ectopic esophageal implantation of the left mainstem bronchus. This strategy ensured constant adaptation of the mechanical ventilatory regimen to the surgical procedure-linked constraints.

Quentin A. Fisher, George D. Politis, Joseph D. Tobias, Lester T. Proctor, Raz Samandari-Stevenson, Alan Roth, and Paul Samuels

Pediatric Anesthesia for Voluntary Services Abroad (Review Article)
Anesth Analg 2002 95: 336-350. [Full Text] [PDF] [Request Permissions]  

AMBULATORY ANESTHESIA:

Ralf E. Gebhard, Tameem Al-Samsam, Jennifer Greger, Ahmad Khan, and Jacques E. Chelly

Distal Nerve Blocks at the Wrist for Outpatient Carpal Tunnel Surgery Offer Intraoperative Cardiovascular Stability and Reduce Discharge Time
Anesth Analg 2002 95: 351-355. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This retrospective analysis of three different anesthetic techniques for ambulatory carpal tunnel surgery shows that nerve blocks performed at the wrist provided excellent intraoperative cardiovascular stability and allowed for earlier discharge.

ANESTHETIC PHARMACOLOGY:

Douglas E. Raines and Robert J. Claycomb

The Role of Electrostatic Interactions in Governing Anesthetic Action on the Torpedo Nicotinic Acetylcholine Receptor
Anesth Analg 2002 95: 356-361. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthetics representing a wide range of chemical classes reduce the apparent agonist dissociation constant of the Torpedo nicotinic acetylcholine receptor with aqueous potencies that are governed by their molecular volumes and hydrogen bond basicities. However, neither their hydrogen bond acidities nor dipole moments influence aqueous potency.

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

Characterization of the Interactions Between Volatile Anesthetics and Neuromuscular Blockers at the Muscle Nicotinic Acetylcholine Receptor
Anesth Analg 2002 95: 362-367. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Isoflurane and sevoflurane enhance the receptor blocking effects of nondepolarizing muscle relaxants on nicotinic acetylcholine receptors.

Olivier Y. Cuignet, Philippe M. Baele, and Luc J. Van Obbergh

A Second-Generation Blood Substitute (Perflubron Emulsion) Increases the Blood Solubility of Modern Volatile Anesthetics In Vitro
Anesth Analg 2002 95: 368-372. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:Perflubron increases the in vitro solubility of volatile anesthetics when present in the blood at clinically relevant concentrations. Volatile anesthetics actually partition into the emulsion, but the solubility in the blood does not change. Further studies are needed to assess whether perflubron will affect the pharmacokinetics of volatile anesthetics in vivo.

Kazuhiko Fukuda, Takehiro Shoda, Hiroyuki Mima, and Hisatoshi Uga

Midazolam Induces Expression of c-Fos and EGR-1 by a Non-GABAergic Mechanism
Anesth Analg 2002 95: 373-378. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Gene expression changes induced by anesthetics in neuronal cells have not been noticed. We demonstrate that a large concentration of midazolam can induce expression of immediate early genes by a non-GABAergic mechanism in PC12 cells, suggesting that the administration of midazolam might lead to long-term changes of neural functions by changing gene expression.

Benoît Plaud, Jean Marty, Bertrand Debaene, Claude Meistelman, Daniel Pellissier, Jean-Yves LePage, Pierre Feiss, Philippe Scherpereel, Marie-Noëlle Bouverne, and Sandrine Fosse

The Cardiovascular Effects of Mivacurium in Hypertensive Patients
Anesth Analg 2002 95: 379-384. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: When mivacurium (0.2 mg/kg) is injected rapidly (e.g., 10 s) the incidence and the intensity of hypotension are greater in hypertensive patients than in healthy patients.

Leslie L. Montgomery, Alisa C. Thorne, Kimberly J. Van Zee, Jane Fey, Alexandra S. Heerdt, Mary Gemignani, Elisa Port, Jeanne Petrek, Hiram S. Cody, III, and Patrick I. Borgen

Isosulfan Blue Dye Reactions During Sentinel Lymph Node Mapping for Breast Cancer
Anesth Analg 2002 95: 385-388. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report the largest single-institution review of adverse reactions to injection of isosulfan blue dye during sentinel lymph node mapping in breast cancer. Bronchospasm and respiratory compromise are unusual, and most patients can be treated with short-term pressor support. Patients with a sulfa allergy do not display a cross-sensitivity to isosulfan blue dye.

Takashi Horiguchi and Toshiaki Nishikawa

Heart Rate Response to Intravenous Atropine During Propofol Anesthesia
Anesth Analg 2002 95: 389-392. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Heart rate response to IV atropine is attenuated during propofol anesthesia, and the decreased responsiveness to atropine cannot be effectively overcome by a large dose of atropine.

Zen’ichiro Wajima, Tatsusuke Yoshikawa, Akira Ogura, Kazuyuki Imanaga, Toshiya Shiga, Tetsuo Inoue, and Ryo Ogawa

Oral Tizanidine, an ₂-Adrenoceptor Agonist, Reduces the Minimum Alveolar Concentration of Sevoflurane in Human Adults
Anesth Analg 2002 95: 393-396. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oral tizanidine (4 mg), an {alpha}2-adrenoceptor agonist, reduces the minimum alveolar concentration of sevoflurane by 18%.

Michael Gruber, Regina Lindner, Christopher Prasser, and Gunther Wiesner

The Effect of Fluoride and Hypothermia on the In Vitro Metabolism of Mivacurium (Brief Report)
Anesth Analg 2002 95: 397-399. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The fluoride inhibition of mivacurium hydrolysis by pseudocholinesterase increases in hypothermia, but it will very rarely occur in clinical practice because it requires rather large fluoride concentrations (>50 {micro}mol/L) and very low temperatures (<28{degrees}C).

Zen’ichiro Wajima, Tatsusuke Yoshikawa, Akira Ogura, Kazuyuki Imanaga, Toshiya Shiga, Tetsuo Inoue, and Ryo Ogawa

Intravenous Verapamil Blunts Hyperdynamic Responses During Electroconvulsive Therapy Without Altering Seizure Activity
Anesth Analg 2002 95: 400-402. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A dose of 0.1 mg/kg of verapamil, administered immediately before anesthesia, significantly reduces the increase in peak heart rate and mean arterial blood pressure after electroconvulsive therapy. Furthermore, the administration of verapamil does not reduce the duration of the seizure.

PAIN MEDICINE:

Robert Cluff, Abdel-Kader Mehio, Steven P. Cohen, Yuchiao Chang, Christine N. Sang, and Milan P. Stojanovic

The Technical Aspects of Epidural Steroid Injections: A National Survey
Anesth Analg 2002 95: 403-408. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A national survey of practices performing epidural steroid injections was conducted. The purpose was to establish whether consensus exists on technical aspects of this procedure. The study results indicate that there is no consensus, and that there is a wide variation in current practices.

A.K. Dam and J.C. Mishra

Managing Ergot-Induced Gangrene: The Anesthesiologist as a Key Player (Case Report)
Anesth Analg 2002 95: 409-410. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:We discuss the successful management of gangrene of the upper and lower limbs after ergot-induced abortion by unlicensed medical charlatans in a developing country. Our purpose is to highlight the dangerous means adopted by unlicensed medical charlatans to induce abortion as well as to emphasize the key role played by anesthesiologists in the management of such cases.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Getúlio Rodrigues de Oliveira Filho

The Construction of Learning Curves for Basic Skills in Anesthetic Procedures: An Application for the Cumulative Sum Method
Anesth Analg 2002 95: 411-416. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Learning curves for peripheral venous cannulation, tracheal intubation, and spinal and epidural anesthesia were constructed using the cumulative sum (cusum) method. There was a wide variability in the number of procedures performed until attainment of acceptable failure rates. The cusum method may improve our means of evaluating residents' technical skills.

CRITICAL CARE AND TRAUMA:

Volker Dörges, Volker Wenzel, Susanne Dix, Alexander Kühl, Thomas Schumann, Michael Hüppe, Heiko Iven, and Klaus Gerlach

The Effect of Midazolam on Stress Levels During Simulated Emergency Medical Service Transport: A Placebo-Controlled, Dose-Response Study
Anesth Analg 2002 95: 417-422. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Simulated emergency medical service patients were more likely to be stressed when being transported by paramedics through a staircase than in an ambulance. Accordingly, it may be beneficial to inject sedative drugs before initiating transport to ensure patient comfort and safety.

NEUROSURGICAL ANESTHESIA:

Jeffrey S. Kroin, Subhash K.S. Nagalla, Asokumar Buvanendran, Robert J. McCarthy, Kenneth J. Tuman, and Anthony D. Ivankovich

The Mechanisms of Intracranial Pressure Modulation by Epidural Blood and Other Injectates in a Postdural Puncture Rat Model
Anesth Analg 2002 95: 423-429. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A rat model was developed to evaluate different drugs that may be injected epidurally to treat postdural puncture headache. Epidural injection of blood or fibrin glue was the most effective method of maintaining increased cerebrospinal fluid pressure after dural puncture. Sealing the dural defect does not effectively correct cerebrospinal fluid pressure unless an epidural tamponade effect is maintained.

Pekka Talke, James E. Caldwell, Ronald Brown, Barbara Dodson, Joan Howley, and Charles A. Richardson

A Comparison of Three Anesthetic Techniques in Patients Undergoing Craniotomy for Supratentorial Intracranial Surgery
Anesth Analg 2002 95: 430-435. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated three anesthetic techniques with and without propofol in patients undergoing elective surgery for supratentorial mass lesions by using a prospective, randomized clinical study design and found that the three anesthetics did not differ in intra- or postoperative hemodynamic stability or early postoperative recovery variables.

OBSTETRIC ANESTHESIA:

J. Sarvela, P. Halonen, A. Soikkeli, and K. Korttila

A Double-Blinded, Randomized Comparison of Intrathecal and Epidural Morphine for Elective Cesarean Delivery
Anesth Analg 2002 95: 436-440. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Spinal morphine is an effective analgesic after cesarean delivery, but it has several side effects. The purpose of this study was to compare the prevalence of side effects and the level of analgesia of epidural morphine with two different doses of spinal morphine after elective cesarean delivery. Although rescue analgesics may be required, intrathecal morphine 100 {micro}g is suggested for postoperative analgesia after cesarean delivery.

Bupesh Kaul, Manuel C. Vallejo, Sivam Ramanathan, Gordon L. Mandell, and Robert G. Krohner

Accidental Spinal Analgesia in the Presence of a Lumboperitoneal Shunt in an Obese Parturient Receiving Enoxaparin Therapy (Case Report)
Anesth Analg 2002 95: 441-443. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:A single shot spinal anesthetic is not practical in a patient with a lumboperitoneal shunt. Neuraxial block and a blood patch (if necessary) may be performed in a patient on enoxaparin therapy if current guidelines for managing patients on anticoagulant therapy are followed.

REGIONAL ANESTHESIA:

Marc Senard, Jean L. Joris, Didier Ledoux, Pierre J. Toussaint, Benoît Lahaye-Goffart, and Maurice L. Lamy

A Comparison of 0.1% and 0.2% Ropivacaine and Bupivacaine Combined with Morphine for Postoperative Patient-Controlled Epidural Analgesia After Major Abdominal Surgery
Anesth Analg 2002 95: 444-449. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Small-dose (0.1%) ropivacaine and bupivacaine have similar potency and result in comparable analgesia and incidence of side effects.

Anil Gupta, Sven E. Thörn, Kjell Axelsson, Lars G. Larsson, Göran Ågren, Björn Holmström, and Narinder Rawal

Postoperative Pain Relief Using Intermittent Injections of 0.5% Ropivacaine Through a Catheter After Laparoscopic Cholecystectomy
Anesth Analg 2002 95: 450-456. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Early postoperative pain can be relieved by intermittent injections of ropivacaine 0.5% through a catheter placed in the bed of the gall bladder after ambulatory laparoscopic cholecystectomy.

Scott S. Reuben, Robert B. Steinberg, Holly Maciolek, and Poornachandran Manikantan

An Evaluation of the Analgesic Efficacy of Intravenous Regional Anesthesia with Lidocaine and Ketorolac Using a Forearm Versus Upper Arm Tourniquet
Anesth Analg 2002 95: 457-460. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Forearm tourniquet intravenous regional anesthesia (IVRA) with 50% less lidocaine and ketorolac provides for both a longer duration of sensory block and prolonged postoperative analgesia compared with upper arm IVRA.

Shahbaz R. Arain and Thomas J. Ebert

The Efficacy, Side Effects, and Recovery Characteristics of Dexmedetomidine Versus Propofol When Used for Intraoperative Sedation
Anesth Analg 2002 95: 461-466. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dexmedetomidine may be useful for perioperative sedation. It has a slower onset and offset of sedation compared with propofol. Dexmedetomidine was associated with improved analgesia and less morphine use in the postoperative period.

Giorgio Danelli, Marco Berti, Valeria Perotti, Andrea Albertin, Paolo Baccari, Francesco Deni, Guido Fanelli, and Andrea Casati

Temperature Control and Recovery of Bowel Function After Laparoscopic or Laparotomic Colorectal Surgery in Patients Receiving Combined Epidural/General Anesthesia and Postoperative Epidural Analgesia
Anesth Analg 2002 95: 467-471. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This prospective, randomized, controlled study demonstrates that laparoscopic colorectal surgery results in less postoperative pain and earlier recovery of bowel function than conventional laparotomy but does not reduce the risk for perioperative hypothermia. Accordingly, active warming must be provided to patients also during laparoscopic procedures.

Beth H. Minzter, Raymond F. Johnson, and Barbara J. Grimm

The Practice of Thoracic Epidural Analgesia: A Survey of Academic Medical Centers in the United States (Special Article)
Anesth Analg 2002 95: 472-475. [Full Text] [PDF] [Request Permissions]  

GENERAL ARTICLES:

M. Wattwil, S.-E. Thörn, A Lövqvist, L. Wattwil, H. Klockhoff, L.-G. Larsson, and I. Näslund

Perioperative Gastric Emptying Is Not a Predictor of Early Postoperative Nausea and Vomiting in Patients Undergoing Laparoscopic Cholecystectomy
Anesth Analg 2002 95: 476-479. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The incidence of postoperative nausea and vomiting is frequent after laparoscopic cholecystectomy. This study has shown that perioperative gastric emptying is not a predictor of early postoperative nausea and vomiting in patients undergoing laparoscopic cholecystectomy.

Shinji Takahashi, Taro Mizutani, Masayuki Miyabe, and Hidenori Toyooka

Hemodynamic Responses to Tracheal Intubation with Laryngoscope Versus Lightwand Intubating Device (Trachlight^®) in Adults with Normal Airway
Anesth Analg 2002 95: 480-484. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The magnitude of hemodynamic changes associated with tracheal intubation with the Trachlight(R) is almost the same as that which occurs with the direct laryngoscope. Hemodynamic changes are likely to occur because of direct tracheal irritation rather than direct stimulation of the larynx.

Basem Abdelmalak, J. Victor Ryckman, Sawsan AlHaddad, and Juraj Sprung

Respiratory Arrest After Successful Neodymium:Yttrium-Aluminum-Garnet Laser Treatment of Subglottic Tracheal Stenosis (Case Report)
Anesth Analg 2002 95: 485-486. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe a patient who developed respiratory arrest 4 h after successful laser treatment of tracheal stenosis. Respiratory arrest was caused, presumably, by airway narrowing due to delayed tissue edema secondary to thermal injury by deep penetration of the laser beam.

Ahmed F. Ghouri, William Mading, and Kavitha Prabaker

Accidental Intraarterial Drug Injections via Intravascular Catheters Placed on the Dorsum of the Hand (Case Report)
Anesth Analg 2002 95: 487-491. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Two cases of placement of a catheter in the dorsum of a hand into an artery mistaken to be a vein are described. Diagnosis and treatment of such mishaps are discussed.

Hui-Ling Lee, Angie C.Y. Ho, Robin K.S. Cheng, and Ming-Hwang Shyr

Successful One-Lung Ventilation in a Patient with Aberrant Tracheal Bronchus (Case Report)
Anesth Analg 2002 95: 492-493. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a 47-yr-old patient who underwent surgery for esophageal cancer. Because of the isolated ventilation of the right upper lobe after occlusion of the right mainstem bronchus, bronchoscopic re-confirmation exposed an aberrant tracheal bronchus. A Fogarty tube was introduced to block the tracheal bronchus and provide one-lung ventilation.

Peter Lierz and Peter Felleiter

Anesthesia as Therapy for Persistent Hiccups
Anesth Analg 2002 95: 494-495. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:Chronic hiccups may be a serious therapeutic problem. Pharmacological treatment with increasing dosages of baclofen, carbamazepine, or gabapentin is not always successful. In this paper, the use of general anesthesia with positive-pressure ventilation and muscle relaxation for the termination of chronic hiccups is described.

LETTERS TO THE EDITOR:

Paul F. White, Kaisa Nelskylä, Helena Puro, Kari Korttila, and Arvi Yli-Hankala

Postoperative Nausea and Vomiting and BIS Monitoring • Response
Anesth Analg 2002 95: 496. [Full Text] [PDF] [Request Permissions]  

Prakash K. Dubey, José A. Sastre Rincón, María A. Prieto Rodrigo, José C. Garzón Sánchez, and Clemente Muriel Villoria

Hydrogen Peroxide Irrigation: Avoid It or Be Prepared for It? • Response
Anesth Analg 2002 95: 497. [Full Text] [PDF] [Request Permissions]  

Lawrence J. Saidman, Henry Kehlet, and Paul F. White

The Objectivity of the Editorialist Must Be Questioned • Response
Anesth Analg 2002 95: 497-498. [Full Text] [PDF] [Request Permissions]  

P. Soeding, G. Hoy, Stephen M. Klein, Karen C. Nielsen, and Susan M. Steele

Intraarticular Analgesia in Shoulder Surgery • Response
Anesth Analg 2002 95: 498. [Full Text] [PDF] [Request Permissions]  

T. Engelhardt, P.R. Lowe, and Edmond I. Eger II

MAC Does Not Matter to the Patient • Response
Anesth Analg 2002 95: 499. [Full Text] [PDF] [Request Permissions]  

Pascal Colson, Frédérique Ryckwaert, and Marie-Laure Cittanova

ACE Inhibitor and Postoperative Renal Dysfunction • Response
Anesth Analg 2002 95: 499-500. [Full Text] [PDF] [Request Permissions]  

Jae-Hyon Bahk

Guidelines for Determining the Appropriateness of Double–Lumen Endobronchial Tube Size
Anesth Analg 2002 95: 501. [Full Text] [PDF] [Request Permissions]  

Jonathan V. Roth and Jay Horrow

Can You Reheparinize After Heparinase-I? • Response
Anesth Analg 2002 95: 501. [Full Text] [PDF] [Request Permissions]  

Peter Lierz, Anja Heinatz, Burkhard Gustorff, and Peter Felleiter

Management of Intratracheal Fire During Laser Surgery
Anesth Analg 2002 95: 502. [Full Text] [PDF] [Request Permissions]  

Sebastian Schulz-Stübner, Dean B. Andropoulos, and Stephen A. Stayer

ECC Guidance for CVC Placement • Response
Anesth Analg 2002 95: 502. [Full Text] [PDF] [Request Permissions]  

Philippe Gain, Gilles Thuret, Christophe Chiquet, Marie-Louise Navez, and Jean Pascal

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Anesth Analg 2002 95: 503. [Full Text] [PDF] [Request Permissions]  

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Anesth Analg 2002 95: 503. [Full Text] [PDF] [Request Permissions]  

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Anesth Analg 2002 95: 504. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

David Ryan Cook, Stanley Murraychick, Ketan Shevde, Doris K. Cope, and Morris Brown

Pediatric Anesthesia: Principles and Practice • Lippincott’s Interactive Anesthesia Library, Version 3.0 • Intraoperative Management of the Cardiac Patient in Noncardiac Surgery, Vol. 40, No. 1 of Intl Anesth Clinic • Heal the Pain, Comfort the Spirit • Top Tips in Critical Care Medicine
Anesth Analg 2002 95: 505-507. [Full Text] [PDF] [Request Permissions]  

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