EDITORIALS:

Peter D. Constable

Hyperchloremic Acidosis: The Classic Example of Strong Ion Acidosis
Anesth Analg 2003 96: 919-922. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Hilde Pleym, Roar Stenseth, Alexander Wahba, Lise Bjella, Asbjørn Karevold, and Ola Dale

Single-Dose Tranexamic Acid Reduces Postoperative Bleeding After Coronary Surgery in Patients Treated with Aspirin Until Surgery
Anesth Analg 2003 96: 923-928. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Continuation of aspirin medication until the day before coronary artery bypass grafting may increase postoperative bleeding. The administration of a single dose of tranexamic acid (30 mg/kg) immediately before cardiopulmonary bypass significantly reduced postoperative bleeding and inhibited fibrinolysis in these patients.

Kai Singbartl, Petra Innerhofer, Jens Radvan, Birgit Westphalen, Dietmar Fries, Raimund Stögbauer, and Hugo Van Aken

Hemostasis and Hemodilution: A Quantitative Mathematical Guide for Clinical Practice
Anesth Analg 2003 96: 929-935. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The causes of quantitative changes of hemostasis during hemodilution, as well as their clinical effect and relevance, remain unclear. Using a validated, realistic mathematical model, we demonstrate that hemostasis, especially plasma fibrinogen, can limit the extent of hemodilution. This phenomenon is particularly prominent when acute normovolemic hemodilution is combined with artificial blood substitutes.

Thomas Standl, Marc-Alexander Burmeister, Frank Schroeder, Eike Currlin, Jan Schulte am Esch, Marc Freitag, and Jochen Schulte am Esch

Hydroxyethyl Starch (HES) 130/0.4 Provides Larger and Faster Increases in Tissue Oxygen Tension in Comparison with Prehemodilution Values than HES 70/0.5 or HES 200/0.5 in Volunteers Undergoing Acute Normovolemic Hemodilution
Anesth Analg 2003 96: 936-943. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effects of three different hydroxyethyl starch (HES) solutions on hemodynamics, rheology, and skeletal muscle tissue tension after acute normovolemic hemodilution were examined in awake volunteers. With HES 130/0.4, increases of tissue oxygen tension in comparison to baseline were larger and more rapid than with HES 70/0.5 or HES 200/0.5.

R. Ross Kennedy and Richard French

The Effect of the Interval Between Blood Pressure Determinations on the Delay in the Detection of Changes: A Computer Simulation
Anesth Analg 2003 96: 944-948. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We used a computer model to study the effect of increasing noninvasive blood pressure (NIBP) sampling interval on the detection of blood pressure changes. The detection time increased only 50% of the increase in the sampling interval. This information may help optimize NIBP intervals in different circumstances.

Leo G. Kevin, Enis Novalija, Matthias L. Riess, Amadou K. S. Camara, Samhita S. Rhodes, and David F. Stowe

Sevoflurane Exposure Generates Superoxide but Leads to Decreased Superoxide During Ischemia and Reperfusion in Isolated Hearts
Anesth Analg 2003 96: 949-955. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Reactive oxygen species (ROS) are implicated in triggering anesthetic preconditioning (APC). The ROS superoxide (O2{middle dot}-) was measured continuously in guinea pig isolated hearts. Sevoflurane directly increased O2{middle dot}- but led to attenuated O2{middle dot}- formation during ischemia. This demonstrates triggering of APC by ROS and clarifies the mechanism of cardioprotection during ischemia.

Derek R. Kieta, Andrew T. McCammon, William L. Holman, and Vance G. Nielsen

Hemostatic Analysis of a Patient Undergoing Off-Pump Coronary Artery Bypass Surgery with Argatroban Anticoagulation (Case Report)
Anesth Analg 2003 96: 956-958. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case describes the impact of argatroban and off-pump coronary revascularization on hemostasis as assessed by conventional hemostatic measures and Thrombelastography (R) in a patient with heparin-induced thrombocytopenia.

Alvin P. Wong and Michael G. Huss

An Unusual Cause of Seizures After Cardiopulmonary Bypass (Case Report)
Anesth Analg 2003 96: 959-961. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We present a case of a 34-yr-old woman who developed seizures after an open-heart procedure requiring cardiopulmonary bypass. The seizures were most likely caused by previously undiagnosed neurocysticercosis and may also have been contributed to by cardiopulmonary bypass.

André Martineau, Geneviève Arcand, Pierre Couture, Denis Babin, Louis P. Perreault, and André Denault

Transesophageal Echocardiographic Diagnosis of Carbon Dioxide Embolism During Minimally Invasive Saphenous Vein Harvesting and Treatment with Inhaled Epoprostenol (Case Report)
Anesth Analg 2003 96: 962-964. [Abstract] [Full Text] [PDF] [VIDEOS]  [Request Permissions]  

IMPLICATIONS: We describe a patient scheduled for coronary artery bypass who developed carbon dioxide (CO2) embolism with acute pulmonary hypertension during endoscopic saphenectomy. Transesophageal echocardiography was useful in the diagnosis of CO2 embolism and to assess response to inhaled epoprostenol.

PEDIATRIC ANESTHESIA:

Scott D. Cook-Sather, Kathleen A. Harris, Rosetta Chiavacci, Paul R. Gallagher, and Mark S. Schreiner

A Liberalized Fasting Guideline for Formula-Fed Infants Does Not Increase Average Gastric Fluid Volume Before Elective Surgery
Anesth Analg 2003 96: 965-969. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Healthy infants aged <=10.5 mo may drink formula up to 4 h before surgery without increasing gastric fluid volume compared with infants allowed clear liquids up to 2 h and formula 8 h before surgery.

Zeev N. Kain, Alison A. Caldwell-Andrews, Shu-Ming Wang, Dawn M. Krivutza, Megan E. Weinberg, and Linda C. Mayes

Parental Intervention Choices for Children Undergoing Repeated Surgeries
Anesth Analg 2003 96: 970-975. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Parents of children who undergo a subsequent surgery prefer to be present during the induction of anesthesia regardless of whether the child was medicated or had parents present or did not receive anything at the initial surgery. Also, parents' preference for medication or parental presence at the subsequent surgery was influenced by the child's anxiety at the initial surgery.

Thomas Hackmann, Marvin Friesen, Suzanne Allen, and David S. Precious

Clonidine Facilitates Controlled Hypotension in Adolescent Children
Anesth Analg 2003 96: 976-981. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that adolescents having major jaw surgery are helped by the blood pressure-decreasing drug clonidine. This drug allows smaller doses of anesthetics, pain relievers, and blood pressure-decreasing drugs to be used; reduces changes in heart rate and blood pressure; and provides faster recovery from the anesthetic.

AMBULATORY ANESTHESIA:

Joseph M. Neal, Susan B. McDonald, Kathleen L. Larkin, and Nayak L. Polissar

Suprascapular Nerve Block Prolongs Analgesia After Nonarthroscopic Shoulder Surgery but Does Not Improve Outcome
Anesth Analg 2003 96: 982-986. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: When used as an adjunct to an interscalene block combined with general anesthesia, suprascapular nerve block with bupivacaine moderately prolongs analgesia without improving other outcome measures after ambulatory nonarthroscopic shoulder surgery.

Mehernoor F. Watcha, Tijani Issioui, Kevin W. Klein, and Paul F. White

Costs and Effectiveness of Rofecoxib, Celecoxib, and Acetaminophen for Preventing Pain After Ambulatory Otolaryngologic Surgery
Anesth Analg 2003 96: 987-994. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Oral premedication with rofecoxib (50 mg) was more effective than celecoxib (200 mg) and acetaminophen (2 g) in reducing postoperative pain and in improving the quality of recovery and patient satisfaction with pain management after outpatient otolaryngologic surgery with only a small increase in cost of care.

Leopold H. J. Eberhart, Roswitha Mayer, Oliver Betz, Stergios Tsolakidis, Wolfgang Hilpert, Astrid M. Morin, Götz Geldner, Hinnerk Wulf, and Wulf Seeling

Ginger Does Not Prevent Postoperative Nausea and Vomiting After Laparoscopic Surgery (Brief Report)
Anesth Analg 2003 96: 995-998. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The potential antiemetic effect of two different oral doses of the herbal remedy ginger (Zingiber officinale) to prevent postoperative nausea and vomiting in 180 patients undergoing gynecologic laparoscopy was investigated in this randomized, double-blinded trial. Ginger failed to reduce the incidence of postoperative nausea and vomiting after these procedures.

ANESTHETIC PHARMACOLOGY:

Joseph F. Antognini, Richard Atherley, and Earl Carstens

Isoflurane Action in Spinal Cord Indirectly Depresses Cortical Activity Associated with Electrical Stimulation of the Reticular Formation
Anesth Analg 2003 96: 999-1003. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Isoflurane action in the spinal cord indirectly reduces the cortical activity associated with electrical stimulation of the reticular formation, an effect that might contribute to anesthetic-induced amnesia and unconsciousness.

Deborah J. Culley, Mark Baxter, Rustam Yukhananov, and Gregory Crosby

The Memory Effects of General Anesthesia Persist for Weeks in Young and Aged Rats
Anesth Analg 2003 96: 1004-1009. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study demonstrates that general anesthesia with isoflurane and nitrous oxide improves spatial memory in young rats but impairs it in aged rats for at least 3 wk, indicating that it can influence memory for much longer than previously recognized and may adversely affect memory processes in the aged.

Edmond I Eger, II, Yilei Xing, Robert Pearce, Steven Shafer, Michael J. Laster, Yi Zhang, Michael S. Fanselow, and James M. Sonner

Isoflurane Antagonizes the Capacity of Flurothyl or 1,2-Dichlorohexafluorocyclobutane to Impair Fear Conditioning to Context and Tone
Anesth Analg 2003 96: 1010-1018. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Conventional inhaled anesthetics and nonimmobilizers are antagonistic in their effects on learning and memory, and this finding suggests that they impair learning and memory, at least in part, by different mechanisms.

Gertrud Haeseler, Diana Tetzlaff, Johannes Bufler, Reinhard Dengler, Sinikka Münte, Hartmut Hecker, and Martin Leuwer

Blockade of Voltage-Operated Neuronal and Skeletal Muscle Sodium Channels by S(+)- and R(-)-Ketamine
Anesth Analg 2003 96: 1019-1026. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Blockade of sodium channels by ketamine shows voltage dependency, an important feature of local anesthetic action. However, ketamine is less effective than lidocaine-like local anesthetics in stabilizing the inactivated state. Because it does not elicit phasic blockade at small concentrations, its ability to reduce the firing frequency of action potentials may be small.

Masayuki Koshizaki, Mikito Kawamata, Steven G. Shimada, Yoji Saito, and J. G. Collins

5-HT₃ Receptors Partially Mediate Halothane Depression of Spinal Dorsal Horn Sensory Neurons
Anesth Analg 2003 96: 1027-1031. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The results of this study support the hypothesis that halothane depression of spinal sensory neuronal responses to low-intensity stimuli is mediated, to a minor extent, by serotonin subtype 3 neurotransmitter systems.

Yoshitaka Fujii, Aki Uemura, and Hidenori Toyooka

The Effect of Inhaled Colforsin Daropate on Contractility of Fatigued Diaphragm in Dogs
Anesth Analg 2003 96: 1032-1034. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Diaphragmatic fatigue may contribute to the development of respiratory failure. Inhaled colforsin daropate improves, in a dose-dependent manner, the contractility of fatigued diaphragm in dogs.

Nazinigouba Ouédraogo, Roger Marthan, and and Etienne Roux

The Effects of Propofol and Etomidate on Airway Contractility in Chronically Hypoxic Rats
Anesth Analg 2003 96: 1035-1041. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Anesthesia may cause airway constriction or bronchospasm in patients with normal or pathological airways. This study investigated the ability of propofol and etomidate to both reverse precontraction and inhibit contraction of tracheal rings isolated from chronically hypoxic rats.

Kyo S. Kim, Mi A. Cheong, Jeong W. Jeon, Jeong H. Lee, and Jae C. Shim

The Dose Effect of Ephedrine on the Onset Time of Vecuronium
Anesth Analg 2003 96: 1042-1046. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS:Ephedrine 70 {micro}g/kg given before the induction of anesthesia improved tracheal intubating conditions at 2 min after vecuronium by increased cardiac output without significant adverse hemodynamic effects.

Alejandro Recart, Shivani Rawal, Paul F. White, Stephanie Byerly, and Larry Thornton

The Effect of Remifentanil on Seizure Duration and Acute Hemodynamic Responses to Electroconvulsive Therapy
Anesth Analg 2003 96: 1047-1050. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Remifentanil (100 {micro}g IV) attenuated the acute hemodynamic response after electroconvulsive therapy (ECT) without adversely affecting the length of the ECT-induced seizure activity or prolonging recovery times.

Juraj Sprung, Michael J. Tully, and Avishai Ziser

Anaphylactic Reactions to Isosulfan Blue Dye During Sentinel Node Lymphadenectomy for Breast Cancer (Case Report)
Anesth Analg 2003 96: 1051-1053. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intraoperative use of isosulfan dye for lymphatic mapping may result in anaphylaxis. Furthermore, in some patients, intravascular absorption of isosulfan may induce serum discoloration causing interference with pulse oximetry function.

Alan S. Multz

Prolonged Dexmedetomidine Infusion as an Adjunct in Treating Sedation-Induced Withdrawal (Case Report)
Anesth Analg 2003 96: 1054-1055. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dexmedetomidine, an {alpha}2-adrenoceptor agonist, is indicated for sedating patients on mechanical ventilation. It has been approved by the Food and Drug Administration for 24-h use. This is a report concerning a patient in whom a continuous infusion of dexmedetomidine was safely used for a week to help in averting frank withdrawal symptoms from an opioid and benzodiazepines.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Augusto Tempia, Maddalena C. Olivei, Eliana Calza, Hans Lambert, Luca Scotti, Eugenio Orlando, Sergio Livigni, and Enrica Guglielmotti

The Anesthetic Conserving Device Compared with Conventional Circle System Used Under Different Flow Conditions for Inhaled Anesthesia
Anesth Analg 2003 96: 1056-1061. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The Anesthetic Conserving Device (ACD) is a new device for anesthetic vapor delivery. We demonstrated that the ACD reduces anesthetic consumption and environmental pollution similarly to a low-flow circle system, offering advantages such as simplicity, no toxicity from compounds produced in the absorber, and potential cost savings.

Donald M. Mathews, Karthic R. Kumaran, and George G. Neuman

Bispectral Index-Derived Facial Electromyography-Guided Fentanyl Titration in the Opiate-Exposed Patient (Case Report)
Anesth Analg 2003 96: 1062-1064. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A 34-yr-old man, possibly opiate tolerant, underwent the second part of a scoliosis repair. We describe a narcotic titration protocol by using facial electromyography data derived from the bispectral index monitor that resulted in a good clinical outcome.

PAIN MEDICINE:

Shuanglin Hao, Keiko Mamiya, Osamu Takahata, Hiroshi Iwasaki, Marina Mata, and David J. Fink

Nifedipine Potentiates the Antinociceptive Effect of Endomorphin-1 Microinjected into the Periaqueductal Gray in Rats
Anesth Analg 2003 96: 1065-1071. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study shows that the potent antinociceptive effect of endomorphin-1 microinjected into the ventrolateral periaqueductal gray is potentiated by concomitant administration of nifedipine. This suggests that calcium channel blockers may enhance the analgesia of opioids in patients with calcium channel blocker treatment.

Masayuki Sasaki, Hideaki Obata, Shigeru Saito, and Fumio Goto

Antinociception with Intrathecal -Methyl-5-Hydroxytryptamine, a 5-Hydroxytryptamine_2A/2C Receptor Agonist, in Two Rat Models of Sustained Pain
Anesth Analg 2003 96: 1072-1078. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Activation of spinal 5-hydroxytryptamine2A/2C receptors mediate antinociception in rat-sustained pain models such as inflammatory pain and neuropathic pain, and spinal muscarinic receptors are involved in this action.

Kazuyoshi Ueta, Kiyoshi Takeda, Hisatoshi Ohsumi, Junichi Haruna, Hiromi Shibuya, and Takashi Mashimo

A Small Preoperative Test Dose of Intravenous Fentanyl Can Predict Subsequent Analgesic Efficacy and Incidence of Side Effects in Patients Due to Receive Epidural Fentanyl
Anesth Analg 2003 96: 1079-1082. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Preoperative administration of a small dose of fentanyl during the induction of anesthesia enables prediction of the analgesic efficacy of postoperative epidural fentanyl and the incidence and severity of side effects.

Brian D. Sites, Michael Beach, Russell Biggs, Christopher Rohan, Christopher Wiley, Athos Rassias, Janice Gregory, and Gilbert Fanciullo

Intrathecal Clonidine Added to a Bupivacaine-Morphine Spinal Anesthetic Improves Postoperative Analgesia for Total Knee Arthroplasty
Anesth Analg 2003 96: 1083-1088. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this prospective, randomized, double-blinded, and placebo-controlled trial, we identify an effective postoperative analgesic approach in total knee replacement surgery. Intrathecal morphine (250 {micro}g) combined with clonidine (25 or 75 {micro}g) provided superior analgesia compared with intrathecal morphine alone.

Brian M. Ilfeld, Timothy E. Morey, Thomas W. Wright, Larry K. Chidgey, and F. Kayser Enneking

Continuous Interscalene Brachial Plexus Block for Postoperative Pain Control at Home: A Randomized, Double-Blinded, Placebo-Controlled Study
Anesth Analg 2003 96: 1089-1095. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This randomized, double-blinded, placebo-controlled study demonstrated that ropivacaine, infused with a portable infusion pump via an interscalene perineural catheter for 3 days at home, significantly decreased postoperative pain after orthopedic surgery of the shoulder. In addition to providing potent analgesia and increasing patient satisfaction, perineural infusion decreased opioid requirements and their associated side effects.

Raf F. De Jongh, Kris C. Vissers, Theo F. Meert, Leo H. D. J. Booij, Catharina S. De Deyne, and René J. Heylen

The Role of Interleukin-6 in Nociception and Pain (Review Article)
Anesth Analg 2003 96: 1096-1103. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: That IL-6 is an interesting target in the study of pain is underscored by its biomolecular properties, its localization after experimental pain, and its modulating effect on pain after administration.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Peter R. Freund and Karen L. Posner

Sustained Increases in Productivity with Maintenance of Quality in an Academic Anesthesia Practice
Anesth Analg 2003 96: 1104-1108. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our academic anesthesia service sustained increases in productivity with maintenance of quality. During a 3-yr period of high productivity, patient injury rates did not increase compared with prior years with lower productivity.

Amr E. Abouleish, Franklin Dexter, Richard H. Epstein, David A. Lubarsky, Charles W. Whitten, and Donald S. Prough

Labor Costs Incurred by Anesthesiology Groups Because of Operating Rooms Not Being Allocated and Cases Not Being Scheduled to Maximize Operating Room Efficiency
Anesth Analg 2003 96: 1109-1113. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe a new application for a previously reported statistical method to calculate operating room (OR) allocations to maximize OR efficiency. When optimal OR allocations and case scheduling are not implemented, the resulting increase in labor costs can be used in negotiations as a statistically sound estimate for the increased labor cost to the anesthesiology department.

Donald C. Tyler, Caroline A. Pasquariello, and Chun-Hung Chen

Determining Optimum Operating Room Utilization
Anesth Analg 2003 96: 1114-1121. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using a simulated operating room (OR), the authors demonstrate that OR utilization higher than 85% to 90% leads to patient delays and staff overtime. Increased efficiency of an OR comes at a cost of patient convenience.

CRITICAL CARE AND TRAUMA:

Michael Booke, Martin Westphal, Frank Hinder, Lillian D. Traber, and Daniel L. Traber

Cerebral Blood Flow Is Not Altered in Sheep with Pseudomonas aeruginosa Sepsis Treated with Norepinephrine or Nitric Oxide Synthase Inhibition
Anesth Analg 2003 96: 1122-1128. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cerebral dysfunction is often found in septic patients. In this regard, it is debated whether vasopressor drugs, such as norepinephrine and LG-mono-methyl-L-arginine, have harmful effects on the cerebral circulation. During experimental hyperdynamic sepsis, however, neither drug altered cerebral vascular resistance or cerebral blood flow.

Stephan M. Jakob

Splanchnic Blood Flow in Low-Flow States (Special Article)
Anesth Analg 2003 96: 1129-1138. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Insufficient splanchnic blood flow in critically ill patients is the result of a multitude of different diseases, treatment modalities and their interplay, and is associated with increased morbidity and mortality. A combination of diminished and heterogeneous mesenteric blood flow, impaired or exhausted regulatory mechanisms and adverse drug effects may coexist with normal systemic hemodynamics.

NEUROSURGICAL ANESTHESIA:

Motoyasu Takenaka, Hiroki Iida, Mami Iida, Masayoshi Uchida, and Shuji Dohi

The Comparative Effects of Prostaglandin E1 and Nicardipine on Cerebral Microcirculation in Rabbits
Anesth Analg 2003 96: 1139-1144. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: When given systemically to produce mild or moderate hypotension, prostaglandin E1 does not induce cerebral vasodilation and maintains cerebrovascular reactivity to hypercapnia and hypoxia, whereas nicardipine dilates cerebral vessels and reduces both reactivities.

Philippe Grillo, Nicolas Bruder, Pascal Auquier, Daniel Pellissier, and François Gouin

Esmolol Blunts the Cerebral Blood Flow Velocity Increase During Emergence from Anesthesia in Neurosurgical Patients
Anesth Analg 2003 96: 1145-1149. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Esmolol blunted the postoperative increase in cerebral blood flow velocity in neurosurgical patients. The origin of sympathetic hyperactivity and its potential deleterious consequences require further study.

Hans-Jürgen Dieterich, Jörg Reutershan, Thomas W. Felbinger, and Holger K. Eltzschig

Penetration of Intravenous Hydroxyethyl Starch into the Cerebrospinal Fluid in Patients with Impaired Blood-Brain Barrier Function
Anesth Analg 2003 96: 1150-1154. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Patients may receive IV hydroxyethyl starch (HES) after head trauma or subarachnoid hemorrhage. The results of the present study indicate that in patients with suspected blood-brain barrier impairment, HES does not penetrate from the plasma into the cerebrospinal fluid.

Bai-Han Li, Jeffrey S. Lohmann, H. Gregg Schuler, and Arthur J. Cronin

Preservation of the Cortical Somatosensory-Evoked Potential During Dexmedetomidine Infusion in Rats
Anesth Analg 2003 96: 1155-1160. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In rats, the administration of a wide range of infusion rates of dexmedetomidine did not significantly affect the somatosensory-evoked potential. These results suggest that dexmedetomidine might be a useful adjunctive drug in patients undergoing intraoperative somatosensory-evoked potential monitoring.

OBSTETRIC ANESTHESIA:

Fabienne Roelants, Michella Rizzo, and Patricia Lavand’homme

The Effect of Epidural Neostigmine Combined with Ropivacaine and Sufentanil on Neuraxial Analgesia During Labor
Anesth Analg 2003 96: 1161-1166. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The combination of epidural neostigmine (4 {micro}g/kg) with the local anesthetic ropivacaine, with or without sufentanil, does not significantly enhance neuraxial analgesia during labor. Such a dose, however, has no bothersome side effects.

Arthur L. Calimaran, Tina P. Strauss-Hoder, Warren Y. Wang, Robert J. McCarthy, and Cynthia A. Wong

The Effect of Epidural Test Dose on Motor Function After a Combined Spinal-Epidural Technique for Labor Analgesia
Anesth Analg 2003 96: 1167-1172. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A lidocaine-epinephrine epidural test dose (3 mL of lidocaine 1.5% with epinephrine 1:200,000), injected immediately after the initiation of combined spinal-epidural labor analgesia with bupivacaine 2.5 mg and fentanyl 25 {micro}g, may interfere with the ability to perform simple tests of motor function and ambulation.

Emmanuel Boselli, Richard Debon, Frédéric Duflo, Boris Bryssine, Bernard Allaouchiche, and Dominique Chassard

Ropivacaine 0.15% Plus Sufentanil 0.5 µg/mL and Ropivacaine 0.10% Plus Sufentanil 0.5 µg/mL Are Equivalent for Patient-Controlled Epidural Analgesia During Labor
Anesth Analg 2003 96: 1173-1177. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ropivacaine 0.10% plus 0.5 {micro}g/mL of sufentanil given via patient-controlled epidural anesthesia for labor analgesia is equally as effective as ropivacaine 0.15% plus 0.5 {micro}g/mL of sufentanil, with a 30% local anesthetic-sparing effect and a 40% reduction in cost. This reduction in ropivacaine concentration is not associated with a decrease in the incidence of motor block, side effects, or instrumental deliveries.

Giorgio Capogna, Michela Camorcia, and Malachy O. Columb

Minimum Analgesic Doses of Fentanyl and Sufentanil for Epidural Analgesia in the First Stage of Labor
Anesth Analg 2003 96: 1178-1182. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study determined the minimum analgesic doses of fentanyl and sufentanil for epidural anesthesia in the first stage of labor. The sufentanil/fentanyl potency ratio was 5.9. This ratio may be used to establish the equivalent doses for fentanyl and sufentanil for epidural analgesia in labor.

REGIONAL ANESTHESIA:

Timo J. Lechner, Maarten G. van Wijk, Ad J. Maas, Frank R. van Dorsten, Ronald A. Drost, Chris J. Langenberg, Leo J. Teunissen, Paul H. Cornelissen, and Jan van Niekerk

Clinical Results with the Acoustic Puncture Assist Device, a New Acoustic Device to Identify the Epidural Space
Anesth Analg 2003 96: 1183-1187. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The authors demonstrate that it is possible to identify the epidural space by an acoustic and visible signal. An experimental setup constructed for this purpose makes the epidural puncture procedure audible and visible.

James C. Crews and Theodore E. Rothman

Seizure After Levobupivacaine for Interscalene Brachial Plexus Block (Case Report)
Anesth Analg 2003 96: 1188-1190. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report describes a patient who demonstrated generalized seizure activity after an injection of 30 mL of levobupivacaine 0.5% for interscalene brachial plexus block. No evidence of cardiovascular toxicity was noted.

Mark Rollins, Warren R. McKay, and Rachel Eshima McKay

Airway Difficulty After a Brachial Plexus Subclavian Perivascular Block (Case Report)
Anesth Analg 2003 96: 1191-1192. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case of upper airway obstruction after subclavian perivascular block in a patient with a preexisting unrecognized paralyzed vocal cord on the opposite side. We discuss the incidence of vocal cord paralysis after subclavian perivascular block and the risk of airway compromise if contralateral vocal cord paralysis is known or suspected.

Annie V. Côté, Claude A. Vachon, Terese T. Horlocker, and Douglas R. Bacon

From Victor Pauchet to Gaston Labat: The Transformation of Regional Anesthesia from a Surgeon’s Practice to the Physician Anesthesiologist (Special Article)
Anesth Analg 2003 96: 1193-1200. [Full Text] [PDF] [Request Permissions]  

GENERAL ARTICLES:

Markus Rehm and Udilo Finsterer

Treating Intraoperative Hyperchloremic Acidosis with Sodium Bicarbonate or Tris-Hydroxymethyl Aminomethane: A Randomized Prospective Study
Anesth Analg 2003 96: 1201-1208. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: By comparing two groups of patients with intraoperative hyperchloremic acidosis receiving equal doses of either sodium bicarbonate or tris-hydroxymethyl aminomethane, we assessed the action of both drugs on acid-base equilibrium. In case of "buffering," the changes in pH were accompanied by, and probably caused by, an increase in strong ion difference.

Mitsuru Shimokawa, Katsuyasu Kitaguchi, Masahiko Kawaguchi, Takanori Sakamoto, Meiko Kakimoto, and Hitoshi Furuya

The Influence of Induced Hypothermia for Hemostatic Function on Temperature-Adjusted Measurements in Rabbits
Anesth Analg 2003 96: 1209-1213. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the influence of induced hypothermia on temperature-adjusted hemostasis function tests in rabbits using Sonoclot Analyzer(R) and Thromboelastography(R). Induced hypothermia delayed the coagulation cascade and reduced platelet function. The conventional coagulation tests performed at 37{degrees}C failed to detect these hypothermia-induced degradations in hemostasis performance.

V. Dimitriou, G. S. Voyagis, C. Iatrou, and J. Brimacombe

A Comparison of the PAxpress^TM and Face Mask Plus Guedel Airway by Inexperienced Personnel After Mannequin-Only Training
Anesth Analg 2003 96: 1214-1217. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ventilation to a target tidal volume of 7 mL/kg in anesthetized, paralyzed adults is equally successful for the PAxpressTM (PAX) and Face Mask/Guedel Airway by inexperienced nurses after mannequin-only training. However, the maximal tidal volume and peak airway pressure is larger and airway trauma more common with the PAX.

Philippe Juvin, Anne Blarel, Fabienne Bruno, and Jean-Marie Desmonts

Is Peripheral Line Placement More Difficult in Obese Than in Lean Patients? (Brief Report)
Anesth Analg 2003 96: 1218. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This work shows that the insertion of a peripheral venous line is more difficult in obese than in lean patients. The usual recommendation, that a central venous line should be inserted routinely in obese patients to perform anesthesia, is not valid.

David L. Hepner and Mariana C. Castells

Latex Allergy: An Update (Review Article)
Anesth Analg 2003 96: 1219-1229. [Full Text] [PDF] [Request Permissions]  

LETTERS TO THE EDITOR:

Hilary P. Grocott, Thomas M. Hemmerling, and Joanne D. Fortier

False Increase BIS Values with Forced-Air Head Warming • Response
Anesth Analg 2003 96: 1230. [Full Text] [PDF] [Request Permissions]  

Bjarte G. Solheim, Anstein Bergan, Frank Brosstad, Robert Innes, and Jan L. Svennevig

Fibrinolysis During Liver Transplant and Use of Solvent/Detergent Virus-Inactivated Plasma (ESDEP®/Octaplas®)
Anesth Analg 2003 96: 1230-1231. [Full Text] [PDF] [Request Permissions]  

Yves Ozier, Claire Rieux, Jeroen de Jonge, Theo H. Groenland, Herold J. Metselaar, Jan N. IJzermans, Huub H. van Vliet, Loes Visser, and Hugo W. Tilanus

Liver Transplantation, Solvent-Detergent Treated Plasma and Antifibrinolytics • Response
Anesth Analg 2003 96: 1231-1232. [Full Text] [PDF] [Request Permissions]  

Takem Shimizu, Shinichi Inomata, and Hidenon Toyooka

Artifactual Dextrocardia Associated with a Defect in the ECG Labeling
Anesth Analg 2003 96: 1232. [Full Text] [PDF] [Request Permissions]  

William H. Rosenblatt and Joy Whipple

The Difficult Airway Algorithm of the American Society of Anesthesiologists
Anesth Analg 2003 96: 1233. [Full Text] [PDF] [Request Permissions]  

Maurizio Fattorutto, George Mychaskiw, II, and Cynthia Vaughn

Massive Hemorrhage During Radiofrequency Ablation of a Pulmonary Neoplasm • Response
Anesth Analg 2003 96: 1233-1234. [Full Text] [PDF] [Request Permissions]  

Sandra Kampe, Christian Pietruck, Christoph Diefenbach, Stephen Hallworth, and Roshan Fernando

Density Determination of Bupivacaine and Bupivacaine-Opioid Mixtures for Spinal Anesthesia • Response
Anesth Analg 2003 96: 1234-1235. [Full Text] [PDF] [Request Permissions]  

Stephan K.W. Schwarz, Connail McCrory, and Sten G. E. Lindahl

COX-2 Inhibition for Postoperative Analgesia • Response
Anesth Analg 2003 96: 1235. [Full Text] [PDF] [Request Permissions]  

Michael E. Goldberg, Muhammad A. Munir, and Shelby Chien

Entrapment of an Exchange Wire by an Inferior Vena Caval Filter: A Technique for Removal • Response
Anesth Analg 2003 96: 1235-1236. [Full Text] [PDF] [Request Permissions]  

Kevin Coonan

Comparison of Computer Based and Patient Simulator Based Crisis
Anesth Analg 2003 96: 1236. [Full Text] [PDF] [Request Permissions]  

Wendy M. Fallis and Daniel I. Sessler

Temperature Measurements • Response
Anesth Analg 2003 96: 1236-1237. [Full Text] [PDF] [Request Permissions]  

Timothy Angelotti and Eric Rey Amador

Right Subclavian Artery Injury
Anesth Analg 2003 96: 1237. [Full Text] [PDF] [Request Permissions]  

Donald H. Lambert, Julia E. Pollock, and Elizabeth Alley

Virginia Mason Medical Center’s Promotion of Outpatient Lidocaine Spinal Anesthesia Questioned • Response
Anesth Analg 2003 96: 1237-1238. [Full Text] [PDF] [Request Permissions]  

Denis L. Bourke and Molouk Sadeghi

A Warm Bed
Anesth Analg 2003 96: 1238. [Full Text] [PDF] [Request Permissions]  

W. J. Fawcett and Robert Friedman

Ketamine for Restless Legs Syndrome • Response
Anesth Analg 2003 96: 1238-1239. [Full Text] [PDF] [Request Permissions]  

Ban C. H. Tsui and Dominic Cave

Discoloration of Parenteral Ondansetron
Anesth Analg 2003 96: 1239. [Full Text] [PDF] [Request Permissions]  

Hirokatsu Toyoyama, Wakaba Minami, and Yoshiro Toyoda

Possible Right Lung Isolation By Blocking the Tracheal Bronchus with only a Univent Tube for Some Patients
Anesth Analg 2003 96: 1239. [Full Text] [PDF] [Request Permissions]  

Frank Wappler, Petra Bischoff, George D. Politis, and Mark S. Quigg

Is Fast Induction with Sevoflurane Associated with an Increased Anesthetic Risk in Pediatric Patients? • Response
Anesth Analg 2003 96: 1239-1240. [Full Text] [PDF] [Request Permissions]  

Clair S. Weenig, Alexander Kober, and Klaus H. Hoerauf

Improving Pulse Oximetry Signal Quality • Response
Anesth Analg 2003 96: 1240. [Full Text] [PDF] [Request Permissions]  

Jae-Hyon Bahk, Alexander Ng, David Raitt, and Graham Smith

Insertion of a Laryngeal Mask Airway in the Prone Position • Response
Anesth Analg 2003 96: 1241. [Full Text] [PDF] [Request Permissions]  

Steven M. Neustein, Tiberiu Ezri, Marian Weisenberg, and Peter Szmuk

Indirect Intubation • Response
Anesth Analg 2003 96: 1241-1242. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Joseph M. Garfield

Anesthesia and Co-Existing Disease, 4th Edition • Books and Multimedia Received
Anesth Analg 2003 96: 1243. [Full Text] [PDF] [Request Permissions]  

ERRATA:

Anesth Analg 2003 96: 958. [Full Text] [PDF] [Request Permissions]  

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