EDITORIALS:

Michael R. Pinsky

Probing the Limits of Arterial Pulse Contour Analysis to Predict Preload Responsiveness
Anesth Analg 2003 96: 1245-1247. [Full Text] [PDF] [Request Permissions]  

Jonas S. Johansson

Noninactivating Tandem Pore Domain Potassium Channels as Attractive Targets for General Anesthetics
Anesth Analg 2003 96: 1248-1250. [Full Text] [PDF] [Request Permissions]  

Linda S. Polley and Malachy O. Columb

Ropivacaine and Bupivacaine: Concentrating on Dosing!
Anesth Analg 2003 96: 1251-1253. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Christoph Wiesenack, Christopher Prasser, Gabriele Rödig, and Cornelius Keyl

Stroke Volume Variation as an Indicator of Fluid Responsiveness Using Pulse Contour Analysis in Mechanically Ventilated Patients
Anesth Analg 2003 96: 1254-1257. [Abstract] [Full Text] [PDF] [Request Permissions]  

Sophie Provenchère, Gaetan Plantefève, Gilles Hufnagel, Eric Vicaut, Cyrille de Vaumas, Jean-Baptiste Lecharny, Jean-Pol Depoix, François Vrtovsnik, Jean-Marie Desmonts, and Ivan Philip

Renal Dysfunction After Cardiac Surgery with Normothermic Cardiopulmonary Bypass: Incidence, Risk Factors, and Effect on Clinical Outcome
Anesth Analg 2003 96: 1258-1264. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We found that postoperative renal dysfunction was a frequent and severe complication after normothermic cardiac surgery, independently associated with poor outcome. Independent predictors of this complication were advanced age, active endocarditis, and recent (within 48 h) radiocontrast agent administration (the only preoperative modifiable factor), as well as postoperative hemodynamic dysfunction.

Duminda N. Wijeysundera, Vivek Rao, W. Scott Beattie, Joan Ivanov, and Keyvan Karkouti

Evaluating Surrogate Measures of Renal Dysfunction After Cardiac Surgery
Anesth Analg 2003 96: 1265-1273. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A convenient surrogate measure of renal function is needed for evaluating renal-protective therapies in cardiac surgery. We evaluated the performance of serum creatinine concentration and calculated creatinine clearance for predicting dialysis, mortality, and prolonged hospitalization. Both measures were correlated with clinical outcomes. Creatinine clearance had the advantage of a distribution suitable for parametric statistical tests.

Colin F. Royse, Alistair G. Royse, Christina T. Wong, and Paul F. Soeding

The Effect of Pericardial Restraint, Atrial Pacing, and Increased Heart Rate on Left Ventricular Systolic and Diastolic Function in Patients Undergoing Cardiac Surgery
Anesth Analg 2003 96: 1274-1279. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pericardial restraint or the institution of atrial pacing do not alter left ventricular function, as assessed by pulmonary artery catheter and transesophageal echocardiography measurements. Diastolic (but not systolic) measurements showed inconsistency with increased heart rate.

Barna Babik, Tibor Asztalos, Ferenc Peták, Zoltán I. Deák, and Zoltán Hantos

Changes in Respiratory Mechanics During Cardiac Surgery
Anesth Analg 2003 96: 1280-1287. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We observed that cardiopulmonary bypass deteriorates lung function by inducing a heterogeneous airway constriction, whereas no such effects were observed in patients undergoing cardiac surgery without bypass. The impairment in parenchymal mechanics, which was obtained in both groups, may result from peripheral airway closure and/or be a consequence of mediator release.

Idar Kirkeby-Garstad, Arve Tromsdal, Olav F. M. Sellevold, Mads Bjørngaard, Lise K. Bjella, Einar M. Berg, Asbjørn Karevold, Rune Haaverstad, Alexander Wahba, Ole Tjomsland, Rafael Astudillo, Arne Krogstad, and Roar Stenseth

Guiding Surgical Cannulation of the Inferior Vena Cava with Transesophageal Echocardiography
Anesth Analg 2003 96: 1288-1293. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Correct positioning of the venous cannula draining blood to the cardiopulmonary bypass circuit is important. Intraoperative transesophageal echocardiography allows satisfactory determination of the cannula position in nearly all patients. Ten percent of venous cannulae are primarily positioned in the right hepatic vein and not in the inferior vena cava as intended.

Mihai V. Podgoreanu, George N. Djaiani, Elizabeth Davis, Barbara Phillips-Bute, and Joseph P. Mathew

Quantitative Echocardiographic Assessment of Regional Wall Motion and Left Ventricular Asynchrony with Color Kinesis in Cardiac Surgery Patients
Anesth Analg 2003 96: 1294-1300. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Quantitative color kinesis allows for objective and sensitive intraoperative echocardiographic assessment of abnormal spatial and temporal patterns of regional ventricular wall motion, with potentially important implications for improving myocardial ischemia detection in patients undergoing cardiac surgery.

Glenn S. Murphy, Joseph W. Szokol, Jesse H. Marymont, Jeffery S. Vender, Michael J. Avram, Todd K. Rosengart, and Eihab A. Alwawi

Recovery of Neuromuscular Function After Cardiac Surgery: Pancuronium Versus Rocuronium
Anesth Analg 2003 96: 1301-1307. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The use of long-acting muscle relaxants in fast-track cardiac surgical patients is associated with significant residual neuromuscular block in the intensive care unit, including signs and symptoms of residual paresis.

Akihiro Suzuki, Zeljko J. Bosnjak, and Wai-Meng Kwok

The Effects of Isoflurane on the Cardiac Slowly Activating Delayed-Rectifier Potassium Channel in Guinea Pig Ventricular Myocytes
Anesth Analg 2003 96: 1308-1315. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effects of a volatile anesthetic, isoflurane, were determined on a cardiac potassium channel current, IKs, a major ionic component underlying the cardiac action potential. The result shows that IKs is significantly inhibited by isoflurane. This may contribute to anesthetic-induced changes in the electrocardiogram, particularly the prolongation of the QT interval.

TECHNICAL COMMUNICATIONS:

Andreas Koster, Derek Chew, Marcus Gründel, Harald Hausmann, Onnen Grauhan, Herman Kuppe, and Bruce D. Spiess

An Assessment of Different Filter Systems for Extracorporeal Elimination of Bivalirudin: An In Vitro Study
Anesth Analg 2003 96: 1316-1319. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bivalirudin is a new, direct thrombin inhibitor. We investigated the extracorporeal elimination rate of different hemofilters and one plasmapheresis filter for bivalirudin. Our data show that bivalirudin can be effectively eliminated via hemofiltration and plasmapheresis, although there were significant differences in the elimination rates among the filter systems investigated.

PEDIATRIC ANESTHESIA:

Robert D. Valley, Eugene B. Freid, Ann G. Bailey, Vincent J. Kopp, Linda S. Georges, James Fletcher, and Anne Keifer

Tracheal Extubation of Deeply Anesthetized Pediatric Patients: A Comparison of Desflurane and Sevoflurane
Anesth Analg 2003 96: 1320-1324. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Deep extubation of children can be performed safely with desflurane or sevoflurane. Airway problems occur more frequently with desflurane. Awakening occurs more quickly with desflurane. Midazolam premedication has a greater effect on emergence times than does the choice of inhaled anesthetic. Emergence agitation occurs frequently with either technique.

Marie T. Aouad, Sahar S. Sayyid, Mirna I. Zalaket, and Anis S. Baraka

Intravenous Lidocaine as Adjuvant to Sevoflurane Anesthesia for Endotracheal Intubation in Children (Brief Report)
Anesth Analg 2003 96: 1325-1327. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Supplementing a sevoflurane induction of anesthesia in children with IV lidocaine 2 mg/kg can suppress cough after tracheal intubation and thus improve intubating conditions. In addition, lidocaine minimizes blood pressure fluctuations after tracheal intubation.

AMBULATORY ANESTHESIA:

Candace Sabers, David J. Plevak, Darrell R. Schroeder, and David O. Warner

The Diagnosis of Obstructive Sleep Apnea as a Risk Factor for Unanticipated Admissions in Outpatient Surgery
Anesth Analg 2003 96: 1328-1335. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In patients scheduled for outpatient surgery in a large academic practice, the diagnosis of obstructive sleep apnea confirmed by polysomnography was not an independent risk factor for unanticipated hospital admission or for other adverse perioperative events.

Mahmut Durmus, Gedik Ender, But A. Kadir, Gulhas Nurcin, Ozturk Erdogan, and M. Ozcan Ersoy

Remifentanil With Thiopental for Tracheal Intubation Without Muscle Relaxants
Anesth Analg 2003 96: 1336-1339. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated in a double-blinded manner the dose requirements for remifentanil with thiopental without muscle relaxants for obtaining acceptable intubation condition. Our results show that remifentanil 4 {micro}g/kg administered before thiopental provided excellent or satisfactory intubation condition in 94% of patients.

ANESTHETIC PHARMACOLOGY:

Woo-Jong Shin and Bruce D. Winegar

Modulation of Noninactivating K⁺ Channels in Rat Cerebellar Granule Neurons by Halothane, Isoflurane, and Sevoflurane
Anesth Analg 2003 96: 1340-1344. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The volatile anesthetics halothane, isoflurane, and sevoflurane, reversibly enhanced a noninactivating outwardly rectifying K+ current in rat cerebellar granule neurons. These findings support a model of anesthesia that includes a site of action at baseline K+ channels.

Karin M. Gerstin, Diane H. Gong, Mona Abdallah, Bruce D. Winegar, Edmond I Eger, II, and Andrew T. Gray

Mutation of KCNK5 or Kir3.2 Potassium Channels in Mice Does Not Change Minimum Alveolar Anesthetic Concentration
Anesth Analg 2003 96: 1345-1349. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Mice harboring mutations in either of two different potassium channels have minimum alveolar anesthetic concentration (MAC) values that do not differ from MAC values found in control mice. Such findings do not support the notion that these potassium channels mediate the capacity of inhaled anesthetics to produce immobility in the face of noxious stimulation.

Edmond I Eger, II, Yilei Xing, Michael Laster, James Sonner, Joseph F. Antognini, and Earl Carstens

Halothane and Isoflurane Have Additive Minimum Alveolar Concentration (MAC) Effects in Rats
Anesth Analg 2003 96: 1350-1353. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Despite differences in their capacities to inhibit spinal dorsal horn cells, isoflurane and halothane are additive in their ability to suppress movement in response to a noxious stimulus.

Gong Cheng and Joan J. Kendig

Enflurane Decreases Glutamate Neurotransmission to Spinal Cord Motor Neurons by Both Pre- and Postsynaptic Actions
Anesth Analg 2003 96: 1354-1359. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Explanations proposed for anesthetic-induced central nervous system depression include enhancement of synaptic inhibition and depression of excitation. The results reported herein suggest that, in the case of enflurane, the mechanism is a shift in the balance toward inhibition. Excitation is uniformly depressed by multiple mechanisms, whereas some anesthetic actions tend to enhance inhibition.

Ken B. Johnson, Talmage D. Egan, Jennifer Layman, Steven E. Kern, Julia L. White, and Scott W. McJames

The Influence of Hemorrhagic Shock on Etomidate: A Pharmacokinetic and Pharmacodynamic Analysis
Anesth Analg 2003 96: 1360-1368. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Hemorrhagic shock produced minimal changes in the pharmacokinetics and no change in the pharmacodynamics of etomidate in swine. These results suggest that, unlike other sedative hypnotics and opioids, minimal adjustment in the dose of etomidate is required to achieve the same drug effect during hemorrhagic shock.

Sungsam Cho, Shiping Zhang, Hiroyuki Ureshino, Tetsuya Hara, Shiro Tomiyasu, and Koji Sumikawa

Hemodynamic Interactions of Propofol and Dantrolene in Chronically Instrumented Dogs
Anesth Analg 2003 96: 1369-1373. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our study suggests that dantrolene reverses the hypotensive action produced by propofol and causes an increase in coronary blood flow with a decrease in coronary vascular resistance, but does not significantly change the negative inotropic effects.

Juraj Sprung, Faisal M. Choudhry, and Brian A. Hall

Extrapyramidal Reactions to Ondansetron: Cross-Reactivity Between Ondansetron and Prochlorperazine? (Case Report)
Anesth Analg 2003 96: 1374-1376. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ondansetron can rarely induce extrapyramidal reactions in susceptible individuals. Our patient had a history of drug-induced dystonic reaction; therefore, these patients may be susceptible to extrapyramidal adverse reactions after ondansetron.

Ashraf S. Habib and Tong J. Gan

Food and Drug Administration Black Box Warning on the Perioperative Use of Droperidol: A Review of the Cases (Brief Report)
Anesth Analg 2003 96: 1377-1379. [Full Text] [PDF] [Request Permissions]  

TECHNOLOGY, COMPUTING, AND SIMULATION:

Maurizio Renna, Jonathan Handy, and Ajit Shah

Low Baseline Bispectral Index of the Electroencephalogram in Patients with Dementia
Anesth Analg 2003 96: 1380-1385. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This prospective, controlled, observational study demonstrates that electroencephalogram slowing associated with dementia affects the Bispectral Index of the electroencephalogram. A significant proportion of patients with dementia have a lower than normal "awake" Bispectral Index.

PAIN MEDICINE:

Tomoki Nishiyama and Kazuo Hanaoka

Midazolam Can Potentiate the Analgesic Effects of Intrathecal Bupivacaine on Thermal- or Inflammatory-Induced Pain
Anesth Analg 2003 96: 1386-1391. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In both acute thermal- and inflammatory-induced pain, intrathecally administered midazolam and bupivacaine produced synergistic analgesia with decreased side effects in intrathecally catheterized rats.

E. Eisenberg, M. Konopniki, E. Veitsman, R. Kramskay, D. Gaitini, and Y. Baruch

Prevalence and Characteristics of Pain Induced by Percutaneous Liver Biopsy
Anesth Analg 2003 96: 1392-1396. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Percutaneous liver biopsy is a painful procedure in most patients. Mild anxiolytic treatment plus local anesthetic infiltration seem to produce insufficient analgesia. A more profound analgesic treatment is required for better control of this pain.

Christian Pietruck, Stefan Grond, Guo-Xi Xie, and Pamela P. Palmer

Local Anesthetics Differentially Inhibit Sympathetic Neuron-Mediated and C Fiber-Mediated Synovial Neurogenic Plasma Extravasation
Anesth Analg 2003 96: 1397-1402. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Local anesthetic wound irrigation is often used to treat postoperative surgical pain. Large concentrations of local anesthetics are usually used, and these concentrations may have possible neurotoxic and myotoxic effects. Our results demonstrate antiinflammatory effects of lidocaine and bupivacaine at concentrations smaller than used clinically.

Yoo-Jin Kang and James C. Eisenach

Intrathecal Clonidine Reduces Hypersensitivity After Nerve Injury by a Mechanism Involving Spinal m4 Muscarinic Receptors
Anesth Analg 2003 96: 1403-1408. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Neuraxial clonidine is an effective adjunct in the treatment of neuropathic pain and increases acetylcholine concentrations in cerebrospinal fluid in humans. These data in animals suggest that spinal m4 type muscarinic receptors are important to the effect of clonidine in treating hypersensitivity to touch after nerve injury.

Hong Ma, Jun Tang, Paul F. White, Ronald H. Wender, Thomas Leverone, Rayond Quon, Scott Pearce, Franklin Chiao, and Susan Erice

The Effect of Clonidine on Gastrointestinal Side Effects Associated with Ultra-Rapid Opioid Detoxification (Special Article)
Anesth Analg 2003 96: 1409-1412. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Clonidine, an {alpha}2-adrenergic agonist, is used to minimize withdrawal symptoms related to ultra-rapid opioid detoxification procedures. These preliminary data suggest that clonidine possesses dose-related antidiarrheal activity.

Santhanam Suresh, Sara Lozono, and Steven C. Hall

Large-Dose Intravenous Methotrexate-Induced Cutaneous Toxicity: Can Oral Magnesium Oxide Reduce Pain? (Case Report)
Anesth Analg 2003 96: 1413-1414. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Chemotherapy for cancer is associated with pain including cutaneous vasculitis. Magnesium, an N-methyl-D-aspartic acid-receptor antagonist, was used successfully to treat an adolescent with pain caused by cutaneous vasculitis secondary to methotrexate therapy.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Eric Marcon, Saïd Kharraja, Nicole Smolski, Brigitte Luquet, and Jean Paul Viale

Determining the Number of Beds in the Postanesthesia Care Unit: A Computer Simulation Flow Approach
Anesth Analg 2003 96: 1415-1423. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Designing new operating room (OR) facilities implies many decisions on the number of ORs, postanesthesia care unit (PACU) beds, and on the staff of nurses and porters. To make these decisions, managers can use rules of thumb or recommendations. Our study highlights the interest of using flow simulation to validate these choices. In this case study we determine the number of PACU beds and porter staff and assess the impact of decreasing the number of porters on PACU bed requirements.

Anna Lee, Po Tong Chui, and Tony Gin

Educating Patients About Anesthesia: A Systematic Review of Randomized Controlled Trials of Media-Based Interventions
Anesth Analg 2003 96: 1424-1431. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effectiveness of media-based interventions for educating patients about general process and risks of anesthesia were compared in this systematic review. The use of video and/or printed information can decrease patient anxiety and increase patient knowledge. However, patient satisfaction was similar between media-based intervention and nonintervention groups.

Kevin K. Tremper, Steven J. Barker, Simon Gelman, Joseph G. Reves, Albert J. Saubermann, Amy M. Shanks, Mary Lou V.H. Greenfield, and Suzanne T. Anderson

A Demographic, Service, and Financial Survey of Anesthesia Training Programs in the United States
Anesth Analg 2003 96: 1432-1446. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A survey was conducted of anesthesia training program directors that demonstrated that their departments' financial conditions have been eroding over the years 2000 to 2002. During this same period of time, departments were receiving an increase in institutional support from $34,319/full-time equivalent (FTE) faculty in the year 2000 to $59,680/FTE in the year 2002. Although there seems to be an approximate 10% shortage in academic faculty, the number of departments with open positions has progressively decreased from 91% to 73% over the past 3 yr. On average, the financial condition of the training departments has deteriorated over the past 3 yr despite a significant increase in institutional support to enable departments to recruit and retain faculty in an era of an apparent national shortage of anesthesiologists.

CRITICAL CARE AND TRAUMA:

Alexander Kober, Thomas Scheck, Freia Tschabitscher, Stefanie Wiltschnig, Sabine Sator-Katzenschlager, Werner Madei, Burkhard Gustorff, and Klaus Hoerauf

The Influence of Local Active Warming on Pain Relief of Patients with Cholelithiasis During Rescue Transport
Anesth Analg 2003 96: 1447-1452. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Active local warming of the upper abdomen is an effective treatment for patients with cholelithiasis being transported to the hospital by paramedics who are not permitted to provide any drug-based pain care. We observed no negative side effects of this treatment.

NEUROSURGICAL ANESTHESIA:

Thomas A. Neff, Martin Doelberg, Cornelius Jungheinrich, Andrea Sauerland, Donat R. Spahn, and Reto Stocker

Repetitive Large-Dose Infusion of the Novel Hydroxyethyl Starch 130/0.4 in Patients with Severe Head Injury
Anesth Analg 2003 96: 1453-1459. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There are concerns that infusion of certain hydroxyethyl starch (HES) types for plasma volume expansion may influence coagulation and renal function. We investigated the safety of the novel HES 130/0.4 in patients with severe cranio-cerebral trauma. The repetitive HES doses administered in this study are the largest reported in the literature.

Kirstin M. Erickson and William L. Lanier

Anesthetic Technique Influences Brain Temperature, Independently of Core Temperature, During Craniotomy in Cats
Anesth Analg 2003 96: 1460-1466. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Deep barbiturate anesthesia reduced brain temperature independently of body temperature in cats and significantly more than the reduction seen with halothane anesthesia. The magnitude of temperature reduction was sufficient to account for cerebral protection by barbiturates independently of any other properties of the drug.

Huagang Hou, Oleg Y. Grinberg, Satoshi Taie, Steve Leichtweis, Minoru Miyake, Stalina Grinberg, Haiyi Xie, Marie Csete, and Harold M. Swartz

Electron Paramagnetic Resonance Assessment of Brain Tissue Oxygen Tension in Anesthetized Rats
Anesth Analg 2003 96: 1467-1472. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Using in vivo electron paramagnetic resonance oximetry, we studied the patterns of cerebral tissue oxygenation (PtO2) during exposure to various inhaled and injected general anesthetics, and to varying levels of inspired oxygen. These data show that inhaled anesthetics result in larger levels of PtO2 in the brain than do several injectable anesthetics. The results highlight the experimental utility of electron paramagnetic resonance in measuring PtO2 during anesthesia and serve as a foundation for further study of PtO2 in response to physiologic perturbations and therapeutic interventions directed at preventing cerebral ischemia.

OBSTETRIC ANESTHESIA:

Stephen H. Halpern and Vivien Walsh

Epidural Ropivacaine Versus Bupivacaine for Labor: A Meta-Analysis
Anesth Analg 2003 96: 1473-1479. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This metaanalysis of 23 randomized controlled trials shows that both ropivacaine and bupivacaine provide excellent labor analgesia. There was no significant difference between the two drugs in mode of delivery, maternal satisfaction, or neonatal outcomes. Whether or not there is a difference in motor block at clinically relevant doses is unresolved.

Frank A. Chervenak, Laurence B. McCullough, and David J. Birnbach

Ethics: An Essential Dimension of Clinical Obstetric Anesthesia (Review Article)
Anesth Analg 2003 96: 1480-1485. [Full Text] [PDF] [Request Permissions]  

Joaquín Hernández-Palazón, J. Pablo Puertas-García, Juan F. Martínez-Lage, and José A. Tortosa

Lumbar Spondylodiscitis Caused by Propionibacterium acnes After Epidural Obstetric Analgesia (Case Report)
Anesth Analg 2003 96: 1486-1488. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case of Propionibacterium acnes spondylodiscitis after the placement of an epidural catheter for obstetric analgesia. This observation should alert the anesthesiologist to the fact that infection, although rare, may occur after uneventful epidural analgesia in the healthy parturient and reinforces the importance of aseptic technique during epidural catheter insertion.

Philip J. Balestrieri and J. E. Ferguson, II

Management of a Parturient with a History of Local Anesthetic Allergy (Case Report)
Anesth Analg 2003 96: 1489-1490. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The management of parturients with a strong history of allergy to local anesthetics poses significant challenges to the obstetric anesthesiologist. We recommend that when such patients have a strong desire to receive labor analgesia with local anesthetics, they undergo provocative challenge testing with preservative-free bupivacaine performed in labor and delivery with preparations for emergent cesarean delivery after 24-wk gestation.

REGIONAL ANESTHESIA:

Joachim Klasen, Axel Junger, Bernd Hartmann, Matthias Benson, Andreas Jost, Anne Banzhaf, Myron Kwapisz, and Gunter Hempelmann

Differing Incidences of Relevant Hypotension with Combined Spinal-Epidural Anesthesia and Spinal Anesthesia
Anesth Analg 2003 96: 1491-1495. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study, based on a large number of patients with a retrospective design by using on-line recorded data, suggests that spinal anesthesia as part of combined spinal-epidural anesthesia may more often lead to relevant hypotension than spinal anesthesia alone. Preexisting arterial hypertension and a sensory block height exceeding T6 are major risk factors for the development of this complication.

I. Dobrydnjov, K. Axelsson, S.-E. Thörn, P. Matthiesen, H. Klockhoff, B. Holmström, and A. Gupta

Clonidine Combined with Small-Dose Bupivacaine During Spinal Anesthesia for Inguinal Herniorrhaphy: A Randomized Double-Blinded Study
Anesth Analg 2003 96: 1496-1503. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The addition of clonidine 15 {micro}g to 6 mg of hyperbaric bupivacaine increases the spread of analgesia, prolongs the time to first analgesic request, and decreases postoperative pain, compared with bupivacaine alone, during inguinal herniorrhaphy under spinal anesthesia.

GENERAL ARTICLES:

Kathrine Holte, Peter Jensen, and Henrik Kehlet

Physiologic Effects of Intravenous Fluid Administration in Healthy Volunteers
Anesth Analg 2003 96: 1504-1509. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Infusion of 40 mL/kg of lactated Ringer's solution in volunteers led to a significant decrease in pulmonary function and a significant weight gain for 24 h but without effects on exercise capacity. These findings may serve as basis information for clinical studies of perioperative fluid management.

Jérôme Frappier, Thierry Guenoun, Didier Journois, Hervé Philippe, Emma Aka, Philippe Cadi, Jacqueline Silleran-Chassany, and Denis Safran

Airway Management Using the Intubating Laryngeal Mask Airway for the Morbidly Obese Patient
Anesth Analg 2003 96: 1510-1515. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The intubating laryngeal mask airway (ILMA) provides an additional technique for airway management of morbidly obese patients. The best choice of the primary technique (laryngoscopy or ILMA) for tracheal intubation of an adult obese patient remains to be determined.

Kyung Y. Yoo, Sung T. Jeong, In H. Ha, and JongUn Lee

Nitrous Oxide Attenuates Pressor but Augments Norepinephrine Response to Laryngoscopy and Endotracheal Intubation
Anesth Analg 2003 96: 1516-1521. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined whether nitrous oxide modifies the cardiovascular response to endotracheal intubation because it activates the sympathetic nervous system. Nitrous oxide attenuated the pressor response, whereas it augmented the norepinephrine response to laryngoscopy and endotracheal intubation.

MEETING REPORT:

John W. Sear and James G. Bovill

Report of the 11th Annual Meeting of ISAP (International Society of Anaesthetic Pharmacology—formerly SIVA)
Anesth Analg 2003 96: 1522-1525. [Full Text] [PDF] [Request Permissions]  

LETTERS TO THE EDITOR:

Sam Golden

Surgical Stress Response in Neonates and Premature Infants
Anesth Analg 2003 96: 1526. [Full Text] [PDF] [Request Permissions]  

Hsiu-chin Chou and Tzu-lang Wu

Thyromental Distance and Anterior Larynx: Misconception and Misnomer?
Anesth Analg 2003 96: 1526-1527. [Full Text] [PDF] [Request Permissions]  

Mari Hasei

The Inexpensive and Easy-to-Use Stopper to Reduce the Leakage of Waste Anesthetic Gases During Inhaled Induction
Anesth Analg 2003 96: 1527. [Full Text] [PDF] [Request Permissions]  

Felipe Urdaneta

TEE Probe via Endoscopy Mask: The Right Thing at the Wrong Time?
Anesth Analg 2003 96: 1527-1528. [Full Text] [PDF] [Request Permissions]  

Jae-Hyon Bahk, Yun-Seok Jeon, Kirstin M. Erickson, Mark T. Keegan, Gerard S. Kamath, and Barry A. Harrison

Selection of an Endotracheal Tube for Device-Guided Intubation • Response
Anesth Analg 2003 96: 1528-1529. [Full Text] [PDF] [Request Permissions]  

Muhammad A. Munir, Muhammad Jaffar, Michael F. Mulroy, and Blake Mitchell

A Further Consideration on Unsolicited Paresthesias with Nerve Stimulator • Response
Anesth Analg 2003 96: 1529. [Full Text] [PDF] [Request Permissions]  

Yoshihisa Fujita, Atsuo Sari, and Tokunori Yamamoto

On-line Monitoring of Systolic Pressure Variation
Anesth Analg 2003 96: 1529-1530. [Full Text] [PDF] [Request Permissions]  

Spyros D. Mentzelopoulos, Kostantinos V. Rellos, George L. Magoufis, Chrysoula S. Gini, Stavros Tobris, and Argyris S. Michalopoulos

Combined McCoy and Balloon Laryngoscopy for the Emergency Airway Management of a Patient with Acute Postoperative Airway Obstruction Due to Extreme Engorgement of the Tongue
Anesth Analg 2003 96: 1531. [Full Text] [PDF] [Request Permissions]  

Bruce Ben-David and Jacques E. Chelly

Current Channeling: A Theory of Nerve Stimulator Failure
Anesth Analg 2003 96: 1531-1532. [Full Text] [PDF] [Request Permissions]  

James F. Mayhew and Susan T. Verghese

A More Dilute Concentration of Bupivacaine in a Larger Volume Can Be Effective in Blocking Spermatic Cord Traction Response in Orchidopexy • Response
Anesth Analg 2003 96: 1532. [Full Text] [PDF] [Request Permissions]  

Scott Groudine, Elliot Greene, Masayuki Ozaki, Kouichiro Minami, and Akio Shigematsu

Multiple Injections with the Same Syringe Increase the Risk of Contamination • Response
Anesth Analg 2003 96: 1532-1533. [Full Text] [PDF] [Request Permissions]  

Masayuki Arakawa, Asokumar Buvanendran, Jeffrey S. Kroin, and Kenneth J. Tuman

Intrathecal Magnesium Prolongs Fentanyl Analgesia • Response
Anesth Analg 2003 96: 1533. [Full Text] [PDF] [Request Permissions]  

Kuo-Ying Lee, An-Kuo Chou, Lin-Cheng Yang, Hartmut Buerkle, and Akira Kudoh

NMDA Receptors Offer More Than One Functionality • Response
Anesth Analg 2003 96: 1533-1534. [Full Text] [PDF] [Request Permissions]  

Yvon Bryan and David Glick

Effects of Anesthesia on Linguistic Skills
Anesth Analg 2003 96: 1534. [Full Text] [PDF] [Request Permissions]  

Gita Rupani

Refilling a Tec 6 Desflurane Vaporizer
Anesth Analg 2003 96: 1534-1535. [Full Text] [PDF] [Request Permissions]  

Harald V. Genzwuerker, Harry Roth, Joachim Schmeck, J. Brimacombe, K. Hill, and C. Keller

Comparing Laryngeal Mask Airway ProSeal and Laryngeal Tube • Response
Anesth Analg 2003 96: 1535-1536. [Full Text] [PDF] [Request Permissions]  

Perry G. Nystrom

Reverse Assembly of a Double-Lumen Tube
Anesth Analg 2003 96: 1536. [Full Text] [PDF] [Request Permissions]  

Bruce Ben-David and Jacques E. Chelly

Continuous Peripheral Neural Blockade for Postoperative Analgesia: Practical Advantages
Anesth Analg 2003 96: 1537. [Full Text] [PDF] [Request Permissions]  

Joel B. Gunter and Robert H. Friesen

Fasting, Halothane, and Hypotension • Response
Anesth Analg 2003 96: 1537-1538. [Full Text] [PDF] [Request Permissions]  

Mitsuru Uzuki, Noriaki Kanaya, Aki Mizuguchi, Saori Kurosawa, Masayasu Nakayama, Keiichi Omote, and Akiyoshi Namiki

One-Lung Ventilation Using a New Bronchial Blocker in a Patient with Tracheostomy Stoma
Anesth Analg 2003 96: 1538-1539. [Full Text] [PDF] [Request Permissions]  

Tom Ruttmann and Vance G. Nielsen

Hemodilution-Induced Hypercoagulability • Response
Anesth Analg 2003 96: 1539-1540. [Full Text] [PDF] [Request Permissions]  

Wolfram Schummer, Claudia Schummer, Rosemarie Fröber, and Narong Kulvatunyou

Internal Jugular Vein and Anatomic Relationship at the Root of the Neck • Response
Anesth Analg 2003 96: 1540-1541. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Peter L. McDermott, Bonnie Milas, and Richard B. Patt

Careers in Anesthesiology: Autobiographical Memoirs, Volume VII • TEE: An Interactive Board Review on CD-ROM • Principles and Practice of Palliative Care and Supportive Oncology, 2nd Edition • Books and Multimedia Received
Anesth Analg 2003 96: 1542-1544. [Full Text] [PDF] [Request Permissions]  

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