EDITORIALS:

Michael K. Nicholas

Managed Care Policies and Pain Management Programs
Anesth Analg 2003 97: 1. [Full Text]  

CARDIOVASCULAR ANESTHESIA:

Marie-Hélène Fléron, Richard B. Weiskopf, Michèle Bertrand, Stéphane Mouren, Daniel Eyraud, Gilles Godet, Bruno Riou, Edouard Kieffer, and Pierre Coriat

A Comparison of Intrathecal Opioid and Intravenous Analgesia for the Incidence of Cardiovascular, Respiratory, and Renal Complications After Abdominal Aortic Surgery
Anesth Analg 2003 97: 2-12. [Abstract] [Full Text]  

IMPLICATIONS: Provision of intense analgesia for the initial postoperative period after major abdominal vascular surgery, via the administration of neuraxial opioid, does not alter the combined incidence of major cardiovascular, respiratory, and renal complications.

D. Harmon, E. Coleman, C. Marshall, W. Lan, and G. Shorten

The Effect of Clomethiazole on Plasma Concentrations of Interleukin-6, -8, -1ß, Tumor Necrosis Factor-, and Neutrophil Adhesion Molecule Expression During Experimental Extracorporeal Circulation
Anesth Analg 2003 97: 13-18. [Abstract] [Full Text]  

IMPLICATIONS: Enhancement of {gamma}-aminobutyric acidA-mediated effects by clomethiazole (CMZ) and associated neuroprotection has been established in animal models of cerebral ischemia. In an ex vivo study, we demonstrated antiinflammatory activity of CMZ in experimental extracorporeal circulation. This represents a potential neuroprotective mechanism of CMZ in patients undergoing coronary artery bypass surgery.

Takashi Okamoto, Junichi Ogata, and Kouichiro Minami

Sino-Atrial Block During Anesthesia in a Patient with Breast Cancer Being Treated with the Anticancer Drug Epirubicin (Case Report)
Anesth Analg 2003 97: 19-20. [Abstract] [Full Text]  

IMPLICATIONS: Epirubicin, an anticancer drug, causes cardiotoxicity. We reported a case of sino-atrial block during general anesthesia in a woman with breast cancer who had received epirubicin. Anesthesiologists should be aware of the possible occurrence of sino-atrial block with epirubicin, and planting a pacemaker might be considered even in asymptomatic patients.

PEDIATRIC ANESTHESIA:

Roman Schumann

Intraoperative Resource Utilization in Anesthesia for Liver Transplantation in the United States: A Survey
Anesth Analg 2003 97: 21-28. [Abstract] [Full Text]  

IMPLICATIONS: Currently no comprehensive data are available describing the intraoperative use of laboratory tests, personnel, infusion and perfusion equipment, monitoring technology, and veno-venous bypass by liver transplantation programs. These postal survey results provide an overview of utilization of these resources in anesthesia for liver transplantation.

Heinz Bruppacher, Adrian Reber, Jürg P. Keller, Jeremy Geiduschek, Thomas O. Erb, and Franz J. Frei

The Effects of Common Airway Maneuvers on Airway Pressure and Flow in Children Undergoing Adenoidectomies
Anesth Analg 2003 97: 29-34. [Abstract] [Full Text]  

IMPLICATIONS: Airway maneuvers are often used in anesthetized children to relieve airway obstruction during spontaneous ventilation. Compared with chin lift and continuous positive airway pressure, the jaw thrust maneuver was the most effective to improve airway patency and ventilation in children undergoing adenoidectomy.

Wandana Joshi, Neil Roy Connelly, Scott S. Reuben, Marten Wolckenhaar, and Nikhil Thakkar

An Evaluation of the Safety and Efficacy of Administering Rofecoxib for Postoperative Pain Management
Anesth Analg 2003 97: 35-38. [Abstract] [Full Text]  

IMPLICATIONS: In children undergoing tonsillectomy, a single preoperative dose of rofecoxib decreases 2- and 24-h pain and decreases nausea and vomiting at home.

Nicole Brown McDermott, Tamitha VanSickle, Dominika Motas, and Robert H. Friesen

Validation of the Bispectral Index Monitor During Conscious and Deep Sedation in Children
Anesth Analg 2003 97: 39-43. [Abstract] [Full Text]  

IMPLICATIONS: We compared bispectral index scores with a validated observational scale of conscious and deep sedation in children and found significant correlation. We conclude that the bispectral index may be a valid measurement of depth of sedation in children.

V. Saldien, K. M. Vermeyen, and F. L. Wuyts

Target-Controlled Infusion of Rocuronium in Infants, Children, and Adults: A Comparison of the Pharmacokinetic and Pharmacodynamic Relationship
Anesth Analg 2003 97: 44-49. [Abstract] [Full Text]  

IMPLICATIONS: Target-controlled infusion (TCI) of rocuronium in infants, children, and adults was used to analyze the pharmacokinetic/pharmacodynamic relationship. Steady-state TCI rocuronium revealed the most potency of rocuronium in infants and the least in children.

Manhal G. Saleeby, Mirjana Vustar, and John Algren

Tracheal Agenesis: A Rare Disease with Unique Airway Considerations (Case Report)
Anesth Analg 2003 97: 50-52. [Abstract] [Full Text]  

IMPLICATIONS: Abnormal tracheal development causes a spectrum of life-threatening anomalies. We report a newborn with tracheal agenesis and a common "esophagotrachea." Ventilation was achieved first by face mask then with an endotracheal tube. In this report, we describe the types of tracheal agenesis and discuss initial airway management.

Robert J. Friedhoff, Steven H. Rose, Michael J. Brown, Timothy R. Long, and C. Thomas Wass

Galactosialidosis: A Unique Disease with Significant Clinical Implications During Perioperative Anesthesia Management (Case Report)
Anesth Analg 2003 97: 53-55. [Abstract] [Full Text]  

IMPLICATIONS: Anesthetic management of patients with mucopolysaccharidoses is well known. The anesthetic implications of patients with galactosialidosis may be similar to those with other well documented mucopolysaccharidoses, but no cases have been reported in the anesthesia-related literature. We present a case describing anesthetic management of a patient with galactosialidosis undergoing cervical spine surgery.

AMBULATORY ANESTHESIA:

Yaakov Beilin, Jeffrey Zahn, Sharon Abramovitz, Howard H. Bernstein, Sabera Hossain, and Carol Bodian

Subarachnoid Small-Dose Bupivacaine Versus Lidocaine for Cervical Cerclage
Anesth Analg 2003 97: 56-61. [Abstract] [Full Text]  

IMPLICATIONS: We found that small-dose subarachnoid bupivacaine (5.25 mg) with fentanyl 20 {micro}g provides reliable anesthesia for cervical cerclage and exhibits a pharmacodynamic profile similar to that of small-dose lidocaine.

Tong J. Gan, Tricia Meyer, Christian C. Apfel, Frances Chung, Peter J. Davis, Steve Eubanks, Anthony Kovac, Beverly K. Philip, Daniel I. Sessler, James Temo, Martin R. Tramèr, and Mehernoor Watcha

Consensus Guidelines for Managing Postoperative Nausea and Vomiting (Special Article)
Anesth Analg 2003 97: 62-71. [Abstract] [Full Text]  

IMPLICATIONS: We present evidence-based guidelines developed by an international panel of experts for the management of postoperative nausea and vomiting.

ANESTHETIC PHARMACOLOGY:

Talmage D. Egan, Steven E. Kern, Kenward B. Johnson, and Nathan L. Pace

The Pharmacokinetics and Pharmacodynamics of Propofol in a Modified Cyclodextrin Formulation (Captisol®) Versus Propofol in a Lipid Formulation (Diprivan®): An Electroencephalographic and Hemodynamic Study in a Porcine Model
Anesth Analg 2003 97: 72-79. [Abstract] [Full Text]  

IMPLICATIONS: A modified cyclodextrin-based formulation of propofol has been developed that may mitigate some of the problems associated with propofol in lipid emulsion. However, reformulation of propofol may change its clinical characteristics. This study in a pig model showed that the novel propofol formulation was substantially similar to the lipid emulsion propofol formulation.

Mohammad I. El-Orbany, Ninos J. Joseph, and M. Ramez Salem

The Relationship of Posttetanic Count and Train-of-Four Responses During Recovery from Intense Cisatracurium-Induced Neuromuscular Blockade
Anesth Analg 2003 97: 80-84. [Abstract] [Full Text]  

IMPLICATIONS: Monitoring posttetanic count during intense neuromuscular blockade allows the clinician to estimate the intensity of the blockade and estimate recovery time. The relationship between posttetanic count and train-of-four recovery from intense cisatracurium-induced neuromuscular blockade was documented under both IV and inhaled anesthesia.

Toshiharu Kasaba, Shin Onizuka, and Mayumi Takasaki

Procaine and Mepivacaine Have Less Toxicity In Vitro Than Other Clinically Used Local Anesthetics
Anesth Analg 2003 97: 85-90. [Abstract] [Full Text]  

IMPLICATIONS: Systematic comparison was assessed morphologically in growth cones and neurites exposed to seven local anesthetics. The order of neurotoxicity was procaine = mepivacaine < ropivacaine = bupivacaine < lidocaine < tetracaine < dibucaine. Although lidocaine is more toxic than bupivacaine and ropivacaine, mepivacaine, which has a similar pharmacological effect to lidocaine, is the safest among clinically used local anesthetics.

Venkatesh Srinivasa, Peter Gerner, Anna Haderer, Salahadin Abdi, Petr Jarolim, and Ging Kuo Wang

The Relative Toxicity of Amitriptyline, Bupivacaine, and Levobupivacaine Administered as Rapid Infusions in Rats
Anesth Analg 2003 97: 91-95. [Abstract] [Full Text]  

IMPLICATIONS:Amitriptyline, a tricyclic antidepressant, has local anesthetic properties and is more potent than bupivacaine. Significantly larger doses of amitriptyline, given by rapid infusion, are required to cause cardiovascular and central nervous system toxicity in rats, when compared with bupivacaine and levobupivacaine.

Tetsuhiro Takei, Hironao Saegusa, Shuqin Zong, Takayuki Murakoshi, Koshi Makita, and Tsutomu Tanabe

Anesthetic Sensitivities to Propofol and Halothane in Mice Lacking the R-Type (Ca_v2.3) Ca²⁺ Channel
Anesth Analg 2003 97: 96-103. [Abstract] [Full Text]  

IMPLICATIONS: Because inhibition of neuronal Ca2+ currents can be a mechanism underlying general anesthesia, we examined anesthetic sensitivities in mice lacking the R-type (Cav2.3) Ca2+ channels both in vivo and in hippocampal slices. Decreased sensitivities in mutant mice imply a possibility that agents blocking this channel may increase the requirements of anesthetics/hypnotics.

Takashi Okamoto, Kouichiro Minami, Yasuhito Uezono, Junichi Ogata, Munehiro Shiraishi, Akio Shigematsu, and Yoichi Ueta

The Inhibitory Effects of Ketamine and Pentobarbital on Substance P Receptors Expressed in Xenopus Oocytes
Anesth Analg 2003 97: 104-110. [Abstract] [Full Text]  

IMPLICATIONS: We investigated the effects of IV anesthetics on substance P receptors (SPR) expressed in Xenopus oocytes. Ketamine and pentobarbital inhibit SPR function via noncompetitive displacing SP binding. The findings imply that the inhibition of SPR function by these compounds may play a role in the analgesic effects of these IV anesthetics.

Steven L. Jinks, Joseph F. Antognini, and Earl Carstens

Isoflurane Depresses Diffuse Noxious Inhibitory Controls in Rats Between 0.8 and 1.2 Minimum Alveolar Anesthetic Concentration
Anesth Analg 2003 97: 111-116. [Abstract] [Full Text]  

IMPLICATIONS: Diffuse noxious inhibitory control (DNIC) occurs when a noxious stimulus is perceived as being less painful when a second noxious stimulus is applied elsewhere on the body. DNIC is present in anesthetized animals, although how anesthesia affects it is unknown. We found that isoflurane depressed DNIC in the transition from 0.8 to 1.2 minimum alveolar anesthetic concentration, suggesting that DNIC is depressed in the anesthetic range needed to suppress movement.

Barbara A. Coda, Anita C. Rudy, Sanford M. Archer, and Daniel P. Wermeling

Pharmacokinetics and Bioavailability of Single-Dose Intranasal Hydromorphone Hydrochloride in Healthy Volunteers
Anesth Analg 2003 97: 117-123. [Abstract] [Full Text]  

IMPLICATIONS: Pharmacokinetics and bioavailability were determined for two doses of intranasal hydromorphone in healthy volunteers. Rapid, reliable absorption, and predictable pharmacokinetics support the investigation of hydromorphone hydrochloride nasal spray as a therapeutic alternative to oral and IM administration.

Dan J. Kopacz, Christopher M. Bernards, Hugh W. Allen, Craig Landau, Partha Nandy, Danlin Wu, and Peter G. Lacouture

A Model to Evaluate the Pharmacokinetic and Pharmacodynamic Variables of Extended-Release Products Using In Vivo Tissue Microdialysis in Humans: Bupivacaine-Loaded Microcapsules
Anesth Analg 2003 97: 124-131. [Abstract] [Full Text]  

IMPLICATIONS: Microcapsules loaded with bupivacaine and dexamethasone and administered by subcutaneous injection produce prolonged cutaneous anesthesia and analgesia. Determination of local tissue pharmacokinetic variables of bupivacaine by microdialysis confirms that the prolonged duration of anesthesia is caused by the extended release characteristics of the microcapsules.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Sinikka Münte, Thomas F. Münte, Jörg Grotkamp, Gertrud Haeseler, Konstantinos Raymondos, Siegfried Piepenbrock, and Gabriele Kraus

Implicit Memory Varies as a Function of Hypnotic Electroencephalogram Stage in Surgical Patients
Anesth Analg 2003 97: 132-138. [Abstract] [Full Text]  

IMPLICATIONS: In this study, implicit memory was observed during general anesthesia at light to moderate, but not deep, hypnotic stages. Hypnotic stages were determined by a commercial electroencephalogram device, and implicit memory was measured by using a postoperative reading speed task. During lighter phases of anesthesia, patients should be protected against acoustic information that could negatively influence their postoperative outcome.

Gunter N. Schmidt, Petra Bischoff, Thomas Standl, Malte Issleib, Moritz Voigt, and Jochen Schulte am Esch

ARX-Derived Auditory Evoked Potential Index and Bispectral Index During the Induction of Anesthesia with Propofol and Remifentanil
Anesth Analg 2003 97: 139-144. [Abstract] [Full Text]  

IMPLICATIONS: The modern electroencephalographic ARX-derived auditory evoked potential index and the bispectral index were superior to the classic electroencephalographic and hemodynamic variables for predicting anesthetic conditions. Variables derived from the auditory evoked potential did not provide an advantage over variables derived from spontaneous electroencephalogram.

Fábio E. Bensenor, Joaquim E. Vieira, and Jose Otávio C. Auler, Jr.

Guidelines for Inspiratory Flow Setting When Measuring the Pressure-Volume Relationship
Anesth Analg 2003 97: 145-150. [Abstract] [Full Text]  

IMPLICATIONS: We suggest guidelines for inspiratory flow setting when measuring the pressure-volume relationship during anesthesia based on the comparison among three different continuous flow values, aiming at better intraoperative respiratory settings in patients with normal respiratory function.

Erich Knolle, Wolfgang Linert, and Hermann Gilly

The Color Change in CO₂ Absorbents On Drying: An In Vitro Study Using Moisture Analysis
Anesth Analg 2003 97: 151-155. [Abstract] [Full Text]  

IMPLICATIONS: In an in vitro study, the moisture content and color change on drying were determined in samples of Amsorb(R) or Superia(R) and in the same absorbents with added NaOH or KOH. With increasing concentrations of alkali hydroxide, a delay in the color change upon drying was observed. However, the moisture content did not change.

PAIN MEDICINE:

Heather Robbins, Robert J. Gatchel, Carl Noe, Noor Gajraj, Peter Polatin, Martin Deschner, Akshay Vakharia, and Laura Adams

A Prospective One-Year Outcome Study of Interdisciplinary Chronic Pain Management: Compromising Its Efficacy by Managed Care Policies
Anesth Analg 2003 97: 156-162. [Abstract] [Full Text]  

IMPLICATIONS: Interdisciplinary pain management is effective and cost-effective in treating the major health problem of chronic pain. The present study demonstrated its efficacy using a prospective, 1-yr posttreatment evaluation methodology. Moreover, physical therapy "carve out" practices by insurance carriers had a negative impact on the outcomes, raising important medico-legal and ethical issues.

Mordechai Averbuch and Meyer Katzper

Severity of Baseline Pain and Degree of Analgesia in the Third Molar Post-Extraction Dental Pain Model
Anesth Analg 2003 97: 163-167. [Abstract] [Full Text]  

IMPLICATIONS: A person taking an analgesic wants to know when and how well it will work. People with moderate pain are more likely to get relief, whereas those with severe pain who get relief will get relatively more relief. Most relief of acute pain occurs within less than 2 h. These data indicate that most people with intense initial pain do not require larger doses of analgesics.

Mark Oatway, Allison Reid, and Jana Sawynok

Peripheral Antihyperalgesic and Analgesic Actions of Ketamine and Amitriptyline in a Model of Mild Thermal Injury in the Rat
Anesth Analg 2003 97: 168-173. [Abstract] [Full Text]  

IMPLICATIONS: This study examines the pain-relieving properties of the local peripheral administration of ketamine and amitriptyline, two drugs in current clinical use, in a thermal injury model of hyperalgesia and demonstrates both antihyperalgesic and analgesic properties. These observations provide support for their potential use as local (e.g., topical) analgesics.

L. A. Kobierski, S. Abdi, L. DiLorenzo, N. Feroz, and D. Borsook

A Single Intravenous Injection of KRN5500 (Antibiotic Spicamycin) Produces Long-Term Decreases in Multiple Sensory Hypersensitivities in Neuropathic Pain
Anesth Analg 2003 97: 174-182. [Abstract] [Full Text]  

IMPLICATIONS: We examined the effect of a novel drug (KRN5500) on nerve damage pain. After the successful effects of this drug in a single human, we have shown that the drug infused as a single application at different doses in a rat model of nerve damage pain produces pain relief in this model for many weeks.

Eric Parisod, Philip J. Siddall, Melissa Viney, Joan M. McClelland, and Michael J. Cousins

Allodynia After Acute Intrathecal Morphine Administration in a Patient with Neuropathic Pain After Spinal Cord Injury (Case Report)
Anesth Analg 2003 97: 183-186. [Abstract] [Full Text]  

IMPLICATIONS: Acute intrathecal administration of relatively small doses of opioids may precipitate neuropathic pain and allodynia in those with spinal cord injury.

S. Mercadante, P. Villari, P. Ferrera, and E. Arcuri

Local Anesthetic Switching for Intrathecal Tachyphylaxis in Cancer Patients with Pain (Case Report)
Anesth Analg 2003 97: 187-189. [Abstract] [Full Text]  

IMPLICATIONS: Switching from bupivacaine to lidocaine may improve intrathecal morphine analgesia in advanced cancer patients, possibly because of different spinal mechanisms limiting the hyperalgesic processes.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Franklin Dexter and Johannes Ledolter

Managing Risk and Expected Financial Return from Selective Expansion of Operating Room Capacity: Mean-Variance Analysis of a Hospital’s Portfolio of Surgeons
Anesth Analg 2003 97: 190-195. [Abstract] [Full Text]  

IMPLICATIONS: Surgeon and subspecialty specific hospital financial data are uncertain, a fact that should be taken into account when making decisions about expanding operating room capacity. We show that mean-variance portfolio analysis can incorporate this uncertainty, thereby guiding operating room management decision-making and reducing the chance of a strategic decision being made based on spurious information.

John P. Abenstein, Jonathan A. Allan, Jennifer A. Ferguson, Steven D. Deick, Steven H. Rose, and Bradly J. Narr

Computer-Based Anesthesiology Paging System
Anesth Analg 2003 97: 196-204. [Abstract] [Full Text]  

IMPLICATIONS: Mayo Clinic installed a computer-based anesthesiology paging system (CAPS) to inform operating suite personnel when assistance is needed in procedure and recovery areas. The CAPS is more reliable than the system it replaced. Anesthesiologists arrive at a patient's bedside faster when they are paged with the CAPS than with a beeper.

CRITICAL CARE AND TRAUMA:

Chi-Yuan Li, Chien-Sung Tsai, Sheau-Huei Chueh, Ping-Ching Hsu, Jia-Yi Wang, Chih-Shung Wong, and Shung-Tai Ho

Dobutamine Inhibits Monocyte Chemoattractant Protein-1 Production and Chemotaxis in Human Monocytes
Anesth Analg 2003 97: 205-209. [Abstract] [Full Text]  

IMPLICATIONS: Monocyte chemoattractant protein-1 (MCP-1) plays important roles in the inflammatory processes associated with pathogenesis of cardiovascular diseases. In this study, dobutamine was found to inhibit lipopolysaccharide-induced MCP-1 production and messenger RNA expression, as well as MCP-1-induced chemotaxis and peak [Ca2+]i, in human monocytes.

Chi-Yuan Li, Chien-Sung Tsai, Ping-Ching Hsu, Ching-Tang Wu, Chih-Shung Wong, and Shung-Tai Ho

Dobutamine Modulates Lipopolysaccharide-Induced Macrophage Inflammatory Protein-1 and Interleukin-8 Production in Human Monocytes
Anesth Analg 2003 97: 210-215. [Abstract] [Full Text]  

IMPLICATIONS: Macrophage inflammatory protein (MIP)-1{alpha} and interleukin (IL)-8 are reported to play an important role in early inflammatory stages, wound healing, sepsis, and some cardiovascular diseases. Our study suggests that dobutamine may inhibit macrophage chemotaxis, as well as lipopolysaccharide-induced MIP-1{alpha} and IL-8 production by human monocytes.

Boris Nohé, Ralph Thomas Kiefer, Annette Ploppa, Helene A. Haeberle, Torsten H. Schroeder, and Hans-Juergen Dieterich

The Effects of Fresh Frozen Plasma on Neutrophil-Endothelial Interactions
Anesth Analg 2003 97: 216-221. [Abstract] [Full Text]  

IMPLICATIONS: During shock, fluid administration leads to a massive dilution of plasma. Apart from maintaining hemodynamics, this might affect tissue damage by influencing leukocyte accumulation in the microvasculature. Using endothelial cells, isolated neutrophils, and a parallel plate flow chamber, we studied the effects of fresh frozen plasma on neutrophil-endothelial interactions.

Satoshi Takahashi, Kouichiro Minami, Midori Ogawa, Hiroshi Miyamoto, Kunio Ikemura, Akio Shigematsu, and Hatsumi Taniguchi

The Preventive Effects of Mupirocin Against Nasotracheal Intubation-Related Bacterial Carriage
Anesth Analg 2003 97: 222-225. [Abstract] [Full Text]  

IMPLICATIONS: We studied the carriage rate of bacteria into the trachea caused by nasal intubation. The bacterial carriage by nasal intubation was more frequent than that by oral intubation, and intranasal administration of mupirocin eliminated the carriage of S. aureus. These results indicate that topical nasal treatment with mupirocin is effective to prevent carriage of bacteria into the trachea.

Karl H. Stadlbauer, Klaus Rheinberger, Volker Wenzel, Claus Raedler, Anette C. Krismer, Hans-Ulrich Strohmenger, Sven Augenstein, Horst G. Wagner-Berger, Wolfgang G. Voelckel, Karl H. Lindner, and Anton Amann

The Effects of Nifedipine on Ventricular Fibrillation Mean Frequency in a Porcine Model of Prolonged Cardiopulmonary Resuscitation
Anesth Analg 2003 97: 226-230. [Abstract] [Full Text]  

IMPLICATIONS: This study evaluates the effects of a calcium channel blocker on ventricular fibrillation mean frequency, hemodynamic variables, and resuscitability during prolonged cardiopulmonary resuscitation (CPR) in pigs. Nifedipine, but not saline placebo, prevented a rapid decrease of ventricular fibrillation mean frequency after the induction of cardiac arrest and maintained ventricular fibrillation mean frequency at ~10 Hz during prolonged CPR but did not improve resuscitability.

NEUROSURGICAL ANESTHESIA:

Shailendra Joshi, Roger Hartl, Mei Wang, Lei Feng, Daniel Hoh, Robert R. Sciacca, and Sundeep Mangla

The Acute Cerebrovascular Effects of Intracarotid Adenosine in Nonhuman Primates
Anesth Analg 2003 97: 231-237. [Abstract] [Full Text]  

IMPLICATIONS: Using a real-time cerebral blood flow (CBF) measurement technique, we evaluated the acute cerebrovascular effects of intracarotid adenosine in anesthetized baboons. The increase in CBF lasted only for the duration of the adenosine infusion. Adenosine might be a suitable drug for trial as an intraarterial vasodilator for the treatment of cerebral vasospasm.

Mohamed Naguib, Phillip G. Schmid, III, and Max T. Baker

The Electroencephalographic Effects of IV Anesthetic Doses of Melatonin: Comparative Studies with Thiopental and Propofol
Anesth Analg 2003 97: 238-243. [Abstract] [Full Text]  

IMPLICATIONS: Anesthetic doses of melatonin produced effects on processed electroencephalographic variables similar to those of thiopental and propofol.

Erich Knolle, Ursula Windberger, Marek Ehrlich, Georg Heinze, Matthias J. Oehmke, Edvin Turkof, Udo Losert, and Hans Georg Kress

Intrathecal Temperature Is Closely Reflected by the Aortic, but Not by the Rectal, Temperature in a Rabbit Model of Spinal Cord Ischemia (Technical Communication)
Anesth Analg 2003 97: 244-246. [Abstract] [Full Text]  

IMPLICATIONS: Experimental ischemic lesions in the lumbar spinal cord of the rabbit can be induced by inflating the balloon of a Swan-Ganz catheter in the abdominal aorta. The intrathecal temperature is significantly better reflected by the temperature from the thermistor of the catheter than by the rectal temperature.

OBSTETRIC ANESTHESIA:

Philip E. Hess, Anasuya Vasudevan, Caroline Snowman, and Stephen D. Pratt

Small Dose Bupivacaine-Fentanyl Spinal Analgesia Combined with Morphine for Labor
Anesth Analg 2003 97: 247-252. [Abstract] [Full Text]  

IMPLICATIONS: A small dose of intrathecal fentanyl 12.5 {micro}g and bupivacaine 2 mg produces effective labor analgesia lasting for approximately 85 min. The addition of a small 125-{micro}g dose of morphine improves pain control during subsequent epidural analgesia and reduces the requirements for postpartum pain medications.

Ruth Landau, Raphaël Giraud, Vincent Delrue, and Christian Kern

Spinal Anesthesia for Cesarean Delivery in a Woman with a Surgically Corrected Type I Arnold Chiari Malformation (Case Report)
Anesth Analg 2003 97: 253-255. [Abstract] [Full Text]  

IMPLICATIONS: We report the successful management and outcome of spinal anesthesia for Cesarean delivery in a woman with a surgically corrected Arnold Chiari Type 1 malformation, a seizure disorder, and idiopathic thrombocytopenia of pregnancy.

J. H. Bamber and M. Dresner

Aortocaval Compression in Pregnancy: The Effect of Changing the Degree and Direction of Lateral Tilt on Maternal Cardiac Output (Brief Report)
Anesth Analg 2003 97: 256-258. [Abstract] [Full Text]  

IMPLICATIONS: Using thoracic bioimpedance to measure maternal cardiac output, we were unable to demonstrate any benefit from increasing the magnitude of lateral table tilt. This implies that it is unnecessary to use extremes of lateral table tilt in healthy pregnancy although this may not apply to women with cardiac compromise or regional anesthesia.

REGIONAL ANESTHESIA:

Szilvia Szarvas, Ramesh S. Chellapuri, Dominic C. Harmon, John Owens, Damian Murphy, and George D. Shorten

A Comparison of Dexamethasone, Ondansetron, and Dexamethasone plus Ondansetron as Prophylactic Antiemetic and Antipruritic Therapy in Patients Receiving Intrathecal Morphine for Major Orthopedic Surgery
Anesth Analg 2003 97: 259-263. [Abstract] [Full Text]  

IMPLICATIONS: Postoperative nausea and vomiting (PONV) and pruritus are common side effects after spinal opioid administration. In this study, dexamethasone 8 mg plus ondansetron 4 mg was as effective as ondansetron 8 mg. The administration of dexamethasone alone was associated with a frequent incidence of PONV, demonstrating a lack of efficacy. This has important cost implications.

Nicole Phillips, Mark Priestley, A. Robert Denniss, and John B. Uther

Brugada-Type Electrocardiographic Pattern Induced by Epidural Bupivacaine (Case Report)
Anesth Analg 2003 97: 264-267. [Abstract] [Full Text]  

IMPLICATIONS: In this case report, we describe the postoperative occurrence of electrocardiogram changes suggestive for the Brugada syndrome in a patient receiving a continuous epidural bupivacaine infusion. After withdrawal of bupivacaine, the electrocardiogram changes were reversible. The patient's history was unremarkable except for an incomplete right bundle branch block. We conclude that local anesthetics, particularly bupivacaine, have the potential to induce serious arrhythmias in patients with Brugada syndrome.

GENERAL ARTICLES:

Juraj Sprung, David G. Whalley, Tommaso Falcone, William Wilks, James E. Navratil, and Denis L. Bourke

The Effects of Tidal Volume and Respiratory Rate on Oxygenation and Respiratory Mechanics During Laparoscopy in Morbidly Obese Patients
Anesth Analg 2003 97: 268-274. [Abstract] [Full Text]  

IMPLICATIONS: Morbid obesity decreases arterial oxygenation and respiratory system compliance. During laparoscopy, arterial oxygenation is affected only by the patient's body weight. Increases in tidal volume or respiratory rate do not improve arterial oxygenation.

Akira Kudoh, Hajime Takase, and Tomoko Takazawa

Chronic Treatment with Antidepressants Decreases Intraoperative Core Hypothermia
Anesth Analg 2003 97: 275-279. [Abstract] [Full Text]  

IMPLICATIONS: Thermoregulation in chronically depressed patients is often altered. The alteration of body temperature is affected by depression itself and by antidepressants. General anesthesia has an influence on thermoregulatory control. However, temperature regulation during anesthesia in chronically depressed patients remains unclear.

Shinichi Kihara and Joseph Brimacombe

Sex-Based ProSeal^TM Laryngeal Mask Airway Size Selection: A Randomized Crossover Study of Anesthetized, Paralyzed Male and Female Adult Patients
Anesth Analg 2003 97: 280-284. [Abstract] [Full Text]  

IMPLICATIONS: When sex is used to select the appropriate size of the ProSealTM laryngeal mask airway, the Size 4 ProSealTM is preferable for women and the Size 5 ProSeal for men.

Hiroshi Makino, Takasumi Katoh, Syunji Kobayashi, Hiromichi Bito, and Shigehito Sato

The Effects of Tracheal Tube Tip Design and Tube Thickness on Laryngeal Pass Ability During Oral Tube Exchange with an Introducer
Anesth Analg 2003 97: 285-288. [Abstract] [Full Text]  

IMPLICATIONS: In situations such as after one-lung anesthesia, when use of a thicker tube exchanger (TE) is not applicable, a newly designed taper-tipped tube with the leading edge in the midline may be considered as an adjunct to an oral tracheal tube exchange, using a thinner TE as the guide for tracheal intubation.

Melissa Ehlers, David McCloskey, and Neil S. Devejian

Alarming Levels of Carboxyhemoglobin in a Unit of Banked Blood (Case Report)
Anesth Analg 2003 97: 289-290. [Abstract] [Full Text]  

IMPLICATIONS: Increased levels of carboxyhemoglobin (COHb) are frequently found in units of packed red blood cells. We report a congenital heart surgery where increased levels of COHb were found in the patient after a blood transfusion and hypothesize that this phenomenon could be dangerous in a cyanotic newborn undergoing open heart surgery.

LETTERS TO THE EDITOR:

Robert A. Herbert

A Personal Story Regarding Pain Control
Anesth Analg 2003 97: 291. [Full Text]  

Yoshihiro Ishikawa, Tetsuya Miyashita, Yasuhiro Koide, Michihiro Sakai, Tomio Andoh, and Yoshitsugu Yamada

A New Technique for Pulmonary Arterial Catheter Insertion into Coronary Sinus Using Transesophageal Echocardiography
Anesth Analg 2003 97: 291-292. [Full Text]  

Venkatesh Srinivasa, Peter Gerner, and Sunil Eappen

Mutism as a Complication of Total Intravenous Anesthesia by Propofol
Anesth Analg 2003 97: 292. [Full Text]  

Scott A. Lang, Ban Tsui, Thomas Grau, T. Kasai, K. Yaegashi, H. Hirose, and Y. Tanaka

New Avenues of Epidural Research • Response
Anesth Analg 2003 97: 292-293. [Full Text]  

Matthias J. Koessler, Nikolaus Aebli, Rocco P. Pitto, Hsueh-Lin Chen, Ching-Tang Wu, and Chih-Shung Wong

Fat and Bone Marrow Embolism During Percutaneous Vertebroplasty • Response
Anesth Analg 2003 97: 293-294. [Full Text]  

Junichi Ogata, Toru Yokoyama, Takashi Okamoto, and Kouichiro Minami

Managing a Tachyarrhythmia in a Patient with Pheochromocytoma with Landiolol, a Novel Ultrashort-Acting ß-Adrenergic Blocker
Anesth Analg 2003 97: 294-295. [Full Text]  

Frank Wappler, Marko Fiege, and Christian Hönemann

Is Desflurane a "Weak" Trigger of Malignant Hyperthermia? • Response
Anesth Analg 2003 97: 295. [Full Text]  

David K. Stinson

An Abbreviation of the ACC/AHA Algorithm for Perioperative Cardiovascular Evaluation for Noncardiac Surgery
Anesth Analg 2003 97: 295-296. [Full Text]  

Pia di Benedetto, Guido Fanelli, Jacques E. Chelly, Andrea Casati, Francis V. Salinas, and Spencer S. Liu

Continuous Sciatic Nerve Block: How to Choose Among Different Proximal Approaches? Gluteal or Subgluteal Continuous Sciatic Nerve Block • Response
Anesth Analg 2003 97: 296-297. [Full Text]  

Flavio Takaoka, Alexandre Teruya, Paulo Massarollo, Sérgio Mies, J. T. Lutz, K. Görlinger, J. Peters, C. Valentin-Gamazo, and M. Malago

Minimizing Risks for Donors Undergoing Right Hepatectomy for Living-Related Liver Transplantation • Response
Anesth Analg 2003 97: 297-298. [Full Text]  

Wiebke Gogarten, Hartmut Buerkle, Hugo Van Aken, Philip J. Peyton, Paul S. Myles, John A. Rigg, Konrad Jamrozik, Brendan S. Silbert, Richard Parsons, and Karen Collins

The Quality of Epidural Anesthesia Is Crucial in the Assessment of Perioperative Outcome • Response
Anesth Analg 2003 97: 298-299. [Full Text]  

Irene P. Osborn and Robert Soper

It’s a Disposable LMA, Just Cut It Shorter—for Fiberoptic Intubation
Anesth Analg 2003 97: 299-300. [Full Text]  

J. Robert Sneyd, Victor De Castro, and Gilles Godet

Remifentanil Manual Versus Target-Controlled Infusion • Response
Anesth Analg 2003 97: 300. [Full Text]  

Mohammed I. El-Orbany, M. Ramez Salem, Ninos J. Joseph, Chakib M. Ayoub, Marwan S. Rizk, Chadi I. Yaacoub, Anis S. Baraka, and Antoine M. Lteif

Tracheal Tube Advancement Over the Fiberoptic Bronchoscope: Size Does Matter • Response
Anesth Analg 2003 97: 301. [Full Text]  

D. Michaloudis, E. Kanoupakis, Avi A. Weinbroum, and Ron Flaishon

Propofol Reduces Idiopathic Prolonged QT Interval and QT Dispersion During Implantation of Cardioverter Defibrillator • Response
Anesth Analg 2003 97: 301-302. [Full Text]  

Ban Ch. Tsui and Stephan Malherbe

Nebulization of Lidocaine with Varied Oxygen Flow Rates
Anesth Analg 2003 97: 302. [Full Text]  

Spyros D. Mentzelopoulos and Argyris S. Michalopoulos

An Endotracheal/Tracheostomy Tube Technique for the Emergency Management of a Midtracheal Tracheoesophageal Fistula
Anesth Analg 2003 97: 302-303. [Full Text]  

Andrew Zimet

Encourage the Use of Noncutting Needles for Diagnostic Lumbar Punctures
Anesth Analg 2003 97: 303. [Full Text]  

Malcolm Watters, Sushil P. Ambesh, Chandra K. Pandey, and Anil Agarwal

Griggs Guide Wire Dilation Forceps Method Is Safer Than Suggested • Response
Anesth Analg 2003 97: 303-304. [Full Text]  

BOOK AND MULTIMEDIA REVIEWS:

Edward R. Sherwood, Steven J. Barker, Andranik Ovassapian, Holly Muir, and John Butterworth

Immunomodulation and the Inflammatory Response: International Anesthesiology Clinics, Volume 41, No.1 • Pulse Oximetry, 2nd edition • The Upper Airway and Anesthesia: Anesthesia Clinics of North America, Volume 20, No. 4 • Obstetric Anesthesia: International Anesthesia Clinics, Volume 40, No. 4 • Evarts A. Graham: The Life, Lives, and Times of the Surgical Spirit of St. Louis • Books and Multimedia Received
Anesth Analg 2003 97: 305-308. [Full Text]  

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