EDITORIALS:

Richard C. Prielipp and Robert J. Sherertz

Skin: The First Battlefield
Anesth Analg 2003 97: 933-935. [Full Text] [PDF] [Request Permissions]  

Robert Udelsman

The Operating Room: War Results in Casualties
Anesth Analg 2003 97: 936-937. [Full Text] [PDF] [Request Permissions]  

Steven J. Barker

Too Much Technology?
Anesth Analg 2003 97: 938-939. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Christian Jeske, Claus Raedler, Achim von Goedecke, Andreas Mayr, Guido Hinterberger, Ch. Aspoeck, Cornelia Lass-Floerl, and Arnulf Benzer

Early Identification of Bacteria Leading to Central Venous Catheter Contamination
Anesth Analg 2003 97: 940-943. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In five of seven central venous catheters removed because of clinical signs of catheter-related blood infections, DNA analysis showed bacteria found on the catheter tip to be identical with bacteria found on the puncture kits used for insertion of these catheters.

Hildur Tomasdottir, Hjörtur Hjartarson, Anne Ricksten, Carina Wasslavik, Anders Bengtsson, and Sven-Erik Ricksten

Tumor Necrosis Factor Gene Polymorphism Is Associated with Enhanced Systemic Inflammatory Response and Increased Cardiopulmonary Morbidity After Cardiac Surgery
Anesth Analg 2003 97: 944-949. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The associations between tumor necrosis factor (TNF) gene polymorphism, plasma cytokines, and cardiopulmonary function after elective cardiac surgery were evaluated. Patients homozygous for the TNFB2 allele displayed larger concentrations of TNF-{alpha} and interleukin-6 and had an increased risk of developing left ventricular and pulmonary dysfunction compared with TNFB1 homo- or heterozygotes.

Sven A. F. Tulner, Robert J. M. Klautz, Gerda L. van Rijk-Zwikker, Frank H. M. Engbers, Jeroen J. Bax, Jan Baan, Ernst E. van der Wall, Robert A. Dion, and Paul Steendijk

Perioperative Assessment of Left Ventricular Function by Pressure-Volume Loops Using the Conductance Catheter Method
Anesth Analg 2003 97: 950-957. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pressure-volume loops provide on-line quantification of intrinsic systolic and diastolic myocardial function in a load-independent fashion. This study shows the feasibility of perioperative pressure-volume analysis by use of the conductance-catheter method. This method provides detailed data about the immediate effects of surgery and may be used to evaluate complex cardiac procedures.

Bharathi H. Scott, Frank C. Seifert, Peter S. A. Glass, and Roger Grimson

Blood Use in Patients Undergoing Coronary Artery Bypass Surgery: Impact Of Cardiopulmonary Bypass Pump, Hematocrit, Gender, Age, and Body Weight
Anesth Analg 2003 97: 958-963. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined the impact of cardiopulmonary bypass, preoperative hematocrit, gender, age, and body weight on blood use in patients undergoing primary coronary artery bypass surgery at a tertiary care institution. We found that all five of these variables are significant predictors of blood use in patients undergoing coronary artery bypass surgery.

Nancy A. Nussmeier, Charles B. Probert, Douglas Hirsch, John R. Cooper, Jr., Igor D. Gregoric, Timothy J. Myers, and O. H. Frazier

Anesthetic Management for Implantation of the Jarvik 2000^TM Left Ventricular Assist System
Anesth Analg 2003 97: 964-971. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The Jarvik 2000 is a left ventricular assist device that produces continuous nonpulsatile axial flow by means of a rotating, vaned impeller. Because the anesthetic considerations differ from those of conventional left ventricular assist devices, we report the perioperative management of the first 10 patients who participated in a bridge-to-transplantation feasibility study of the Jarvik 2000.

Valéria Perez-de-Sá, Doris Cunha-Goncalves, Henning Schou, Christer Jonmarker, and Olof Werner

The Hemodynamic and Metabolic Effects of Shivering During Acute Normovolemic Hemodilution
Anesth Analg 2003 97: 972-978. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effect of acute increases in oxygen consumption (shivering) on severely anemic individuals has not been evaluated. In this experimental model, left ventricular oxygen balance was marginal, as evidenced by decreased lactate extraction.

Susumu Fujioka, Yoshinari Niimi, Kazuo Hirata, Itaru Nakamura, and Shigeho Morita

Tetraplegia After Coronary Artery Bypass Grafting (Case Report)
Anesth Analg 2003 97: 979-980. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The authors present a rare case of tetraplegia after coronary artery bypass grafting. It is suggested that neck extension during surgery might have aggravated an occult preexisting cervical spinal canal stenosis to produce cervical injury.

Maurice Lippmann, Sonny Rubin, Richard Ginsburg, Rodney A. White, Jason Lee, James Lee, and Ihab Aziz

An Alternative Anesthetic Technique for the Morbidly Obese Patient Undergoing Endovascular Repair of an Abdominal Aortic Aneurysm (Case Report)
Anesth Analg 2003 97: 981-983. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This case report discusses a minimally invasive anesthetic approach towards the morbidly obese patient undergoing endovascular abdominal aortic aneurysm repair. It demonstrates a safe and cost-effective means of managing a patient with numerous comorbidities. We also discuss an anesthetic/surgical approach on how to provide maximum analgesia with minimal anesthesia.

PEDIATRIC ANESTHESIA:

Susan M. Goobie, Carolyne J. Montgomery, Rahul Basu, Jillian McFadzean, Gerald J. O’Connor, Kenneth Poskitt, and Ban C. H. Tsui

Confirmation of Direct Epidural Catheter Placement Using Nerve Stimulation in Pediatric Anesthesia
Anesth Analg 2003 97: 984-988. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A new technique to confirm epidural catheter position uses low current electrical stimulation in pediatric patients. This study evaluated the use of electrical stimulation in 30 pediatric patients for directly placed catheters. Electrical stimulation did not provide any advantage over conventional methods (e.g., cutaneous landmarks) for confirmation of catheter position.

Jennifer Sokol, Susan Elizabeth Jacobs, and Desmond Bohn

Inhaled Nitric Oxide for Acute Hypoxic Respiratory Failure in Children and Adults: A Meta-analysis (Review Article)
Anesth Analg 2003 97: 989-998. [Abstract] [Full Text] [PDF] [Request Permissions]  

Theodore G. Wong, Biauw-Chi Ong, Claire Ang, and Huei-Leng Chee

Anesthetic Management for a Five-Day Separation of Craniopagus Twins (Case Report)
Anesth Analg 2003 97: 999-1002. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The following case report documents the anesthetic planning and management leading to and including a 5-day separation of twins joined at the head. This case report also details the difficulties encountered during the unique combination of a rarely performed procedure and a long operating time.

AMBULATORY ANESTHESIA:

Christopher J. Jankowski, James R. Hebl, Michael J. Stuart, Michael G. Rock, Mark W. Pagnano, Christopher M. Beighley, Darrell R. Schroeder, and Terese T. Horlocker

A Comparison of Psoas Compartment Block and Spinal and General Anesthesia for Outpatient Knee Arthroscopy
Anesth Analg 2003 97: 1003-1009. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Outpatient knee arthroscopy may be performed using a variety of anesthetic techniques. We report that spinal anesthesia and psoas compartment block are superior to general anesthesia when considering resource utilization, patient satisfaction, and postoperative analgesic management.

Shu-Ming Wang, Alison A. Caldwell-Andrews, and Zeev N. Kain

The Use of Complementary and Alternative Medicines by Surgical Patients: A Follow-Up Survey Study
Anesth Analg 2003 97: 1010-1015. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Most surgical patients use some form of complementary-alternative medical therapies (CAM) and are willing to accept CAM therapy as part of their perioperative management.

Seval Izdes, Sibel Orhun, Sacit Turanli, Ezgi Erkilic, and Orhan Kanbak

The Effects of Preoperative Inflammation on the Analgesic Efficacy of Intraarticular Piroxicam for Outpatient Knee Arthroscopy
Anesth Analg 2003 97: 1016-1019. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Intraarticular administration of piroxicam along with bupivacaine improves postoperative analgesia in synovial inflammation before surgery.

ANESTHETIC PHARMACOLOGY:

Yilei Xing, Yi Zhang, Caroline R. Stabernack, Edmond I Eger, II, and Andrew T. Gray

The Use of the Potassium Channel Activator Riluzole to Test Whether Potassium Channels Mediate the Capacity of Isoflurane to Produce Immobility
Anesth Analg 2003 97: 1020-1024. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Riluzole, a drug that activates potassium channels and decreases glutamatergic neurotransmission, primarily acts on supraspinal sites to produce immobility in response to noxious stimuli. This finding does not support the hypothesis that potassium channels mediate the capacity of inhaled anesthetics to produce immobility in the face of noxious stimulation.

Yuri Nakae, Shinji Kohro, Quinn H. Hogan, and Zeljko J. Bosnjak

Intracellular Mechanism of Mitochondrial Adenosine Triphosphate-Sensitive Potassium Channel Activation with Isoflurane
Anesth Analg 2003 97: 1025-1032. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our results show that isoflurane activates mitochondrial adenosine triphosphate-sensitive potassium (mitoKATP) channels, but not through pathways involving adenosine, protein kinase C, tyrosine kinase, or p38 mitogen-activated protein kinase. Isoflurane may directly activate mitoKATP channels.

Marie-Agnes Docquier, Patricia Lavand’homme, Christian Ledermann, Valérie Collet, and Marc De Kock

Can Determining the Minimum Alveolar Anesthetic Concentration of Volatile Anesthetic Be Used as an Objective Tool to Assess Antinociception in Animals?
Anesth Analg 2003 97: 1033-1039. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The MAC-sparing effect provides several variables that allow comparison between different analgesic substances. However, the observations made are not simply the result of the antinociceptive effects of the tested drugs but rather the result of complex interactions between these drugs and a halogenated vapor.

Seppo T. Mustola, Gerhard A. Baer, Juhani K. Toivonen, Anne Salomäki, Mika Scheinin, Heini Huhtala, Pekka Laippala, and Ville Jäntti

Electroencephalographic Burst Suppression Versus Loss of Reflexes Anesthesia with Propofol or Thiopental: Differences of Variance in the Catecholamine and Cardiovascular Response to Tracheal Intubation
Anesth Analg 2003 97: 1040-1045. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our results did not support the hypothesis that the responses to tracheal intubation can be more accurately predicted when unconsciousness is controlled with the aid of an electroencephalographic burst suppression pattern. Significant differences were found in the reactions between propofol and thiopental. At the burst suppression level, the catecholamine response was abolished with propofol.

Ron Flaishon, Avi A. Weinbroum, Leo Veenman, Svetlana Leschiner, Valerie Rudick, and Moshe Gavish

Flumazenil Attenuates Development of Tolerance to Diazepam After Chronic Treatment of Mice with Either Isoflurane or Diazepam
Anesth Analg 2003 97: 1046-1052. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Flumazenil attenuates the development of tolerance to isoflurane and diazepam after chronic isoflurane pretreatment. Isoflurane, like diazepam, attenuates the increase in central benzodiazepine receptor (CBR) density caused by flumazenil. These findings suggest that isoflurane and diazepam share a mechanism of action, most probably via the gamma-aminobutyric acid system and the CBR.

Markus W. Hollmann, Katrin Kurz, Susanne Herroeder, Danja Struemper, Klaus Hahnenkamp, Noud S. Berkelmans, Christel G. den Bakker, and Marcel E. Durieux

The Effects of S(-)-, R(+)-, and Racemic Bupivacaine on Lysophosphatidate-Induced Priming of Human Neutrophils
Anesth Analg 2003 97: 1053-1058. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Overactive inflammatory responses underlie several perioperative disorders. Compared with racemic bupivacaine and other anesthetics, S(-)-bupivacaine appears particularly effective in suppressing neutrophil priming, a process responsible in part for the overactive neutrophil response.

Osamu Shibata, Masataka Saito, Maki Yoshimura, Masakazu Yamaguchi, Tetsuji Makita, and Koji Sumikawa

Interactions of Edrophonium with Neostigmine in the Rat Trachea
Anesth Analg 2003 97: 1059-1063. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We examined the effects of edrophonium on neostigmine-induced contractile and phosphatidylinositol responses of rat trachea. Neostigmine-induced tension and inositol monophosphate accumulation were attenuated by edrophonium. This attenuation was reversed by washing. The results suggest that edrophonium would bind to the allosteric site.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Mark E. Comunale

A Laboratory Evaluation of the Level 1 Rapid Infuser (H1025) and the Belmont Instrument Fluid Management System (FMS 2000) for Rapid Transfusion
Anesth Analg 2003 97: 1064-1069. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The FMS 2000 and Level 1 H1025 warming capabilities were similar at metered flows of 500 mL/min. At more rapid flow rates, which are achieved by the H1025, fluid warming decreases dramatically. The air-detection and -elimination system of the FMS 2000 is superior to that of the H1025.

G. Summer, P. Lirk, K. Hoerauf, U. Riccabona, F. Bodrogi, H. Raifer, M. Deibl, J. Rieder, and W. Schobersberger

Sevoflurane in Exhaled Air of Operating Room Personnel
Anesth Analg 2003 97: 1070-1073. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The present study depicts the profile of volatile anesthetics, isoflurane and sevoflurane, in exhaled air of ambulatory patients. Biomonitoring of expired anesthetic concentrations is a noninvasive and rapid method to determine volatile anesthetic excretion.

Michael P. Eaton and Anahat K. Dhillon

Relative Performance of the Level 1 and Ranger Pressure Infusion Devices (Technical Communication)
Anesth Analg 2003 97: 1074-1077. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pressure infusion devices are widely used to treat patients with large-volume blood loss. The use of these devices may subject patients to the risk of venous air embolism. Our study found the new Ranger device to be superior to the widely used Level 1 in air elimination.

Christopher L. Wu, Mohammad Naqibuddin, Andrew J. Rowlingson, Steven A. Lietman, Roland M. Jermyn, and Lee A. Fleisher

The Effect of Pain on Health-Related Quality of Life in the Immediate Postoperative Period
Anesth Analg 2003 97: 1078-1085. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Severity of postoperative pain may affect quality of life

PAIN MEDICINE:

André Gottschalk, Marc-Alexander Burmeister, Patricia Radtke, Markus Krieg, Faraneh Farokhzad, Sonja Kreissl, Matthias Strauss, and Thomas Standl

Continuous Wound Infiltration with Ropivacaine Reduces Pain and Analgesic Requirement After Shoulder Surgery
Anesth Analg 2003 97: 1086-1091. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The continuous postoperative wound infiltration after shoulder surgery with different concentrations of ropivacaine, 2 mg/mL and 3.75 mg/mL, results in lower pain scores and opioid requirement compared with infiltration with placebo. Plasma levels of ropivacaine remained less than the toxic threshold.

Alper Kararmaz, Sedat Kaya, Haktan Karaman, Selim Turhanoglu, and Mehmet Ali Ozyilmaz

Intraoperative Intravenous Ketamine in Combination with Epidural Analgesia: Postoperative Analgesia After Renal Surgery
Anesth Analg 2003 97: 1092-1096. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Renal nociception conducted multisegmentally by both the spinal nerves (T10 to L1) and the vagus nerve cannot be blocked by epidural analgesia alone. We demonstrated that IV ketamine had an improved analgesic or opioid-sparing effect when it was combined with epidural bupivacaine and morphine after renal surgery.

Nathaniel P. Katz, Summer Sherburne, Michael Beach, Robert J. Rose, Janet Vielguth, Joyce Bradley, and Gilbert J. Fanciullo

Behavioral Monitoring and Urine Toxicology Testing in Patients Receiving Long-Term Opioid Therapy
Anesth Analg 2003 97: 1097-1102. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Monitoring both urine toxicology and aberrant behavior in chronic-pain patients treated with opioids identified more problem patients than by monitoring either alone. The authors recommend routine urine testing on all patients prescribed opioids for noncancer pain and as a required element in all opioid analgesic studies.

Yuri A. Kolesnikov, Marcela Cristea, and Gavril W. Pasternak

Analgesic Synergy Between Topical Morphine and Butamben in Mice
Anesth Analg 2003 97: 1103-1107. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Topical administration of the opioid {micro}-agonist morphine and the sodium channel inhibitors butamben and benzocaine results in a synergistic interaction for antinociception in radiant heat tail-flick assay in mice, suggesting that the combination of these drugs will enhance rather than detract from the analgesia of either alone.

Andrei B. Petrenko, Tomohiro Yamakura, Hiroshi Baba, and Koki Shimoji

The Role of N-Methyl-D-Aspartate (NMDA) Receptors in Pain: A Review (Review Article)
Anesth Analg 2003 97: 1108-1116. [Abstract] [Full Text] [PDF] [Request Permissions]  

Jacqueline M. Hyland and John Butterworth

Severe Acute Visceral Pain from Varicella Zoster Virus (Case Report)
Anesth Analg 2003 97: 1117-1118. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a patient with lymphoma, prior bone marrow transplant, and acute visceral pain for whom IV opioids in large doses proved inadequate. An interventional pain management technique was considered until characteristic varicella vesicles appeared over the patient's trunk. We report this case to alert others who treat oncology patients that the diagnosis of visceral zoster should be considered when patients who have undergone bone marrow transplantation present with severe visceral pain.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

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

Use of Operating Room Information System Data to Predict the Impact of Reducing Turnover Times on Staffing Costs
Anesth Analg 2003 97: 1119-1126. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Many anesthesiologists work at hospitals where surgeons and/or operating room (OR) committees focus repeatedly on turnover time reduction. We developed a methodology by which the reductions in staffing cost as a result of turnover time reduction can be calculated for each facility using its own data. Staffing cost reductions are generally very small and would be achieved predominantly by reducing allocated OR time to the surgeons.

Misa Dzoljic, Marieke Zimmerman, Dink Legemate, and Niek S. Klazinga

Reduced Nurse Working Time and Surgical Productivity and Economics
Anesth Analg 2003 97: 1127-1132. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Our retrospective study describes an increase of 20% in nursing costs after a 4% decrease in nurse working time. During the period of implementation of the new working schedule, an increase in sick leave was observed. The interaction between shortage of nursing personnel, working time, and wages is discussed.

Nivez F. Rasic, Robert M. Friesen, Bruce Anderson, Shirley A. Hoban, Nancy Olson, and Jacob Kress

Prepared Endotracheal Tubes: Are They a Potential Source for Pathogenic Microorganisms?
Anesth Analg 2003 97: 1133-1136. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Prepared endotracheal tubes (PETTs) are back-up airway equipment to be used in the case of a difficult intubation. A short PETT shelf life because of unknown safe storage time results in significant budget costs. This blinded, controlled study examined the pathogenic potential of PETTs in the operating room environment.

CRITICAL CARE AND TRAUMA:

Tsuneo Tatara

The Contribution of Solute-Solvent Exchange at the Membrane Surface to the Reduction by Albumin of the Hydraulic Permeability Coefficient of an Artificial Semipermeable Membrane
Anesth Analg 2003 97: 1137-1142. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Albumin concentrations more than 2.4 wt% decreased the water permeabilities of ultrafiltration membranes compared with those measured in the absence of albumin. The finding may be explained by slowed solute-solvent exchange at the membrane surface, suggesting that the reduction in water permeability of capillary membranes by colloidal macromolecules may not be caused solely by plugging of the capillary pores.

Gaetano Perchiazzi, Rocco Giuliani, Loreta Ruggiero, Tommaso Fiore, and Göran Hedenstierna

Estimating Respiratory System Compliance During Mechanical Ventilation Using Artificial Neural Networks
Anesth Analg 2003 97: 1143-1148. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We studied the application of artificial neural networks (ANN) to the estimation of respiratory compliance during mechanical ventilation. The study was performed on an animal model of acute lung injury, testing the performance of ANN in both healthy and diseased conditions of the lung.

Jeffrey Lipman, Steven C. Wallis, and Robert J. Boots

Cefepime Versus Cefpirome: The Importance of Creatinine Clearance
Anesth Analg 2003 97: 1149-1154. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Some intensive care patients have very large creatinine clearances that result in very low levels of fourth-generation cephalosporins. Serum levels of these antibiotics need to be maintained (time > minimum inhibitory concentration is important). Because routine measurements of cephalosporin levels are generally unavailable, we suggest that more frequent use be made of creatinine clearances to allow prediction of low levels and, hence, alterations in dosing.

NEUROSURGICAL ANESTHESIA:

Kristin Engelhard, Christian Werner, William E. Hoffman, Bianca Matthes, Manfred Blobner, and Eberhard Kochs

The Effect of Sevoflurane and Propofol on Cerebral Neurotransmitter Concentrations During Cerebral Ischemia in Rats
Anesth Analg 2003 97: 1155-1161. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During incomplete cerebral ischemia, the neuroprotective anesthetics sevoflurane and propofol suppressed cerebral increases in norepinephrine and glutamate concentrations. In contrast, propofol, but not sevoflurane, suppressed the ischemia-induced increase in circulating catecholamines to baseline levels. The results question a role for plasma catecholamines in cerebral ischemic injury.

Kyung Y. Yoo, Seong W. Jeong, Seok J. Kim, In H. Ha, and JongUn Lee

Cardiovascular Responses to Endotracheal Intubation in Patients with Acute and Chronic Spinal Cord Injuries
Anesth Analg 2003 97: 1162-1167. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cardiovascular and catecholamine responses to endotracheal intubation may differ according to the time elapsed and the level of injury in patients with complete spinal cord injury.

REGIONAL ANESTHESIA:

Atsuko Shono, Yoji Saito, Shinichi Sakura, Katsushi Doi, and Naomi Yokokawa

Sevoflurane Requirements to Suppress Responses to Transcutaneous Electrical Stimulation During Epidural Anesthesia with 0.5% and 1% Lidocaine
Anesth Analg 2003 97: 1168-1172. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We evaluated sevoflurane requirements to suppress skin vasomotor reflex and pupillary dilation in response to a transcutaneous electrical stimulation at the surgical site during combined epidural-general anesthesia. Our results indicate that when epidural anesthesia is combined, general anesthetic requirements decrease depending on the lidocaine concentration for epidural anesthesia and the site where surgical stimulation is applied.

Wolfgang Zink, Christoph Seif, Jürgen R. E. Bohl, Nicola Hacke, Peter M. Braun, Barbara Sinner, Eike Martin, Rainer H. A. Fink, and Bernhard M. Graf

The Acute Myotoxic Effects of Bupivacaine and Ropivacaine After Continuous Peripheral Nerve Blockades
Anesth Analg 2003 97: 1173-1179. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: After continuous peripheral nerve blockades, the long-acting local anesthetics bupivacaine and ropivacaine both induce fiber necrosis in porcine skeletal muscle tissue. In comparison with ropivacaine, bupivacaine causes tissue damage of a significantly larger extent and additionally induces apoptosis in skeletal muscle cells.

Bruce Ben-David, Rama Joshi, and Jacques E. Chelly

Sciatic Nerve Palsy After Total Hip Arthroplasty in a Patient Receiving Continuous Lumbar Plexus Block (Case Report)
Anesth Analg 2003 97: 1180-1182. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A case is presented of sciatic palsy developing after total hip arthroplasty in a patient receiving a continuous lumbar plexus block. The case highlights various issues in the use of continuous peripheral nerve blocks for postoperative analgesia.

GENERAL ARTICLES:

Robert C. Morell, Richard C. Prielipp, Timothy N. Harwood, Robert L. James, and John F. Butterworth

Men Are More Susceptible Than Women to Direct Pressure on Unmyelinated Ulnar Nerve Fibers
Anesth Analg 2003 97: 1183-1188. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The ability of direct pressure to produce a greater inhibition of unmyelinated C-fibers in male subjects compared with female subjects is consistent with, and may help explain, the male increased susceptibility to perioperative ulnar nerve dysfunction.

Gay Clery, Joseph Brimacombe, Tisha Stone, Christian Keller, and Sandy Curtis

Routine Cleaning and Autoclaving Does Not Remove Protein Deposits from Reusable Laryngeal Mask Devices
Anesth Analg 2003 97: 1189-1191. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Routine cleaning and autoclaving does not remove protein material from reusable laryngeal mask airway devices.

Joseph Brimacombe and Christian Keller

Aspiration of Gastric Contents During Use of a ProSeal^TM Laryngeal Mask Airway Secondary to Unidentified Foldover Malposition (Case Report)
Anesth Analg 2003 97: 1192-1194. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case of gastric aspiration with the ProSealTM laryngeal mask during a laparoscopic cholecystectomy secondary to an unidentified foldover malposition. It is imperative that the position and patency of the drain tube be verified in all patients with the ProSealTM laryngeal mask.

LETTERS TO THE EDITOR:

Dirk Karovic, Stephan Blumenthal, Alberto Schneeberger, Alain Borgeat, Joseph M. Neal, Susan B. McDonald, and Kathleen L. Larkin

Suprascapular Nerve Block Prolongs Analgesia After Nonarthroscopic Shoulder Surgery but Does Not Improve Outcome: Suprascapular Nerve Blocked One, Two...or More Times? • Response
Anesth Analg 2003 97: 1195-1196. [Full Text] [PDF] [Request Permissions]  

K. P. Unnikrishnan, Prabhat Kumar Sinha, and Praveen Kumar Neema

Unusual Cause of Intraoperative Hypertension and Tachycardia
Anesth Analg 2003 97: 1196. [Full Text] [PDF] [Request Permissions]  

Taras I. Usichenko, Dragan Pavlovic, and Argyro Fassoulaki

Suggesting the Optimal Control Procedure for Acupressure Studies • Response
Anesth Analg 2003 97: 1196-1197. [Full Text] [PDF] [Request Permissions]  

Carlo D. Franco, Serge G. Tyler, Radha Sukhani, Kenneth Candido, Robert Doty, Jr., Edward Yaghmour, and Robert McCarthy

Modified Subgluteal Approach to the Sciatic Nerve • Response
Anesth Analg 2003 97: 1197-1198. [Full Text] [PDF] [Request Permissions]  

Salvatore Sia, M. Tariq Bhatti, and F. Kayser Enneking

Hypotensive Technique and Sitting Position in Shoulder Surgery • Response
Anesth Analg 2003 97: 1198-1199. [Full Text] [PDF] [Request Permissions]  

Prabhat Tewari, Zahid Hussain Khan, and Arash Kashfi

Alas, Too Big a Bite! • Response
Anesth Analg 2003 97: 1199. [Full Text] [PDF] [Request Permissions]  

Matthew M. Kumar and Juraj Sprung

The Use of Hyaluronidase to Treat Mannitol Extravasation
Anesth Analg 2003 97: 1199-1200. [Full Text] [PDF] [Request Permissions]  

Vincent Souron, Youri Reiland, Antoine De Traverse, Laurent Delaunay, and Laurent Lafosse

Interpleural Migration of an Interscalene Catheter
Anesth Analg 2003 97: 1200-1201. [Full Text] [PDF] [Request Permissions]  

Jeffrey A. Green, Catherine L. Cooper, Octavio A. Falcucci, Amira Safwat, Thomas Slaughter, Bruce D. Spiess, and Vance G. Nielsen

Argatroban for Off-Pump Coronary Artery Bypass Surgery • Response
Anesth Analg 2003 97: 1201-1202. [Full Text] [PDF] [Request Permissions]  

Tim Cook, Eduardo Figueredo, and Miguel Martínez

Comparing the ProSeal^TM Laryngeal Mask Airway with the Laryngeal Tube Airway • Response
Anesth Analg 2003 97: 1202-1203. [Full Text] [PDF] [Request Permissions]  

Evan J. Goodman and Pat A. Johnson

Radiofrequency Ablation of Hepatic Tumors Can Cause Elevation of the Patient’s Temperature
Anesth Analg 2003 97: 1203-1204. [Full Text] [PDF] [Request Permissions]  

Jeffrey S. Lee, Philip J. Balestrieri, and James E. Ferguson, II

Local Anesthetic Allergy in a Parturient • Response
Anesth Analg 2003 97: 1204. [Full Text] [PDF] [Request Permissions]  

John G. Brock-Utne, David L. Hepner, and Mariana C. Castells

Clinical Manifestations of Latex Anaphylaxis During Anesthesia Differ from Those Not Anesthesia/Surgery-Related • Response
Anesth Analg 2003 97: 1204-1205. [Full Text] [PDF] [Request Permissions]  

Kazuyoshi Aoyama, Etsuko Yasunaga, Ichiro Takenaka, Chakib M. Ayoub, Marwan S. Rizk, Chadi I. Yaacoub, Anis S. Baraka, and Antoine M. Lteif

Another Sleeve for Fiberoptic Tracheal Intubation • Response
Anesth Analg 2003 97: 1205-1206. [Full Text] [PDF] [Request Permissions]  

Paul J. Manberg, Andrew Ronald Gordon Muncaster, James Wallace Sleigh, and Murray Williams

BIS Monitoring Requires Proper Electrode Placement for Optimum Performance • Response
Anesth Analg 2003 97: 1206. [Full Text] [PDF] [Request Permissions]  

Thomas Ebert and Rachel Eshima

Airway Responses to Sevoflurane vs. Desflurane: Comparing Apples to Oranges? • Response
Anesth Analg 2003 97: 1206-1207. [Full Text] [PDF] [Request Permissions]  

Vincenzo Fodale, Letterio B. Santamaria, Deborah J. Culley, and Gregory Crosby

The Inhibition of Central Nicotinic nAch Receptors Is the Possible Cause of Prolonged Cognitive Impairment After Anesthesia • Response
Anesth Analg 2003 97: 1207. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Lydia Conley, Adam R. Burkey, Dell R. Burkey, W. Andrew Kofke, and John Butterworth

"This is No Humbug!" Reminiscences of the Department of Anesthesia at the MGH • Drugs for Pain • The Clinical Practice of Critical Care Neurology, 2nd ed. • Integrity in Scientific Research: Creating an Environment That Promotes Responsible Conduct • Books and Multimedia Received
Anesth Analg 2003 97: 1208-1210. [Full Text] [PDF] [Request Permissions]  

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