EDITORIALS:

Thomas Geiser

The Role of Neutrophils and Neutrophil Products in Pulmonary Hemodynamics of Endotoxin in Oleic Acid-Induced Lung Injury
Anesth Analg 2004 98: 281-282. [Full Text] [PDF] [Request Permissions]  

Joseph R. Tobin and John Butterworth

Sickle Cell Disease: Dogma, Science, and Clinical Care
Anesth Analg 2004 98: 283-284. [Full Text] [PDF] [Request Permissions]  

CARDIOVASCULAR ANESTHESIA:

Andreas Koster, Sabine Huebler, Frank Merkle, Thomas Hentschel, Marcus Gründel, Thomas Krabatsch, Luc Tambeur, Michael Praus, Helmut Habazettl, Wolfgang M. Kuebler, and Hermann Kuppe

Heparin-Level-Based Anticoagulation Management During Cardiopulmonary Bypass: A Pilot Investigation on the Effects of a Half-Dose Aprotinin Protocol on Postoperative Blood Loss and Hemostatic Activation and Inflammatory Response
Anesth Analg 2004 98: 285-290. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The use of half-dose aprotinin and heparin-level-based anticoagulation management during cardiopulmonary bypass leads to a significant reduction of postoperative blood loss after cardiac surgery. This effect can most likely be attributed to the antifibrinolytic effects of aprotinin, as we did not observe effects on other variables of activation of the hemostatic/inflammatory system.

Anne H. Kuitunen, Markku J. Hynynen, Elina Vahtera, and Markku T. Salmenperä

Hydroxyethyl Starch as a Priming Solution for Cardiopulmonary Bypass Impairs Hemostasis After Cardiac Surgery
Anesth Analg 2004 98: 291-297. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The influence of hydroxyethyl starch (HES) on postoperative hemostasis was investigated in cardiac surgery. The thromboelastographic values indicated that HES solutions, when given in connection with the cardiopulmonary bypass prime, compromise hemostasis after cardiac surgery. This effect seems to occur through the formation of a less stable clot.

Hilary P. Grocott, Joseph P. Mathew, Elizabeth H. Carver, Barbara Phillips-Bute, Kevin P. Landolfo, and Mark F. Newman

A Randomized Controlled Trial of the Arctic Sun® Temperature Management System Versus Conventional Methods for Preventing Hypothermia During Off-Pump Cardiac Surgery
Anesth Analg 2004 98: 298-302. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The Arctic Sun(R) Temperature Management System was more effective than conventional methods in preventing hypothermia during off-pump coronary artery bypass graft surgery.

Joby Chandy, Toshiko Nakai, Randall J. Lee, Wayne H. Bellows, Samir Dzankic, and Jacqueline M. Leung

Increases in P-Wave Dispersion Predict Postoperative Atrial Fibrillation After Coronary Artery Bypass Graft Surgery
Anesth Analg 2004 98: 303-310. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In addition to clinical factors, such as advanced age and body surface area, we demonstrated that electrophysiologic changes involving an increase in P-wave dispersion postoperatively independently predict atrial fibrillation after coronary artery bypass graft surgery.

Idar Kirkeby-Garstad, Olav F. M. Sellevold, Roar Stenseth, Eirik Skogvoll, and Asbjørn Karevold

Marked Mixed Venous Desaturation During Early Mobilization After Aortic Valve Surgery
Anesth Analg 2004 98: 311-317. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: During early mobilization after aortic valve replacement, a marked and consistent reduction in mixed venous oxygen saturation to 35% and mixed venous oxygen partial pressure to 3 kPa was observed.

John A. Dilger, Edwin H. Rho, Florencia G. Que, and Juraj Sprung

Octreotide-Induced Bradycardia and Heart Block During Surgical Resection of a Carcinoid Tumor (Case Report)
Anesth Analg 2004 98: 318-320. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In some susceptible patients, IV bolus administration of octreotide may cause significant bradycardia and cardiac conduction defects. Therefore, when octreotide is administered as a bolus, it may be advisable to give it slowly while monitoring the electrocardiogram.

PEDIATRIC ANESTHESIA:

B. Craig Weldon, Martin Bell, and Thomas Craddock

The Effect of Caudal Analgesia on Emergence Agitation in Children After Sevoflurane Versus Halothane Anesthesia
Anesth Analg 2004 98: 321-326. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Effective postoperative analgesia may reduce the incidence of emergence agitation reported with sevoflurane anesthesia. The Yale Preoperative Anxiety Scale appears to be helpful in identifying young children who are at risk for developing emergence agitation.

Ban C. H. Tsui, Alese Wagner, Dominic Cave, Clark Elliott, Hamdy El-Hakim, and Stephan Malherbe

The Incidence of Laryngospasm with a "No Touch" Extubation Technique After Tonsillectomy and Adenoidectomy
Anesth Analg 2004 98: 327-329. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study re-emphasizes the importance of a sound anesthetic technique in tracheally extubating pediatric patients.

Santhanam Suresh, Sandra L. Barcelona, Nancy M. Young, Corri L. Heffner, and Charles J. Coté

Does a Preemptive Block of the Great Auricular Nerve Improve Postoperative Analgesia in Children Undergoing Tympanomastoid Surgery?
Anesth Analg 2004 98: 330-333. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This double-blinded randomized controlled trial compared the efficacy of preemptive analgesia with a peripheral nerve block of the great auricular nerve for decreasing postoperative pain in children undergoing tympanomastoid surgery. Preemptive analgesia did not improve the quality or duration of postoperative analgesia in our cohort.

Daniela Alexianu, Eric T. Skolnick, Annie C. Pinto, Susumu Ohkawa, David P. Roye, Jr., David E. Solowiejczyk, Joshua E. Hyman, and Lena S. Sun

Severe Hypotension in the Prone Position in a Child with Neurofibromatosis, Scoliosis and Pectus Excavatum Presenting for Posterior Spinal Fusion (Case Report)
Anesth Analg 2004 98: 334-335. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A child with neurofibromatosis, scoliosis, and a chest wall deformity presenting for spinal fusion developed severe hypotension while prone. This was due to compression of the heart by the sternum, not compression of the great vessels by neurofibromas. Sternal pressure in prone patients with chest wall deformities should be avoided. Unique management included the use of transesophageal echocardiography to determine the cause of the hypotension.

AMBULATORY ANESTHESIA:

Girish P. Joshi, Eugene R. Viscusi, Tong J. Gan, Harold Minkowitz, Mark Cippolle, Rienhard Schuller, Raymond Y. Cheung, and John G. Fort

Effective Treatment of Laparoscopic Cholecystectomy Pain with Intravenous Followed by Oral COX-2 Specific Inhibitor
Anesth Analg 2004 98: 336-342. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Parecoxib 40 mg IV, 30-45 min preoperatively followed by oral valdecoxib 40 mg qd reduced opioid requirements and provided superior pain relief as well as improved patient global evaluation after laparoscopic cholecystectomy.

Taras I. Usichenko, Dragan Pavlovic, Sebastian Foellner, and Michael Wendt

Reducing Venipuncture Pain by a Cough Trick: A Randomized Crossover Volunteer Study
Anesth Analg 2004 98: 343-345. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effectiveness of a cough trick for pain reduction during peripheral venipuncture was tested in a volunteer study in which each subject served as his own control. The easily performed cough-trick procedure was effective for pain reduction, although the mechanism remains unclear.

ANESTHETIC PHARMACOLOGY:

Tsutomu Oshima and Shuji Dohi

Isoflurane Facilitates Hiccup-Like Reflex Through Gamma Aminobutyric Acid (GABA)_A- and Suppresses Through GABA_B-Receptors in Pentobarbital-Anesthetized Cats
Anesth Analg 2004 98: 346-352. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Isoflurane facilitated the hiccup-like reflex through activation of central and peripheral gamma aminobutyric acid (GABA)A receptors but suppressed it via activation of central and peripheral GABAB receptors. The net result was that the hiccup-like reflex was inhibited in proportion to the alveolar isoflurane concentration.

Chun-Su Yuan, Sangeeta Mehendale, Yingping Xiao, Han H. Aung, Jing-Tian Xie, and Michael K. Ang-Lee

The Gamma-Aminobutyric Acidergic Effects of Valerian and Valerenic Acid on Rat Brainstem Neuronal Activity
Anesth Analg 2004 98: 353-358. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Valerian is an herb used in treating anxiety and insomnia. We observed that the valerian effects are mediated through brain gamma-aminobutyric acid (GABA) receptors in a rat brainstem preparation. Thus, valerian may potentiate the effects of anesthetics that act on GABA receptors, and presurgical valerian use may cause a valerian-anesthetic interaction.

Martín Santos, Viviana Kunkar, Palma García-Iturralde, and Francisco J. Tendillo

Meloxicam, a Specific COX-2 Inhibitor, Does Not Enhance the Isoflurane Minimum Alveolar Concentration Reduction Produced by Morphine in the Rat
Anesth Analg 2004 98: 359-363. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A synergistic effect between morphine and aspirin on isoflurane minimum alveolar concentration has been observed in the rat—an effect that does not occur between morphine and meloxicam.

James A. Blunk, Martin Schmelz, Susanne Zeck, Per Skov, Rudolf Likar, and Wolfgang Koppert

Opioid-Induced Mast Cell Activation and Vascular Responses Is Not Mediated by µ-Opioid Receptors: An In Vivo Microdialysis Study in Human Skin
Anesth Analg 2004 98: 364-370. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Opioid effects on mast cells were assessed using intradermal microdialysis. Mast cell activation was seen with codeine and meperidine; no other opioid induced degranulation. Therefore, histamine release seen at large concentrations of potent {micro} agonists is caused by an unspecific effect rather than an activation of opioid receptors.

Nathaniel P. Katz, David E. Shapiro, Timothy E. Herrmann, Joseph Kost, and Linda M. Custer

Rapid Onset of Cutaneous Anesthesia with EMLA Cream After Pretreatment with a New Ultrasound-Emitting Device
Anesth Analg 2004 98: 371-376. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A prospective, randomized, double-blinded, placebo-controlled clinical trial demonstrated rapid onset of cutaneous anesthesia by pretreatment of the skin with ultrasound before application of EMLA cream.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Thomas M. Hemmerling, Guillaume Michaud, Guillaume Trager, Stéphane Deschamps, Denis Babin, and François Donati

Phonomyography and Mechanomyography Can Be Used Interchangeably to Measure Neuromuscular Block at the Adductor Pollicis Muscle
Anesth Analg 2004 98: 377-381. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Mechanomyography and phonomyography (PMG), a novel method of monitoring neuromuscular blockade (NMB) by recording low-frequency sounds emitted by muscle contraction, can be used interchangeably to determine NMB at the adductor pollicis muscle. PMG is easier to apply, does not need a special monitoring board and could be a reliable monitor to determine NMB in daily routine.

Harry J. M. Lemmens and John G. Brock-Utne

Heat and Moisture Exchange Devices: Are They Doing What They Are Supposed to Do?
Anesth Analg 2004 98: 382-385. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There is considerable variability in the in vivo performance of heat and moisture exchangers that have similar manufacturer specifications. These specifications, based on the International Standards Organization 9360 standard, which is measured in vitro, cannot be used to predict clinical performance.

Stephen W. Cone, Lynne Gehr, Russell Hummel, Azhar Rafiq, Charles R. Doarn, and Ronald C. Merrell

Case Report of Remote Anesthetic Monitoring Using Telemedicine (Case Report)
Anesth Analg 2004 98: 386-388. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study validates the use of telecommunications technology from a remote location to monitor an anesthetic event. This type of work makes expert advice available during surgical procedures.

PAIN MEDICINE:

Marc Senard, Abdourhamane Kaba, Murielle J. Jacquemin, Luc M. Maquoi, Marie-Pierre N. Geortay, Pierre D. Honoré, Maurice L. Lamy, and Jean L. Joris

Epidural Levobupivacaine 0.1% or Ropivacaine 0.1% Combined with Morphine Provides Comparable Analgesia After Abdominal Surgery
Anesth Analg 2004 98: 389-394. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Small concentrations (0.1%) of epidural levobupivacaine and ropivacaine combined with morphine (0.1 mg/h) produce comparable analgesia and have similar side effects for similar dose requirements.

Hélène Beloeil, Noémie Delage, Isabelle Nègre, Jean-Xavier Mazoit, and Dan Benhamou

The Median Effective Dose of Nefopam and Morphine Administered Intravenously for Postoperative Pain After Minor Surgery: A Prospective Randomized Double-Blinded Isobolographic Study of Their Analgesic Action
Anesth Analg 2004 98: 395-400. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pharmacologic interaction between nefopam and morphine shows infra-additivity but their combination may be clinically useful as morphine consumption is decreased in postoperative patients.

Burkhard Gustorff, Katharina Hoechtl, Thomas Sycha, Evangelos Felouzis, Stephan Lehr, and Hans G. Kress

The Effects of Remifentanil and Gabapentin on Hyperalgesia in a New Extended Inflammatory Skin Pain Model in Healthy Volunteers
Anesth Analg 2004 98: 401-407. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Opioid analgesia was reliably demonstrated in a new inflammatory model of primary and secondary hyperalgesia. Gabapentin showed no antihyperalgesic and no opioid-enhancing effect in this model.

Katja Wiech, Ralph-Thomas Kiefer, Stephanie Töpfner, Hubert Preissl, Christoph Braun, Klaus Unertl, Herta Flor, and Niels Birbaumer

A Placebo-Controlled Randomized Crossover Trial of the N-Methyl-D-Aspartic Acid Receptor Antagonist, Memantine, in Patients with Chronic Phantom Limb Pain
Anesth Analg 2004 98: 408-413. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: NMDA receptors play a substantial role in central nervous system changes underlying neuropathic pain. In a placebo-controlled double-blinded study we tested the effect of 30 mg memantine on chronic phantom limb pain and pain-associated cortical reorganization.

Ying Lu, Sarah M. Sweitzer, Charles E. Laurito, and David C. Yeomans

Differential Opioid Inhibition of C- and A- Fiber Mediated Thermonociception After Stimulation of the Nucleus Raphe Magnus
Anesth Analg 2004 98: 414-419. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Opiates differentially inhibit pain produced by the activation of myelinated or unmyelinated pain sensing neurons, a distinction that is clinically important. This article demonstrates that the brain's own pain control system operates with similar selectivity, and that this selectivity is partly mediated by different opiate receptor subtypes.

Gabriella Kekesi, Ildiko Dobos, György Benedek, and Gyöngyi Horvath

The Antinociceptive Potencies and Interactions of Endogenous Ligands During Continuous Intrathecal Administration: Adenosine, Agmatine, and Endomorphin-1
Anesth Analg 2004 98: 420-426. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Adenosine and agmatine have little antinociceptive efficacy during continuous intrathecal administration, as shown by the inflammatory pain test in rats, but both potentiate the effect of endomorphin-1. These data suggest that the combination of these endogenous ligands might represent novel targets for the therapeutic modulation of pain; however, the systematic examination of side effects is essential.

Jacques E. Chelly, Jeffrey Grass, Timothy W. Houseman, Harold Minkowitz, and Alex Pue

The Safety and Efficacy of a Fentanyl Patient-Controlled Transdermal System for Acute Postoperative Analgesia: A Multicenter, Placebo-Controlled Trial
Anesth Analg 2004 98: 427-433. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This multicenter, randomized, double-blinded, placebo-controlled trial showed that an on-demand fentanyl HCl patient-controlled transdermal system (PCTS) was superior to placebo and well tolerated for the control of moderate to severe postoperative pain for up to 24 h after major surgery. This fentanyl HCl PCTS is a preprogrammed, needle free, self-contained drug-delivery system that uses electrotransport technology (iontophoresis) to deliver 40 {micro}g of fentanyl per on-demand dose.

Ban C. H. Tsui, Stephan Malherbe, John Koller, and Keith Aronyk

Reversal of an Unintentional Spinal Anesthetic by Cerebrospinal Lavage (Case Report)
Anesth Analg 2004 98: 434-436. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cerebrospinal lavage may be a helpful adjunct to the conventional supportive management of patients in the event of an inadvertent total spinal.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Karen L. Posner and Peter R. Freund

Resident Training Level and Quality of Anesthesia Care in a University Hospital
Anesth Analg 2004 98: 437-442. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Appropriate supervision of anesthesia residents helps to ensure patient safety. Anesthesia management problems are most common during the CA2 yr and result in higher costs for the institution.

Anja Baltussen and Christoph H. Kindler

Citation Classics in Anesthetic Journals
Anesth Analg 2004 98: 443-451. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We performed a citation analysis to identify important contributions and contributors to the anesthetic literature. These classic articles have influenced many people and have brought to our attention the many important advances in anesthesia made during the last 50 yr.

CRITICAL CARE AND TRAUMA:

Laureen L. Hill, Delphine L. Chen, James Kozlowski, and Daniel P. Schuster

Neutrophils and Neutrophil Products Do Not Mediate Pulmonary Hemodynamic Effects of Endotoxin on Oleic Acid-Induced Lung Injury
Anesth Analg 2004 98: 452-457. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Acute respiratory failure is characterized by severe decreases in blood oxygen. The pattern of blood flow within the lungs can contribute to this problem. This study investigated the potential role of white blood cells and their products in mediating abnormal pulmonary blood flow patterns in an experimental animal model of respiratory failure.

Christian Kolbitsch, Wilhelm Eisner, Axel Kleinsasser, Matthias Biebl, Thomas Fiegele, Alexander Löckinger, Ingo H. Lorenz, Gregor Mikuz, and Patrizia L. Moser

External Cardiac Defibrillation Does Not Cause Acute Histopathological Changes Typical of Thermal Injuries in Pigs with In Situ Cerebral Stimulation Electrodes
Anesth Analg 2004 98: 458-460. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Repeated cardiac defibrillation did not cause histopathologic changes typical of thermal injury at the implantation site of cerebral stimulation electrodes. The function of the stimulator device after defibrillation, however, ranged from normal to total loss of function.

Yves A. Debaveye and Greet H. Van den Berghe

Is There Still a Place for Dopamine in the Modern Intensive Care Unit? (Review Article)
Anesth Analg 2004 98: 461-468. [Abstract] [Full Text] [PDF] [Request Permissions]  

Mehmet S. Ozcan and Dietrich Gravenstein

The Presence of Working Memory Without Explicit Recall in a Critically Ill Patient (Case Report)
Anesth Analg 2004 98: 469-470. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The presence of intact working memory during sedation is a poor predictor of explicit recall when bispectral index values are maintained less than 60.

NEUROSURGICAL ANESTHESIA:

Kenji Yoshitani, Masahiko Kawaguchi, Kazuyuki Tatsumi, Noriyuki Sasaoka, Norio Kurumatani, and Hitoshi Furuya

Intravenous Administration of Flurbiprofen Does Not Affect Cerebral Blood Flow Velocity and Cerebral Oxygenation Under Isoflurane and Propofol Anesthesia
Anesth Analg 2004 98: 471-476. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Indomethacin, a nonsteroidal antiinflammatory drug (NSAID), has been demonstrated to reduce cerebral blood flow (CBF). The CBF effects of flurbiprofen, another NSAID, are unknown. We investigated cerebral blood flow velocity (CBFV) and cerebral oxygenation during and after the administration of flurbiprofen under isoflurane and propofol anesthesia. We found that flurbiprofen had no effect on CBFV and cerebral oxygenation.

Hiroki Iida, Mami Iida, Hiroto Ohata, Kiyoshi Nagase, and Shuji Dohi

Hypothermia Attenuates the Vasodilator Effects of Dexmedetomidine on Pial Vessels in Rabbits In Vivo
Anesth Analg 2004 98: 477-482. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In normothermic rabbits anesthetized with pentobarbital, topically applied dexmedetomidine induces a concentration-dependent dilation in both large and small cerebral arterioles, but mild to moderate hypothermia attenuates these responses.

OBSTETRIC ANESTHESIA:

Anna Lee, Warwick D. Ngan Kee, and Tony Gin

A Dose-Response Meta-Analysis of Prophylactic Intravenous Ephedrine for the Prevention of Hypotension During Spinal Anesthesia for Elective Cesarean Delivery
Anesth Analg 2004 98: 483-490. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The authors performed a systematic review of dose-response studies of IV bolus ephedrine for preventing hypotension during spinal anesthesia for cesarean delivery. Prophylactic ephedrine cannot be recommended. The efficacy is poor at smaller doses, whereas at larger doses, the likelihood of causing hypertension is actually more than that of preventing hypotension.

Raymond Wee-Lip Goy and Alex Tiong-Heng Sia

Sensorimotor Anesthesia and Hypotension After Subarachnoid Block: Combined Spinal-Epidural Versus Single-Shot Spinal Technique
Anesth Analg 2004 98: 491-496. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study confirms that induction of subarachnoid block by a combined-spinal epidural technique produces a greater sensorimotor anesthesia and results in prolonged recovery when compared with a single-shot spinal technique. There is a more frequent incidence of hypotension and vasoconstrictor administration despite identical doses of intrathecally administered local anesthetic.

Danja Strümper, Wiebke Gogarten, Marcel E. Durieux, Kristian Hartleb, Hugo Van Aken, and Marco A. E. Marcus

The Effects of S(+)-Ketamine and Racemic Ketamine on Uterine Blood Flow in Chronically Instrumented Pregnant Sheep
Anesth Analg 2004 98: 497-502. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The effects of S(+)-ketamine on uterine perfusion and maternal/fetal hemodynamics are similar to those of the racemic mixture in chronically instrumented pregnant sheep. A decreased effect of S(+)-ketamine, as compared with the racemic mixture, on maternal and fetal PCO2 levels was noted.

Shmuel Evron, Marek Glezerman, Ethan Harow, Oscar Sadan, and Tiberiu Ezri

Human Immunodeficiency Virus: Anesthetic and Obstetric Considerations (Review Article)
Anesth Analg 2004 98: 503-511. [Abstract] [Full Text] [PDF] [Request Permissions]  

REGIONAL ANESTHESIA:

Thomas Standl, Ales Stanek, Marc-Alexander Burmeister, Sven Grüschow, Bianca Wahlen, Katrin Müller, Jürgen Biscoping, and Hans-Anton Adams

Spinal Anesthesia Performance Conditions and Side Effects Are Comparable Between the Newly Designed Ballpen and the Sprotte Needle: Results of a Prospective Comparative Randomized Multicenter Study
Anesth Analg 2004 98: 512-517. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This multicenter study examined characteristics of the newly designed Ballpen needle with the Sprotte needle in 700 patients undergoing lower abdominal or extremity surgery in single-dose spinal anesthesia. Technical variables and side effects were comparable between both noncutting spinal needles.

Carlo D. Franco, Zohra Salahuddin, and Amir Rafizad

Bilateral Brachial Plexus Block (Case Report)
Anesth Analg 2004 98: 518-520. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Reports on bilateral regional blocks are extremely rare in the literature. Whereas they have the potential for more complications than a single technique, they can be very useful in specific clinical situations.

Mira Dernedde, Danièlle Furlan, René Verbesselt, Elisabeth Gepts, and Jean G. Boogaerts

Grand Mal Convulsion After an Accidental Intravenous Injection of Ropivacaine (Case Report)
Anesth Analg 2004 98: 521-523. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: An accidental IV injection of approximately 300 mg of ropivacaine was followed by seizures without any arrhythmia. The patient recovered uneventfully.

Grzegorz P. Kozikowski and Steven P. Cohen

Lumbar Puncture Associated with Pneumocephalus: Report of a Case (Case Report)
Anesth Analg 2004 98: 524-526. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We report a case of symptomatic pneumocephalus in a woman with normal pressure hydrocephalus after an unremarkable lumbar puncture. The possible mechanisms for this occurrence, along with steps that can be taken to prevent this complication, are discussed.

GENERAL ARTICLES:

Brigitte Migneault, François Girard, Caroline Albert, Philippe Chouinard, Daniel Boudreault, Diane Provencher, Alexandre Todorov, Monique Ruel, and Dominique C. Girard

The Effect of Music on the Neurohormonal Stress Response to Surgery Under General Anesthesia
Anesth Analg 2004 98: 527-532. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Listening to music under general anesthesia did not reduce perioperative stress hormone release or opioid consumption in patients undergoing gynecological surgery.

Ariane K. Lewis, Irene P. Osborn, and Ram Roth

The Effect of Hemispheric Synchronization on Intraoperative Analgesia
Anesth Analg 2004 98: 533-536. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The purpose of this study was to determine the decrease in analgesia requirement for patients listening to hemispheric synchronization (musical tones) while under general anesthesia. We demonstrated that bariatric patients who listened to hemispheric synchronization had a smaller analgesia requirement than those who listened to a blank tape.

Jonathan H. Waters, Julia ShinJung Lee, Eric Klein, Jerome O’Hara, Craig Zippe, and Paul S. Potter

Preoperative Autologous Donation Versus Cell Salvage in the Avoidance of Allogeneic Transfusion in Patients Undergoing Radical Retropubic Prostatectomy
Anesth Analg 2004 98: 537-542. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this prospective cohort study, cell salvage and preoperative autologous donation were compared with respect to their ability to avoid allogeneic transfusion. There was a suggestion that cell salvage might offer better allogeneic transfusion avoidance.

Abdulmohsin Abdulla Al-Ghamdi

Bilateral Total Knee Replacement with Tourniquets in a Homozygous Sickle Cell Patient (Case Report)
Anesth Analg 2004 98: 543-544. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The use of a tourniquet in patients with sickle cell is controversial. The author describes a case of bilateral total knee replacement performed using a tourniquet in a patient with sickle cell disease.

Vladimir Nekhendzy and and Paul K. Simmonds

Rigid Bronchoscope-Assisted Endotracheal Intubation: Yet Another Use of the Gum Elastic Bougie (Case Report)
Anesth Analg 2004 98: 545-547. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe a technique of using a gum elastic bougie to facilitate an endotracheal intubation in a patient undergoing rigid bronchoscopy, which can be useful in a variety of clinical situations when the rigid bronchoscope is used in patients with abnormal airway.

Thomas J. Papadimos, Mohamad Almasri, James C. Padgett, and Joanne E. Rush

A Suspected Case of Delayed Onset Malignant Hyperthermia with Desflurane Anesthesia (Case Report)
Anesth Analg 2004 98: 548-549. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: There are multiple genetic variations for malignant hyperthermia (MH) at the ryanodine receptor. Desflurane, as a sole trigger of MH, is weak, and on two occasions in the literature (including this case), less than optimal doses of dantrolene were given with a good result. There may be possible to engineer the risk of MH out of an anesthetic once the genetics of the ryanodine receptor are better understood.

LETTERS TO THE EDITOR:

John Butterworth

What Constitutes a "Consensus Guideline"?
Anesth Analg 2004 98: 550. [Full Text] [PDF] [Request Permissions]  

Paul F. White

Consensus Guidelines for Managing Postoperative Nausea and Vomiting: Is There a Conflict of Interest?
Anesth Analg 2004 98: 550. [Full Text] [PDF] [Request Permissions]  

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

Incomplete Guidelines • Response
Anesth Analg 2004 98: 550-551. [Full Text] [PDF] [Request Permissions]  

Steven L. Shafer, Ashraf S. Habib, and Tong J. Gan

Safety of Patients Reason for FDA Black Box Warning on Droperidol • Response
Anesth Analg 2004 98: 551-552. [Full Text] [PDF] [Request Permissions]  

Moeen K. Panni and Stephen B. Corn

Operating Room Gas Contamination
Anesth Analg 2004 98: 552-553. [Full Text] [PDF] [Request Permissions]  

Indu Sen, Deepak Thapa, and Kanti K. Gombar

Oculocutaneous Albinism and Spurious Pulse Oximetry
Anesth Analg 2004 98: 553. [Full Text] [PDF] [Request Permissions]  

Virendra K. Arya and Arun Kumar

Technique for Retrieval of J-Tip Guide Wire Without Withdrawing Introducer Needle During Central Venous Cannulation by Seldinger Technique
Anesth Analg 2004 98: 553-554. [Full Text] [PDF] [Request Permissions]  

John L. Bastien, Morgan G. McCarroll, and Lucinda L. Everett

Uncoiling of Arrow Flextip Plus Epidural Catheter Reinforcing Wire During Catheter Removal: An Unusual Complication
Anesth Analg 2004 98: 554-555. [Full Text] [PDF] [Request Permissions]  

Gregory M. Janelle, Charles T. Klodell, and Tomas D. Martin

Other Potential Solutions to Facilitate Thoracoabdominal Aortic Aneurysm Repair When Uncontrolled Hemorrhage Develops at the Subclavian Clamp Site
Anesth Analg 2004 98: 555. [Full Text] [PDF] [Request Permissions]  

Vincent Souron and Salvatore Sia

Plasma Concentrations of Epinephrine Need to Be Monitored in Study of Incidence of Hypotensive/Bradycardic Events • Response
Anesth Analg 2004 98: 556-557. [Full Text] [PDF] [Request Permissions]  

Eriko Okamoto, Tadakazu Sakuragi, Yasuyuki Sugi, Shinjiro Shono, and Kazuo Higa

Endotracheal Intubation and a Laryngeal Mask Airway in a Child with Mallampati Class Zero Airway
Anesth Analg 2004 98: 557. [Full Text] [PDF] [Request Permissions]  

Chih-Ping Yang, Chun-Chang Yeh, Chih-Shung Wong, Ching-Tang Wu, S. Mercadante, P. Villari, P. Ferrera, and E. Arcuri

Local Anesthetic Switching for Intrathecal Tachyphylaxis in Cancer Patients with Pain • Response
Anesth Analg 2004 98: 557-558. [Full Text] [PDF] [Request Permissions]  

John J. McCloskey, Joseph R. Tobin, Donald Schwartz, and Neil Roy Connelly

Pyloric Stenosis, Hyperkalemia, and Anesthesia Practice • Response
Anesth Analg 2004 98: 558. [Full Text] [PDF] [Request Permissions]  

Fritz Mertzlufft, Friedhelm Bach, Rolf Zander, and Thomas Standl

Hydroxyethyl Starch (HES) 130/0.4 During Acute Normovolemic Hemodilution Increases Tissue Oxygen Tension Larger and Faster than HES 70/0.5 or HES 200/0.5 • Response
Anesth Analg 2004 98: 559-560. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Benjamin A. Kohl and Michael K. Cahalan

A Practical Approach to Transesophageal Echocardiography • Practical Perioperative Transoesophageal Echocardiography • Books and Multimedia Received
Anesth Analg 2004 98: 561-562. [Full Text] [PDF] [Request Permissions]  

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