CARDIOVASCULAR ANESTHESIA:

Bernard Lo, Rob Fijnheer, Domenico Castigliego, Cornelius Borst, Cor J. Kalkman, and Arno P. Nierich

Activation of Hemostasis After Coronary Artery Bypass Grafting With or Without Cardiopulmonary Bypass
Anesth Analg 2004 99: 634-640. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Coronary artery bypass grafting with cardiopulmonary bypass is associated with excessive thrombin generation and fibrinolytic activity immediately after surgery compared with off-pump procedures. However, after off-pump coronary surgery, patients demonstrated a delayed postoperative response that became equal in magnitude to that of those having on-pump procedures in the later (20-96 h) postoperative period.

Shahar Bar-Yosef, Joseph P. Mathew, Mark F. Newman, Kevin P. Landolfo, Hilary P. Grocott, and The Neurological Outcome Research Group and C.A.R.E. Investigators of the Duke Heart Center

Prevention of Cerebral Hyperthermia During Cardiac Surgery by Limiting On-Bypass Rewarming in Combination with Post-Bypass Body Surface Warming: A Feasibility Study
Anesth Analg 2004 99: 641-646. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cerebral hyperthermia during rewarming from cardiopulmonary bypass is associated with increased neurological injury. In this randomized, controlled study, we have shown that limiting the target rewarming temperature on bypass to 35{degrees}C, combined with continuous surface warming, can prevent cerebral hyperthermia without risking prolonged postoperative hypothermia.

Jacqueline M. Leung, Wayne H. Bellows, and Darwin Pastor

Does Intraoperative Evaluation of Left Ventricular Contractile Reserve Predict Myocardial Viability? A Clinical Study Using Dobutamine Stress Echocardiography in Patients Undergoing Coronary Artery Bypass Graft Surgery
Anesth Analg 2004 99: 647-654. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: To assess the left ventricular contractile reserve during reperfusion in patients undergoing coronary artery bypass graft surgery, we measured the response of left ventricular regional wall motion and thickening by using dobutamine stress echocardiography (DSE) after myocardial revascularization, with validation by postoperative thallium-201 myocardial perfusion to assess myocardial viability. Our results demonstrate that a normal response to DSE (improvement in function) is highly specific for viable myocardium; however, a positive response to DSE has a low sensitivity in predicting nonviable myocardium. The majority of new postbypass regional wall motion abnormalities appear to be related to stunned myocardium.

Maike A. Grosse Hartlage, Elmar Berendes, Hugo Van Aken, Manfred Fobker, Marc Theisen, and Thomas P. Weber

Xenon Improves Recovery from Myocardial Stunning in Chronically Instrumented Dogs
Anesth Analg 2004 99: 655-664. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Inhalational administration of 75 vol% xenon provides cardiovascular stability and improves recovery from myocardial stunning in chronically instrumented dogs under fentanyl/midazolam anesthesia. This suggests that xenon may be a safe anesthetic for patients at high risk of perioperative myocardial ischemia.

Engelbert Deusch, Ulrich Thaler, and Sibylle A. Kozek-Langenecker

The Effects of High Molecular Weight Hydroxyethyl Starch Solutions on Platelets
Anesth Analg 2004 99: 665-668. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Hydroxyethyl starch (HES) solutions are widely used for fluid replacement in patients undergoing surgery, but they may compromise platelet function. The present study demonstrates that novel high molecular weight HES solutions differ from previous preparations in respect to side effects on platelet reactivity.

Parneeta Bhatia, Nahel N. Saied, and Mark E. Comunale

Management of an Unusual Complication During Placement of a Pulmonary Artery Catheter (Case Report)
Anesth Analg 2004 99: 669-671. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pulmonary artery catheters are widely used to manage critically ill patients but can be associated with various complications. This case report describes the occurrence and management of a highly unusual complication associated with the placement of a pulmonary artery catheter through a previously well positioned introducer sheath.

Gerard R. Manecke, Jr., Andreas Kotzur, Gus Atkins, Peter F. Fedullo, William R. Auger, David P. Kapelanski, and Stuart W. Jamieson

Massive Pulmonary Hemorrhage After Pulmonary Thromboendarterectomy (Case Report)
Anesth Analg 2004 99: 672-675. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Massive pulmonary hemorrhage is a potentially devastating complication of pulmonary thromboendarterectomy. Anesthesiologists involved in pulmonary artery surgery must be prepared to treat this complication with a variety of techniques.

Marie-Josée Nadeau, Dany Côté, and Jean S. Bussières

The Combination of Inhaled Nitric Oxide and Pulmonary Artery Balloon Inflation Improves Oxygenation During Whole-Lung Lavage (Case Report)
Anesth Analg 2004 99: 676-679. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We present a case in which the use of inhaled nitric oxide associated with temporary partial unilateral pulmonary artery occlusion further improved oxygenation during whole-lung lavage. This is the first case in the literature describing the simultaneous use of these two modalities.

Michael F. James and Larissa Cronjé

Pheochromocytoma Crisis: The Use of Magnesium Sulfate (Case Report)
Anesth Analg 2004 99: 680-686. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Pheochromocytoma crisis is a life-threatening condition that requires expert management. The effective use of magnesium sulfate is described in three cases in which conventional management had failed.

Wei-Zen Sun, Chin-Shuang Lin, Andy A. Lee, and Wei-Hung Chan

The Absence of Arterial Oxygen Desaturation During Massive Oxygen Embolism After Hydrogen Peroxide Irrigation (Case Report)
Anesth Analg 2004 99: 687-688. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We describe a young patient who developed circulatory collapse after intramedullary irrigation with H2O2. Notably, arterial oxygen saturation did not substantially change throughout the resuscitation from presumed oxygen embolization.

PEDIATRIC ANESTHESIA:

Jörg Bubeck, Karin Boos, Helmut Krause, and Karl-Christian Thies

Subcutaneous Tunneling of Caudal Catheters Reduces the Rate of Bacterial Colonization to That of Lumbar Epidural Catheters
Anesth Analg 2004 99: 689-693. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated the rates of bacterial colonization of tunneled and untunneled caudal epidural catheters and lumbar epidural catheters in children. Tunneled caudal catheters had no more colonization than lumbar-inserted catheters, whereas untunneled caudal catheters showed significantly more colonization.

Ban C. H. Tsui, Alese Wagner, Dominic Cave, and Rob Seal

Threshold Current for an Insulated Epidural Needle in Pediatric Patients
Anesth Analg 2004 99: 694-696. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Electrical stimulation may be a useful adjuvant tool for confirming proper thoracic epidural needle placement. The threshold current for an insulated needle is higher than the original Tsui test criteria described for an epidural catheter in the epidural space.

Li Meng, Joseph J. Quinlan, and Erin Sullivan

The Anesthetic Management of a Patient with Cohen Syndrome (Case Report)
Anesth Analg 2004 99: 697-698. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cohen syndrome is a rare genetic disorder caused by autosomal recessive inheritance. It is characterized by mental retardation and facial malformations. The administration of general anesthesia in patients with Cohen syndrome can be a challenge. We describe the anesthetic management of a patient with Cohen syndrome.

AMBULATORY ANESTHESIA:

Jeffrey L. Apfelbaum, Tong J. Gan, Sean Zhao, David B. Hanna, and Connie Chen

Reliability and Validity of the Perioperative Opioid-Related Symptom Distress Scale
Anesth Analg 2004 99: 699-709. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The symptom distress scale (SDS) was designed to evaluate the level of distress associated with the adverse effects of commonly used opiates. This study reports on the reliability and validity of the SDS in a group of patients undergoing laparoscopic cholecystectomy. The validity of the SDS was demonstrated by using specific symptoms directly assessed in the clinical trial and patient responses to questions regarding general satisfaction and daily activities.

Ismail Kati, Murat Tekin, Emin Silay, Urfettin A. Huseyinoglu, and Huseyin Yildiz

Does Benzydamine Hydrochloride Applied Preemptively Reduce Sore Throat Due to Laryngeal Mask Airway?
Anesth Analg 2004 99: 710-712. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We investigated whether preemptive benzydamine hydrochloride (BH) treatment could prevent sore throat due to a laryngeal mask airway (LMA) cuff inflated with air. We conclude that preemptive topical BH treatment may prevent sore throat due to LMA use.

Helena Kallio, Eljas-Veli T. Snäll, Markku P. Kero, and Per H. Rosenberg

A Comparison of Intrathecal Plain Solutions Containing Ropivacaine 20 or 15 mg Versus Bupivacaine 10 mg
Anesth Analg 2004 99: 713-717. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In spinal anesthesia, ropivacaine provided two thirds of the duration in sensory block and half of the duration in motor block compared with bupivacaine. Both 20 and 15 mg of ropivacaine are suitable for lower-extremity surgery of 1 h in duration. The latter dose is preferable in day-case surgery because of rapid motor recovery.

ANESTHETIC PHARMACOLOGY:

Peter Kranke, Leopold H. Eberhart, Norbert Roewer, and Martin R. Tramèr

Single-Dose Parenteral Pharmacological Interventions for the Prevention of Postoperative Shivering: A Quantitative Systematic Review of Randomized Controlled Trials
Anesth Analg 2004 99: 718-727. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: With prophylactic clonidine or meperidine, the incidence of postoperative shivering may be reduced by a factor of approximately 1.6. When the baseline risk is extremely high, one in three to four patients may profit. Other interventions—for instance, nefopam—may be even more effective but have been less well studied.

Jin-Tae Kim, Chul-Woo Jung, and Kook-Hyun Lee

The Effect of Insulin on the Resuscitation of Bupivacaine-Induced Severe Cardiovascular Toxicity in Dogs
Anesth Analg 2004 99: 728-733. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Bupivacaine-induced cardiac toxicity is extremely difficult to treat. We found that profound cardiovascular depression by bupivacaine in dogs was effectively reversed with insulin-glucose-potassium infusion.

Chiu-Ming Ho, Shung-Tai Ho, Jhi-Joung Wang, Shen-Kou Tsai, and Chok-Yung Chai

Dexamethasone Has a Central Antiemetic Mechanism in Decerebrated Cats
Anesth Analg 2004 99: 734-739. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Dexamethasone has an antiemetic property, but the mechanism remains unclear. An oscillographic vomiting model was used in unanesthetized and decerebrated cats to demonstrate that a stereotaxic microinjection of dexamethasone had an antiemetic effect against xylazine-induced emesis by acting on glucocorticoid receptors in the bilateral nuclei tractus solitarii.

Bahattin Tuncali, Ayse Karci, Binnur Erdalkiran Tuncali, Omur Mavioglu, Cimen Gulben Olguner, Selin Ayhan, and Zahide Elar

Dilution of Rocuronium to 0.5 mg/mL with 0.9% NaCl Eliminates the Pain During Intravenous Injection in Awake Patients
Anesth Analg 2004 99: 740-743. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In awake patients, pain on injection of rocuronium during the induction of general anesthesia is common. The osmolality and pH of the solutions were the same in all groups. Dilution of rocuronium to 1 and 0.5 mg/mL with 0.9 % NaCl decreased or prevented the pain during IV injection.

Jason C. Sewell and John W. Sear

Derivation of Preliminary Three-Dimensional Pharmacophores for Nonhalogenated Volatile Anesthetics
Anesth Analg 2004 99: 744-751. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We have derived an activity model for a group of structurally diverse nonhalogenated volatile anesthetics that correlates in vivo potency (minimum alveolar anesthetic concentration) with the spatial distribution of their molecular bulk and electrostatic potential. Our results suggest that there is a common molecular basis for the immobilizing activity of the anesthetics.

Sylvia Cechova and Thomas N. Pajewski

The Soluble Guanylyl Cyclase Inhibitor ODQ, 1H-[1,2,4]oxadiazolo[4,3-a]quinoxalin-1-one, Dose-Dependently Reduces the Threshold for Isoflurane Anesthesia in Rats
Anesth Analg 2004 99: 752-757. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The nitric oxide-guanylyl cyclase signaling pathway has been proposed to be involved in sedation, analgesia, and anesthesia. Specific inhibitors of the enzyme nitric oxide synthase resulted in a reduction in the anesthetic requirements (MAC) for isoflurane. In the present study, we demonstrate that ODQ, a specific inhibitor of soluble guanylyl cyclase, was also capable of reducing the MAC for isoflurane anesthesia in the rat.

Alan D. Kaye, Jason M. Hoover, Syed R. Baber, Ikhlass N. Ibrahim, and Aaron M. Fields

Analysis of Gamma-Aminobutyric Acid-Mediated Responses in the Pulmonary Vascular Bed of the Cat
Anesth Analg 2004 99: 758-763. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The {gamma}-aminobutyric acid (GABA) receptor and its subtypes, GABAA and GABAB, have been extensively studied in recent years. GABA agonists and antagonists have been used for the treatment of various medical conditions. The results of this investigation suggest a role for GABA modulators in pulmonary hypertensive processes.

Maki Mizogami, Hironori Tsuchiya, and Ko Takakura

Local Anesthetics Adsorbed onto Infusion Balloon
Anesth Analg 2004 99: 764-768. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Lidocaine, bupivacaine, ropivacaine, and mepivacaine decreased in the effluents flowing out of infusion balloons, indicating that local anesthetics are often adsorbed onto the balloons and that their actual infused concentrations may be smaller than predicted.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Michael Laster, Patricia Roth, and Edmond I Eger, II

Fires from the Interaction of Anesthetics with Desiccated Absorbent
Anesth Analg 2004 99: 769-774. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Fire may result from the interaction of sevoflurane, but not desflurane or isoflurane, with desiccated carbon dioxide absorbent, particularly Baralyme(R).

Mairead Heaney, Leo G. Kevin, Alex R. Manara, Tracey J. Clayton, Shelly D. Timmons, John J. Angel, Kenneth R. Smith, Brent Ibata, Ciaran Bolger, and Anthony J. Cunningham

Ocular Microtremor During General Anesthesia: Results of a Multicenter Trial Using Automated Signal Analysis
Anesth Analg 2004 99: 775-780. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Ocular microtremor (OMT), a fine physiologic tremor of the eye of neurogenic origin, is suppressed by general anesthetics, suggesting that it could serve as a marker of the conscious state. Furthermore, OMT can be easily measured by using an automated analysis module even under conditions of neuromuscular blockade and altered patient position.

Ashraf A. Dahaba, Markus Mattweber, Andreas Fuchs, Wilhelm Zenz, Peter H. Rehak, Werner F. List, and Helfried Metzler

The Effect of Different Stages of Neuromuscular Block on the Bispectral Index and the Bispectral Index-XP Under Remifentanil/Propofol Anesthesia
Anesth Analg 2004 99: 781-787. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The bispectral index (BIS) and its new version, the BIS-XP, monitor the depth of anesthesia. Under propofol/remifentanil anesthesia, the BIS readings did not significantly change during complete neuromuscular block or during various levels of neuromuscular recovery.

Peter E. Horowitz, Miguel A. Delagarza, Jaime J. Pulaski, and Robert A. Smith

Flow Rates and Warming Efficacy with Hotline and Ranger Blood/Fluid Warmers
Anesth Analg 2004 99: 788-792. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared the ability of a new dry heat blood/fluid warmer (Ranger) with the water bath warmer Hotline in terms of flow rates and outflow temperatures by using room temperature saline and 10{degrees}C diluted packed red blood cells (RBCs). Flow rates were similar, but the Ranger provided higher outflow temperatures at flows >4 L/h, especially during rapid pressurized infusions of both RBCs and saline.

Toshiya Kawagishi, Noriaki Kanaya, Masayasu Nakayama, Saori Kurosawa, and Akiyoshi Namiki

A Comparison of the Failure Times of Pulse Oximeters During Blood Pressure Cuff-Induced Hypoperfusion in Volunteers
Anesth Analg 2004 99: 793-796. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We compared the failure times of pulse oximeters during cuff-induced hypoperfusion in volunteers. The MasimoSET Radical did not lose a signal as rapidly as the other oximeters studied. MasimoSET Radical was similar in performance to the Nellcor N-395 at providing useful data sooner than conventional technology after a loss of the signal. These observations suggest that data will be more available with fewer false-positive alarms when using the MasimoSET oximeter followed by the Nellcor N-395 when compared with conventional oximeters.

PAIN MEDICINE:

Peter Kranke, Astrid M. Morin, Norbert Roewer, and Leopold H. Eberhart

Patients’ Global Evaluation of Analgesia and Safety of Injected Parecoxib for Postoperative Pain: A Quantitative Systematic Review
Anesth Analg 2004 99: 797-806. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Parecoxib significantly improved patients' global evaluation with the study medication compared with placebo when it was used for prophylaxis and treatment of perioperative pain. In the treatment of pain, the tolerability and efficacy of parecoxib 40 mg in terms of patients' global evaluation were comparable to those with 30-60 mg of ketorolac.

David J. Chang, Paul J. Desjardins, Thomas R. King, Tara Erb, and Gregory P. Geba

The Analgesic Efficacy of Etoricoxib Compared with Oxycodone/Acetaminophen in an Acute Postoperative Pain Model: A Randomized, Double-Blind Clinical Trial
Anesth Analg 2004 99: 807-815. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In this study we used the dental pain model to compare the efficacy of etoricoxib and oxycodone/acetaminophen in the treatment of acute pain. As demonstrated by this study, etoricoxib offers rapid, effective, and durable analgesia with fewer incidences of nausea and vomiting while perhaps reducing the risk of postsurgical bleeding.

Boris A. Chizh, Martin Dusch, Martin Puthawala, Martin Schmelz, Louise M. Cookson, Reynaldo Martina, John Brown, and Wolfgang Koppert

The Effect of Intravenous Infusion of Adenosine on Electrically Evoked Hyperalgesia in a Healthy Volunteer Model of Central Sensitization
Anesth Analg 2004 99: 816-822. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A controlled study of IV adenosine in a healthy volunteer model of electrically evoked hyperalgesia demonstrated a reduction of measures of central sensitization, a key mechanism of neuropathic pain. Because adenosine can alleviate neuropathic pain in patients, the model may be useful for early characterization of new treatments for this indication in humans.

Gisela Scharbert, Engelbert Deusch, Hans Georg Kress, Manfred Greher, Burkhard Gustorff, and Sibylle A. Kozek-Langenecker

Inhibition of Platelet Function by Hydroxyethyl Starch Solutions in Chronic Pain Patients Undergoing Peridural Anesthesia
Anesth Analg 2004 99: 823-827. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Crystalloids and hydroxyethyl starch (HES) solutions are widely used for fluid replacement in patients undergoing peridural anesthesia. We found a relevant antiplatelet effect of HES. Because hemostasiological competence is a prerequisite for safe neuraxial blockade, the decision of HES for fluid administration before blockade should be critically made.

Sachiko Todoroki, Hiroaki Morooka, Michiko Yamaguchi, Toshiya Tsujita, and Koji Sumikawa

Ropivacaine Inhibits Neurite Outgrowth in PC-12 Cells
Anesth Analg 2004 99: 828-832. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: To determine if ropivacaine affects sympathetic sprouting, we used pheochromocytoma (PC-12) cells, which differentiate into neurons on exposure to nerve growth factor. Neurite outgrowth was quantified as neurite extension after exposure to ropivacaine. Ropivacaine inhibited the neurite outgrowth in a dose-dependent manner.

ECONOMICS, EDUCATION, AND HEALTH SYSTEMS RESEARCH:

Peter S. Sebel, T. Andrew Bowdle, Mohamed M. Ghoneim, Ira J. Rampil, Roger E. Padilla, Tong Joo Gan, and Karen B. Domino

The Incidence of Awareness During Anesthesia: A Multicenter United States Study
Anesth Analg 2004 99: 833-839. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Data from 19,575 patients indicate that the incidence of awareness with recall after surgery under general anesthesia is 0.13%. This means that the minimum incidence of awareness is 1.3 patients per 1000.

Jeffrey M. Feldman

Do Anesthesia Information Systems Increase Malpractice Exposure? Results of a Survey
Anesth Analg 2004 99: 840-843. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: A survey of departments using an anesthesia information system for anesthesia record keeping suggests that these systems are useful for managing malpractice risk and do not increase malpractice exposure.

Jeana E. Havidich, Gary R. Haynes, and J. G. Reves

The Effect of Lengthening Anesthesiology Residency on Subspecialty Education
Anesth Analg 2004 99: 844-856. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The purpose of this study was to determine the long-term effect of the additional year of anesthesia training instituted in 1989 by the American Board of Anesthesiology on the number of individuals enrolled in subspecialty training. Our data indicate that the number of fellows increased over 10 yr. We conclude that factors other than the duration of training influence the selection of subspecialty education.

CRITICAL CARE AND TRAUMA:

Ettore Crimi, Antonio Liguori, Mario Condorelli, Michele Cioffi, Marinella Astuto, Paola Bontempo, Orlando Pignalosa, Maria Teresa Vietri, Anna Maria Molinari, Vincenzo Sica, Francesco Della Corte, and Claudio Napoli

The Beneficial Effects of Antioxidant Supplementation in Enteral Feeding in Critically Ill Patients: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial
Anesth Analg 2004 99: 857-863. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Massive oxidative injury may promote poor clinical outcome in critically ill patients. This study demonstrates that antioxidant intervention is associated with reduced oxidative stress, enhanced antioxidant defenses, and reduced 28-day mortality in critically ill patients.

Lars G. Fischer, Jan H. Hilpert, Hendrik Freise, Doreen Wendholt, Hugo Van Aken, and Andreas W. Sielenkämper

Bradykinin-Induced Pulmonary Vasoconstriction Is Time and Inducible Nitric Oxide Synthase Dependent in a Peritonitis Sepsis Model
Anesth Analg 2004 99: 864-871. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This study demonstrated in a more clinical sepsis model (cecal ligation and perforation) a time dependency of bradykinin-induced vasoconstriction in an isolated perfused rat lung setup, indicating endothelial injury. Inducible nitric oxide synthase appeared to play an important role in the pathogenesis of this pulmonary endothelial dysfunction.

Yuji Kadoi, Hiroshi Hinohara, Fumio Kunimoto, Shigeru Saito, Fumio Goto, Takayuki Kosaka, and Keisuke Ieta

Pilot Study of the Effects of ONO-5046 in Patients with Acute Respiratory Distress Syndrome
Anesth Analg 2004 99: 872-877. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: ONO-5046 decreased cytokine levels more rapidly in acute respiratory distress syndrome patients treated with sivelestat than in those who received placebo. However, these decreases did not appear to affect other clinical variables, such as the duration of mechanical ventilation or survival rates.

Martin Westphal, Andreas Wilhelm Sielenkämper, Hugo Van Aken, Henning Dirk Stubbe, Fritz Daudel, Ralf Schepers, Simone Schulte, and Hans-Georg Bone

Dopexamine Reverses the Vasopressin-Associated Impairment in Tissue Oxygen Supply but Decreases Systemic Blood Pressure in Ovine Endotoxemia
Anesth Analg 2004 99: 878-885. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Because vasopressin decreases cardiac output and oxygen delivery, we investigated the use of dopexamine as an adjunct to vasopressin infusion. During experimental endotoxemia, small doses of dopexamine reversed the arginine vasopressin-linked depression in cardiac index, thereby improving oxygen supply. Although large-dose dopexamine (10 {micro}g {middle dot} kg-1 {middle dot} min-1) improved the pulmonary circulation, systemic hypotension and tachycardia occurred.

Werner Rabitsch, Wolfgang J. Köstler, Wolfgang Fiebiger, Christoph Dielacher, Heidrun Losert, Camillo Sherif, Thomas Staudinger, Edith Seper, Walter Koller, Florian Daxböck, Ernst Schuster, Paul Knöbl, Heinz Burgmann, and Michael Frass

Closed Suctioning System Reduces Cross-Contamination Between Bronchial System and Gastric Juices
Anesth Analg 2004 99: 886-892. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This is the first prospective, randomized study comparing open versus closed suctioning with respect to microbiological cross-contamination between bronchial system and gastric juices and the incidence of ventilator-associated pneumonia in mechanically ventilated patients in the intensive care unit.

Thomas Edrich, Andrew D. Friedrich, Holger K. Eltzschig, and Thomas W. Felbinger

Ketamine for Long-Term Sedation and Analgesia of a Burn Patient (Case Report)
Anesth Analg 2004 99: 893-895. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: The care of critically ill burn patients can be challenging because of a rapidly escalating tolerance for opioids. In this case, a large-dose ketamine infusion was useful for both analgesia and sedation. It significantly reduced the opioid requirement and overcame the adverse effects of opioids.

NEUROSURGICAL ANESTHESIA:

Noriko Yokoo, Huaxin Sheng, Javier Mixco, H. Mayumi Homi, Robert D. Pearlstein, and David S. Warner

Intraischemic Nitrous Oxide Alters Neither Neurologic Nor Histologic Outcome: A Comparison with Dizocilpine
Anesth Analg 2004 99: 896-903. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Rats were subjected to temporary focal cerebral ischemia and allowed to recover for 3 days or 2 wk. There was no effect of intraischemic N2O on histologic or behavioral outcome at either recovery interval, whereas the N-methyl-D-aspartate antagonist dizocilpine caused persistent improvement in both outcome measures.

Hiroyuki Kinoshita, Katsutoshi Nakahata, Mayuko Dojo, Yoshiki Kimoto, and Yoshio Hatano

Lidocaine Impairs Vasodilation Mediated by Adenosine Triphosphate-Sensitive K⁺ Channels but Not by Inward Rectifier K⁺ Channels in Rat Cerebral Microvessels
Anesth Analg 2004 99: 904-909. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: In parenchymal arterioles of the rat cerebral cortex, lidocaine impairs vasodilation mediated by adenosine triphosphate (ATP)-sensitive K+ channels but not by inward rectifier K+ channels. These results indicate that lidocaine may impair vasodilator responses mediated via ATP-sensitive K+ channels, resulting in decreased cerebral parenchymal perfusion.

OBSTETRIC ANESTHESIA:

Laurence Bal, Stéphane Thierry, Elsa Brocas, Marie Adam, Andry Van de Louw, and Alain Tenaillon

Pulmonary Edema Induced by Calcium-Channel Blockade for Tocolysis (Case Report)
Anesth Analg 2004 99: 910-911. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: This report describes pulmonary edema that occurred during tocolysis with nicardipine plus betamethasone.

REGIONAL ANESTHESIA:

Juri L. Pedersen, Jesper Lillesø, Niels A. Hammer, Mads U. Werner, Kathrine Holte, Peter G. Lacouture, and Henrik Kehlet

Bupivacaine in Microcapsules Prolongs Analgesia After Subcutaneous Infiltration in Humans: A Dose-Finding Study
Anesth Analg 2004 99: 912-918. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Incorporation of bupivacaine and dexamethasone in microcapsules compared with aqueous bupivacaine significantly prolonged analgesia after subcutaneous infiltration in volunteers. Analgesia was seen 96 h after infiltration.

Andrea Casati, Federico Vinciguerra, Gianluca Cappelleri, Giorgio Aldegheri, Crispino Grispigni, Marta Putzu, and Paola Rivoltini

Levobupivacaine 0.2% or 0.125% for Continuous Sciatic Nerve Block: A Prospective, Randomized, Double-Blind Comparison with 0.2% Ropivacaine
Anesth Analg 2004 99: 919-923. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Comparing 0.2% ropivacaine with 0.125% and 0.2% levobupivacaine for continuous lateral popliteal sciatic nerve block after hallux valgus repair, this prospective, randomized, double-blinded study demonstrated that both 0.125% and 0.2% levobupivacaine provide effective adequate postoperative analgesia without differences from that provided by 0.2% ropivacaine. If early mobilization of the operated foot is required, the 0.125% concentration of levobupivacaine is preferred rather than 0.2%.

Makoto Tanaka, Toru Goyagi, Tetsu Kimura, and Toshiaki Nishikawa

The Effects of Cervical and Lumbar Epidural Anesthesia on Heart Rate Variability and Spontaneous Sequence Baroreflex Sensitivity
Anesth Analg 2004 99: 924-929. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Cervical epidural anesthesia with lidocaine produces depressed heart rate variability and baroreflex control of heart rate, whereas lumbar epidural anesthesia exerts minimal effects on autonomic nervous system activity in conscious humans.

Christian W. Hönemann, Klaus Hahnenkamp, Tobias Podranski, Danja Strumper, Markus W. Hollmann, and Marcel E. Durieux

Local Anesthetics Inhibit Thromboxane A₂ Signaling in Xenopus Oocytes and Human K562 Cells
Anesth Analg 2004 99: 930-937. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: We demonstrated, using two different models, that thromboxane receptor functioning is inhibited by commonly used local anesthetics. One site of action seems to be inside the cell. This suggests that some of the beneficial effects of regional anesthesia techniques might be due to direct interaction of local anesthetics with the functioning of membrane proteins.

GENERAL ARTICLES:

Kerryn M. Martin, Peter D. Larsen, Reny Segal, and Colin P. Marsland

Effective Nonanatomical Endoscopy Training Produces Clinical Airway Endoscopy Proficiency
Anesth Analg 2004 99: 938-944. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Endoscopic skills can be developed and measured on models with the expectation that good model performance will result in good clinical performance. Benchmark levels of endoscopic dexterity can be achieved clinically without a novice learning curve. DexterTM is a more effective model than "Choose the Hole" for learning endoscopic dexterity. Caution is warranted in the use of topical lidocaine in amounts approaching the upper limits of published dose ranges.

William C. Culp, Jr. and Michael P. Kinsky

Sequential One-Lung Isolation Using a Double Arndt Bronchial Blocker Technique (Case Report)
Anesth Analg 2004 99: 945-946. [Abstract] [Full Text] [PDF] [Request Permissions]  

IMPLICATIONS: Double Arndt bronchial blocker lung isolation may provide an alternate means of sequential lung isolation and one-lung ventilation.

LETTERS TO THE EDITOR:

Dietmar Fries, Corinna Velik-Salchner, Petra Innerhofer, Suryanarayana Pothula, Vajubhai T. Sanchala, Basavaraj Nagappala, and Mario A. Inchiosa, Jr.

Antiplatelet and Anticoagulant Prophylaxis and Postoperative Blood Loss in Cardiac Surgery • Response
Anesth Analg 2004 99: 947. [Full Text] [PDF] [Request Permissions]  

Linda Shore-Lesserson, Kenichi A. Tanaka, Jerrold H. Levy, Suryanarayana Pothula, Vajubhai T. Sanchala, Basavaraj Nagappala, and Mario A. Inchiosa, Jr.

Antiplatelet Agents and Bleeding After Cardiac Surgery • Response
Anesth Analg 2004 99: 947-948. [Full Text] [PDF] [Request Permissions]  

Matthew T. V. Chan, Sin Shing Ho, Tony Gin, Gunter N. Schmidt, Thomas Standl, and Petra Bischoff

AEP "Click Detection" Failure: May Be, May Be Not! • Response
Anesth Analg 2004 99: 948-950. [Full Text] [PDF] [Request Permissions]  

Jean-Pol Depoix, Jean-Paul Couetil, Norredine Chick, Jean-Marie Desmonts, and Jean Mantz

A Simple Technique to Properly Position a Swan Ganz Catheter in Cardiac Surgical Patients with Situs Inversus
Anesth Analg 2004 99: 950. [Full Text] [PDF] [Request Permissions]  

Richard Brull, Colin J. L. McCartney, Vincent W. S. Chan, Øivind Klaastad, Hans-Jørgen Smith, Örjan Smedby, Eldrid H. Winther-Larssen, Per Brodal, Harald Breivik, and Erik T. Fosse

A Novel Approach to Infraclavicular Brachial Plexus Block: The Ultrasound Experience • Response
Anesth Analg 2004 99: 950-951. [Full Text] [PDF] [Request Permissions]  

B. S. von Ungern-Sternberg and T. O. Erb

Partial Airway Obstruction by a Pediatric Laryngeal Mask Airway
Anesth Analg 2004 99: 951. [Full Text] [PDF] [Request Permissions]  

Young-Chang P. Arai, Wataru Manabe, Kayo Fukunaga, Seiji Hirota, Noriko Kitaoka, and Wasa Ueda

Warm Steaming Increases the Analgesic Effect of Topical Lidocaine Tape on Venous Cannulation
Anesth Analg 2004 99: 951-952. [Full Text] [PDF] [Request Permissions]  

Yushi U. Adachi, Maiko Satomoto, and Hideyuki Higuchi

Tracheal Intubation in the Lateral Position
Anesth Analg 2004 99: 952. [Full Text] [PDF] [Request Permissions]  

Prabhat Kumar Sinha, Sethuraman Manikandan, Taras I. Usichenko, and Dragan Pavlovic

Reducing Venipuncture Pain by Cough Trick • Response
Anesth Analg 2004 99: 952-953. [Full Text] [PDF] [Request Permissions]  

Timothy Lacy, Neil Roy Connelly, Katharine Freeman, Anil Agarwal, Mohammad F. Ansari, Sanjay Dhiraaj, and Mehdi Raza

Don’t Use Thiopental to Decrease Propofol Injection Pain • Response
Anesth Analg 2004 99: 953-954. [Full Text] [PDF] [Request Permissions]  

Scott A. Lang, M. E. Rooney, Bruce Ben-David, and Jacques Chelly

Postoperative Analgesia Following Total Knee Arthroplasty • Response
Anesth Analg 2004 99: 954-955. [Full Text] [PDF] [Request Permissions]  

Leo Stemp, Thomas J. Papadimos, Indu Sen, Deepak Thapa, and Kanti K. Gombar

Interpretation of PO₂ via FIO₂ • Response • Response
Anesth Analg 2004 99: 955. [Full Text] [PDF] [Request Permissions]  

Tomasz Gaszynski and Philippe Juvin

Standard Clinical Tests for Predicting Difficult Intubation Are Not Useful Among Morbidly Obese Patients • Response
Anesth Analg 2004 99: 956. [Full Text] [PDF] [Request Permissions]  

Shahzad G. Raja, Yves A. Debaveye, and Greet H. Van den Berghe

Let Us Not Displace Small-Dose Dopamine from the Modern ICU So Soon • Response
Anesth Analg 2004 99: 956-957. [Full Text] [PDF] [Request Permissions]  

BOOK AND MULTIMEDIA REVIEWS:

Linda Shore-Lesserson

Clinical Monitoring and Transesophageal Echocardiography: Part I. International Anesthesiology Clinics. • Books and Multimedia Received
Anesth Analg 2004 99: 958. [Full Text] [PDF] [Request Permissions]  

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