EDITORIALS:

Martin J. London

Quo Vadis, Perioperative Beta Blockade? Are You "POISE'd" on the Brink?
Anesth Analg 2008 106: 1025-1030. [Full Text] [PDF]  

Azriel Perel

Automated Assessment of Fluid Responsiveness in Mechanically Ventilated Patients
Anesth Analg 2008 106: 1031-1033. [Full Text] [PDF]  

CARDIOVASCULAR ANESTHESIOLOGY:

W. Scott Beattie, Duminda N. Wijeysundera, Keyvan Karkouti, Stuart McCluskey, and Gordon Tait

Does Tight Heart Rate Control Improve Beta-Blocker Efficacy? An Updated Analysis of the Noncardiac Surgical Randomized Trials
Anesth Analg 2008 106: 1039-1048. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The trials that achieve the most effective control of heart rate are associated with a reduced incidence of postoperative myocardial infarction, suggesting that effective control of heart rate is important for achieving cardioprotection. This meta-analysis, however, demonstrates that administration of {beta}-blockers does not reliably decrease heart rates, and may be associated with increased side effects.

Matthias L. Riess, Alexandre D. Costa, Richard Carlson, Jr, Keith D. Garlid, André Heinen, and David F. Stowe

Differential Increase of Mitochondrial Matrix Volume by Sevoflurane in Isolated Cardiac Mitochondria
Anesth Analg 2008 106: 1049-1055. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Maintenance of mitochondrial matrix volume due to potassium influx has been implicated in cardioprotection via KATP channel opening. Here, we show that sevoflurane increases mitochondrial matrix volume by opening KATP channels. These findings add to our understanding of the intracellular mechanisms of volatile anesthetics as cardioprotective drugs.

Niamh P. Conlon, Eilis P. Bale, G. Peter Herbison, and Maire McCarroll

Postoperative Anemia and Quality of Life After Primary Hip Arthroplasty in Patients Over 65 Years Old
Anesth Analg 2008 106: 1056-1061. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We found a positive correlation between hemoglobin levels on discharge and quality of life in elderly patients after primary hip arthroplasty. This should direct us to reconsider the appropriateness of a restrictive transfusion policy in this subgroup of patients.

Hugh M. Smith, Stacy J. Farrow, SRNA, Joel D. Ackerman, James R. Stubbs, and Juraj Sprung

Cardiac Arrests Associated with Hyperkalemia During Red Blood Cell Transfusion: A Case Series
Anesth Analg 2008 106: 1062-1069. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A rapid and large transfusion of red blood cells (RBC) can result in hyperkalemia and cardiac arrest. Various conditions associated with hemorrhagic shock may worsen hyperkalemia and/or increase potassium cardiotoxicity during large RBC transfusions.

Gerhard Dickneite, Baerbel Doerr, and Franz Kaspereit

Characterization of the Coagulation Deficit in Porcine Dilutional Coagulopathy and Substitution with a Prothrombin Complex Concentrate
Anesth Analg 2008 106: 1070-1077. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Using a porcine model, this study showed that treatment with a prothrombin complex concentrate improves coagulation after dilutional coagulopathy and reduces time to hemostasis with both venous and arterial bleeding.

Thorsten Haas, Dietmar Fries, Carmen Holz, Petra Innerhofer, Werner Streif, Anton Klingler, Alexander Hanke, and Corinna Velik-Salchner

Less Impairment of Hemostasis and Reduced Blood Loss in Pigs After Resuscitation from Hemorrhagic Shock Using the Small-Volume Concept with Hypertonic Saline/Hydroxyethyl Starch as Compared to Administration of 4% Gelatin or 6% Hydroxyethyl Starch Solution
Anesth Analg 2008 106: 1078-1086. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: When compared with fluid resuscitation using 6% hydroxyethyl starch (HES) 130/0.4 or 4% gelatin solution, small-volume resuscitation using 4 mL/kg hypertonic saline-HES might be preferable because the net effects of limited intravascular volume load and the preserved clot formation seem to reduce further blood loss.

Michael P. Eaton

Antifibrinolytic Therapy in Surgery for Congenital Heart Disease (Review Article)
Anesth Analg 2008 106: 1087-1100. [Abstract] [Full Text] [PDF] [CME]  

Christian Bauer, Zuzana Vichova, Patrick Ffrench, Christiane Hercule, Olivier Jegaden, Olivier Bastien, and Jean-Jacques Lehot

Extracorporeal Membrane Oxygenation with Danaparoid Sodium After Massive Pulmonary Embolism (Case Report)
Anesth Analg 2008 106: 1101-1103. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: During extracorporeal membrane oxygenation (ECMO), anticoagulation therapy is usually achieved with unfractionated heparin. We report on an ECMO with danaparoid sodium for a patient with massive pulmonary embolism and suspected type 2 heparin-induced thrombocytopenia.

Toshiyuki Sawai, Shinichiro Miyazaki, Junko Nakahira, Masayuki Ito, Masayuki Oka, Motoshige Tanaka, Hideaki Imanaka, and Toshiaki Minami

Intraoperative Transesophageal Echocardiography Enables Characterization of Coronary Artery Fistula in Coexistence with Multiple Giant Coronary Artery Aneurysms (Echo Rounds)
Anesth Analg 2008 106: 1104-1106. [Full Text] [PDF] [Echo Rounds]   

PEDIATRIC ANESTHESIOLOGY:

Agnes Rigouzzo, Laure Girault, Nicolas Louvet, Frederique Servin, Tom De-Smet, Veronique Piat, Robert Seeman, Isabelle Murat, and Isabelle Constant

The Relationship Between Bispectral Index and Propofol During Target-Controlled Infusion Anesthesia: A Comparative Study Between Children and Young Adults
Anesth Analg 2008 106: 1109-1116. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: In a study comparing plasma concentrations and target-controlled concentrations of propofol in children and young adults, the relationship between propofol and bispectral index in children appears to be less sensitive than in young adults.

Peter J. Davis, Kathleen M. Fertal, Karen R. Boretsky, Gina M. Fedel, Michael D. Ingram, Susan K. Woelfel, Paul C. Hoffmann, Harshad Gurnaney, and Michael C. Young

The Effects of Oral Ondansetron Disintegrating Tablets for Prevention of At-Home Emesis in Pediatric Patients After Ear-Nose-Throat Surgery
Anesth Analg 2008 106: 1117-1121. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Oral disintegrating tablets decrease at-home emesis in children undergoing tonsillectomy with or without adenoidectomy.

Jeong-Rim Lee, Young-Sun Lee, Chong Sung Kim, Seong Deok Kim, and Hee-Soo Kim

A Comparison of the End-Tidal Sevoflurane Concentration for Removal of the Laryngeal Mask Airway and Laryngeal Tube in Anesthetized Children
Anesth Analg 2008 106: 1122-1125. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study demonstrates that the end-tidal sevoflurane concentration needed for removal of a laryngeal mask airway and a laryngeal tube in children are similar.

AMBULATORY ANESTHESIOLOGY:

Richard L. Kahn, Maureen A. Stanton, Sarani Tong-Ngork, Gregory A. Liguori, Chris R. Edmonds, and David S. Levine

One-Year Experience with Day-of-Surgery Pregnancy Testing Before Elective Orthopedic Procedures
Anesth Analg 2008 106: 1127-1131. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: During 1 yr of mandatory urine pregnancy testing on the day of elective orthopedic surgery, three unrecognized pregnancies and one unrecognized ectopic pregnancy were detected. Patient history would not have been a reliable screening mechanism. There was also one false positive and three false "weak positive" tests, all in perimenopausal patients.

Hélène Gonzalez, Vincent Minville, Khedija Delanoue, Michel Mazerolles, Dominique Concina, and Olivier Fourcade

The Importance of Increased Neck Circumference to Intubation Difficulties in Obese Patients
Anesth Analg 2008 106: 1132-1136. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We investigated what anatomical elements were associated with difficult intubation. Using the intubation difficulty scale, thyromental distance, increasing neck circumference, body mass index, and a Mallampati score >= 3 were associated with a higher incidence of a difficult intubation. Neck circumference should be included when assessing patients preoperatively to predict difficult intubation.

B. Richez, L. Saltel, F. Banchereau, R. Torrielli, and A. M. Cros

A New Single Use Supraglottic Airway Device with a Noninflatable Cuff and an Esophageal Vent: An Observational Study of the i-Gel (Brief Report)
Anesth Analg 2008 106: 1137-1139. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The i-gel is a new single-use supraglottic airway device with a noninflatable cuff and an esophageal vent. This first clinical study demonstrates a first insertion success rate of 97%, a mean leak pressure 30 {+/-} 7 cm H2O, average peak pressure 11 {+/-} 3 cm H2O, and a low morbidity rate.

ANESTHETIC PHARMACOLOGY:

Marie-Pierre Bonnet, Hélène Beloeil, Dan Benhamou, Jean-Xavier Mazoit, and Karim Asehnoune

The µ Opioid Receptor Mediates Morphine-Induced Tumor Necrosis Factor and Interleukin-6 Inhibition in Toll-Like Receptor 2-Stimulated Monocytes
Anesth Analg 2008 106: 1142-1149. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: After toll-like receptor 2 stimulation with peptidoglycan, morphine inhibits tumor necrosis factor and interleukin (IL)-6 production in human monocytes via the {micro} opioid receptors pathway. IL-10 is not a factor for this inhibition.

Martin Roesslein, Michael Frick, Volker Auwaerter, Matjaz Humar, Ulrich Goebel, Christian Schwer, Klaus K. Geiger, Heike L. Pahl, Benedikt H. J. Pannen, and Torsten Loop

Sevoflurane-Mediated Activation of p38-Mitogen-Activated Stresskinase is Independent of Apoptosis in Jurkat T-Cells
Anesth Analg 2008 106: 1150-1160. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Our data suggest that sevoflurane and isoflurane are specific inducers of the ASK1-, MKK3/MKK6-p38 MAP kinase cascade in Jurkat T-cells. Sevoflurane-induced p38 activation and sevoflurane-mediated apoptosis are two uncorrelated phenomena. Since these changes are only induced by supra-clinical concentrations, their clinical relevance is uncertain.

Tao Luo, Ailin Luo, Miu Liu, and Xianyi Liu

Inhibition of the HERG Channel by Droperidol Depends on Channel Gating and Involves the S6 Residue F656
Anesth Analg 2008 106: 1161-1170. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Droperidol potently blocks human-ether-a-go-go-related gene potassium channels in the open and inactivated state. Aromatic residue at position 656 may participate in droperidol binding, and inactivation gating can induce a conformational state that optimizes droperidol binding to the channel. This finding provides a molecular mechanism for the previously reported QT interval prolongation under clinical administration of droperidol.

Sascha Kreuer, Jörgen Bruhn, Elisabeth Walter, Reinhard Larsen, Christian C. Apfel, Ulrich Grundmann, Andreas Biedler, and Wolfram Wilhelm

Comparative Pharmacodynamic Modeling Using Bispectral and Narcotrend-Index With and Without a Pharmacodynamic Plateau During Sevoflurane Anesthesia
Anesth Analg 2008 106: 1171-1181. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A pharmacokinetic/pharmacodynamic model with two sigmoidal curves connected by a intervening plateau describes the effect of sevoflurane on Bispectral Index and Narcotrend indices better than the classical Emax model with a single sigmoid curve. This new model might have advantages in studies where higher doses could result in electroencephalographic burst suppression.

TECHNOLOGY, COMPUTING, AND SIMULATION:

Simon Ford, Jeremy Daniels, Joanne Lim, Valentyna Koval, Guy Dumont, Stephan K. W. Schwarz, and J. Mark Ansermino

A Novel Vibrotactile Display to Improve the Performance of Anesthesiologists in a Simulated Critical Incident
Anesth Analg 2008 106: 1182-1188. [Abstract] [Full Text] [PDF] [Data Supplement]   

IMPLICATIONS: A vibrotactile display can enhance information transfer to the anesthesiologist and improve response times to a simulated clinical critical incident.

Maxime Cannesson, Bertrand Delannoy, Antoine Morand, Pascal Rosamel, Yassin Attof, Olivier Bastien, and Jean-Jacques Lehot

Does the Pleth Variability Index Indicate the Respiratory-Induced Variation in the Plethysmogram and Arterial Pressure Waveforms?
Anesth Analg 2008 106: 1189-1194. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The pleth variability index (Masimo Corp., Irvine, CA) is an automated method for calculating the respiratory-induced variation in the plethysmogram and follows similar changes in the arterial pulse pressure.

Maxime Cannesson, Juliette Slieker, Olivier Desebbe, Christian Bauer, Pascal Chiari, Roland Hénaine, and Jean-Jacques Lehot

The Ability of a Novel Algorithm for Automatic Estimation of the Respiratory Variations in Arterial Pulse Pressure to Monitor Fluid Responsiveness in the Operating Room
Anesth Analg 2008 106: 1195-1200. [Abstract] [Full Text] [PDF] [CME]  

IMPLICATIONS: Automated estimation of the magnitude of arterial blood pressure change due to respiratory variation agrees with manual estimation, and supports identifying patients who are likely to respond to fluid administration.

Jose Otavio Auler, Jr., Filomena Galas, Ludhmila Hajjar, Luciana Santos, Thiago Carvalho, and Frédéric Michard

Online Monitoring of Pulse Pressure Variation to Guide Fluid Therapy After Cardiac Surgery
Anesth Analg 2008 106: 1201-1206. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Automatic calculation and real-time monitoring of arterial pulse pressure variation induced by mechanical ventilation is possible using a bedside monitor and, in contrast to the measurement of cardiac filling pressures, can reliably predict the hemodynamic effects of intravascular fluid administration during the immediate postoperative period of cardiac surgery.

Javier F. Belda, Marina Soro, Rafael Badenes, Andreas Meiser, María Luisa García, Gerardo Aguilar, and Francisco J. Martí

The Predictive Performance of a Pharmacokinetic Model for Manually Adjusted Infusion of Liquid Sevofluorane for Use with the Anesthetic-Conserving Device (AnaConDa): A Clinical Study
Anesth Analg 2008 106: 1207-1214. [Abstract] [Full Text] [PDF] [Data Supplement]   

IMPLICATIONS: This pharmacokinetic model provides a simplified dosage scheme for administering liquid sevoflurane using the AnaConDa anesthetic-conserving device to sedate mechanically ventilated intensive care patients.

PATIENT SAFETY:

Steven I. Abramson, Allen A. Holmes, and Carin A. Hagberg

Awake Insertion of the Bonfils Retromolar Intubation Fiberscope^TM in Five Patients with Anticipated Difficult Airways (Case Report)
Anesth Analg 2008 106: 1215-1217. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Five cases are presented in which the Bonfils Retromolar Intubation FiberscopeTM was used for awake orotracheal intubation.

CRITICAL CARE AND TRAUMA:

Junya Nakada, Sayo Nagai, Masao Nishira, Renko Hosoda, Tatsuya Matsura, and Yoshimi Inagaki

Sealing of a Tracheoesophageal Fistula Using a Sengstaken-Blakemore Tube for Mechanical Ventilation During General Anesthesia (Case Report)
Anesth Analg 2008 106: 1218-1219. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Anesthetic management for insertion of a Dumon stent to seal a large tracheoesophageal fistula is difficult because of the care needed to prevent aspiration of esophageal contents and diversion of oxygen through the fistula into the stomach from the trachea when patients are under mechanical ventilation. Our method of sealing a large tracheoesophageal fistula with a Sengstaken-Blakemore tube was performed successfully, and seems to be simple but effective for this purpose.

OBSTETRIC ANESTHESIOLOGY:

Gligor Gucev, Grant M. Yasui, Tien-Yu Chang, and Jeffrey Lee

Bilateral Ultrasound-Guided Continuous Ilioinguinal-Iliohypogastric Block for Pain Relief After Cesarean Delivery (Case Report)
Anesth Analg 2008 106: 1220-1222. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We report three cases of successful bilateral, ultrasound-guided, continuous ilioinguinal-iliohypogastric nerve block for pain relief after cesarean delivery.

ECONOMICS, EDUCATION, AND POLICY:

Danielle Masursky, Franklin Dexter, Colleen E. O’Leary, Carol Applegeet, and Nancy A. Nussmeier

Long-Term Forecasting of Anesthesia Workload in Operating Rooms from Changes in a Hospital’s Local Population Can Be Inaccurate
Anesth Analg 2008 106: 1223-1231. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Current and predicted increases in age-adjusted population are often used to justify expansion of healthcare facilities to satisfy expected future demand. Analysis of operative data from three hospitals showed that annual changes in local population can be of no value in predicting their annual increases in anesthesia workload. At one hospital, operating room time increased despite a decline in the local population, including elderly.

Franklin Dexter, Elisabeth U. Dexter, Danielle Masursky, and Nancy A. Nussmeier

Systematic Review of General Thoracic Surgery Articles to Identify Predictors of Operating Room Case Durations
Anesth Analg 2008 106: 1232-1241. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Previous statistical analyses of operating room (OR) information systems databases have shown the importance of estimating OR case durations using a combination of scheduled procedure(s), surgeon, and type of anesthetic. A systematic review of general thoracic surgery articles identified those same data to be the principal predictors of case duration, emphasizing the importance of relying on all of these data.

SURGICAL ANESTHESIOLOGY:

Bing Zhang, Xia Wei, Xiaoguang Cui, Huacheng Zhou, Wengang Ding, and Wenzhi Li

Desflurane Affords Greater Protection Than Halothane in the Function of Mitochondria Against Forebrain Ischemia Reperfusion Injury in Rats
Anesth Analg 2008 106: 1242-1249. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We investigated the effect of treatment with two concentrations of desflurane on the properties of mitochondria isolated from rats subjected to forebrain ischemia and compared it with the effect of halothane. Better preservation of mitochondrial function was observed in the desflurane group when compared with the halothane group, which was assessed at 4 h after reperfusion.

GENERAL ARTICLES:

Paul F. White

Reengineering Fast-Track Anesthesia: The Expanding Role of Anesthesiologists in Perioperative Medical Care Meeting in Abano Terme, Padova, Italy, on June 19–20, 2007 (Meeting Report)
Anesth Analg 2008 106: 1250-1251. [Full Text] [PDF]  

ANALGESIA:

Kenneth J. Kardash, Frederic Sarrazin, Michael J. Tessler, and Ana M. Velly

Single-Dose Dexamethasone Reduces Dynamic Pain After Total Hip Arthroplasty
Anesth Analg 2008 106: 1253-1257. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: A single, preoperative IV dose of dexamethasone 40 mg has a prolonged suppressive effect on the inflammatory response and dynamic pain after total hip arthroplasty. Single-dose glucocorticoids may be a useful addition to multimodal postoperative analgesia.

Scott S. Reuben, Asokumar Buvenandran, Brennan Katz, and Jeffrey S. Kroin

A Prospective Randomized Trial on the Role of Perioperative Celecoxib Administration for Total Knee Arthroplasty: Improving Clinical Outcomes
Anesth Analg 2008 106: 1258-1264. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The perioperative administration of celecoxib, a cyclooxygenase (COX)-2 inhibitor, reduces postoperative pain and opioid consumption after major orthopedic surgery. In addition, this COX-2 inhibition has important long-term outcome benefits after total knee arthroplasty, including improved knee function scores and less time to achieve effective joint range of motion.

Urs Eichenberger, Frank Neff, Gorazd Sveticic, Steinar Björgo, Steen Petersen-Felix, Lars Arendt-Nielsen, and Michele Curatolo

Chronic Phantom Limb Pain: The Effects of Calcitonin, Ketamine, and Their Combination on Pain and Sensory Thresholds
Anesth Analg 2008 106: 1265-1273. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We found that ketamine, but not calcitonin, reduced the intensity of chronic phantom limb pain compared to placebo. This study confirms the potential usefulness of N-methyl-d-aspartate-antagonists in the treatment of this difficult pain condition and suggests further research for the translation of this knowledge into benefits for patients.

Chul Joong Lee, Yong Chul Kim, Jae Hyuck Shin, Francis Sahngun Nahm, Hyo Min Lee, Yun Suk Choi, Sang Chul Lee, Justin Sang Ko, Tae Hyeong Kim, Woo Seok Sim, Chung Su Kim, and Hyun Sung Cho

Intravascular Injection in Lumbar Medial Branch Block: A Prospective Evaluation of 1433 Injections
Anesth Analg 2008 106: 1274-1278. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Real-time fluoroscopy with contrast enhancement should be performed during the lumbar medial branch block procedure to increase diagnostic and therapeutic values and to avoid complications.

Yang Hyun Kim, Pyung Bok Lee, Chul Joong Lee, Sang Chul Lee, Yong Chul Kim, and Jin Huh

Dermatome Variation of Lumbosacral Nerve Roots in Patients with Transitional Lumbosacral Vertebrae
Anesth Analg 2008 106: 1279-1283. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The function of the lumbosacral nerve roots is altered in patients with a sacralized L5 or lumbarized S1. Therefore, in patients receiving epidurals or selective nerve root injections, one should be aware of a transitional segment before initiating the injection.

Lucinda A. Grande, John D. Loeser, and Ali Samii

Recurrent Transient Global Amnesia with Intrathecal Baclofen (Case Report)
Anesth Analg 2008 106: 1284-1287. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: We describe a patient who experienced repeated episodes of transient global amnesia as an adverse effect of intrathecal baclofen. Although such profound memory loss due to baclofen may be unique, this case draws the attention of clinicians to mild memory impairment as an occasional adverse effect. The discovery of exacerbating and alleviating factors may provide insight into the rare and poorly understood phenomenon of transient global amnesia.

Jeffrey S. Kroin, Mayumi Takatori, Jinyuan Li, Er-Yun Chen, Asokumar Buvanendran, and Kenneth J. Tuman

Upregulation of Dorsal Horn Microglial Cyclooxygenase-1 and Neuronal Cyclooxygenase-2 After Thoracic Deep Muscle Incisions in the Rat
Anesth Analg 2008 106: 1288-1295. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Deep surgical wounds can produce spinal upregulation of both cyclooxygenase-1 and -2 in selective cell types coincident with postoperative pain.

Andre Shih, Vjekoslav Miletic, Gordana Miletic, and Lesley J. Smith

Midazolam Administration Reverses Thermal Hyperalgesia and Prevents -Aminobutyric Acid Transporter Loss in a Rodent Model of Neuropathic Pain
Anesth Analg 2008 106: 1296-1302. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: This study evaluated the effect of the benzodiazepine, midazolam, on thermal hyperalgesia in a neuropathic pain model. Our results suggested that {gamma}-aminobutyric acid (GABA) inhibition may be attenuated after peripheral nerve injury and that this may contribute to resulting hyperalgesia. Our results imply that systemic administration of benzodiazepines prevents loss of the GABA transporter protein and that this class of drugs could be of help in alleviating symptoms of neuropathic pain.

Mathieu G. Sommers, Nha-Khanh Nguyen, Jan G. Veening, Kris C. Vissers, Merel Ritskes-Hoitinga, and Jan van Egmond

Suppression of Noxious-Induced C-Fos Expression in the Rat Lumbar Spinal Cord by Isoflurane Alone or Combined with Fentanyl
Anesth Analg 2008 106: 1303-1308. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: The noxious-induced withdrawal model combined with spinal Fos-immunoreactivity is a useful model for evaluating the differential effects of inhaled anesthetics and opioids on nociceptive processing during general anesthesia in rats.

Takahiro Suzuki, Kazuyoshi Ueta, Shinji Tamagaki, and Takashi Mashimo

Antiallodynic and Antihyperalgesic Effect of Milnacipran in Mice with Spinal Nerve Ligation
Anesth Analg 2008 106: 1309-1315. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Milnacipran showed antinociceptive, antiallodynic, and antihyperalgesic effects in mice with spinal nerve ligation. The analgesic effects may be mediated by an action at a supraspinal and spinal site via an activation of spinal noradrenaline and serotonin neurons.

Michael J. Barrington, David J. Olive, Craig A. McCutcheon, Christopher Scarff, Simone Said, Roman Kluger, Nicola Gillett, and Peter Choong

Stimulating Catheters for Continuous Femoral Nerve Blockade After Total Knee Arthroplasty: A Randomized, Controlled, Double-Blinded Trial
Anesth Analg 2008 106: 1316-1321. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Continuous femoral nerve blockade for postoperative analgesia after total knee arthroplasty was established with a stimulating or a nonstimulating catheter technique. We found no difference in opioid requirements, sensory blockade, and pain scores using these two techniques. The nonstimulating technique may be preferable because of its simplicity of insertion.

Hany A. Mowafi, Samer A. Arab, Salah A. Ismail, and AbdulMohsin Al-Ghamdi

The Effects of Intravenous Granisetron on the Sensory and Motor Blockade Produced by Intrathecal Bupivacaine
Anesth Analg 2008 106: 1322-1325. [Abstract] [Full Text] [PDF]  

IMPLICATIONS: Serotonin is an essential central nociceptive-modulating neurotransmitter. Blockade of 5-HT3 receptors after IV administration of granisetron is associated with a faster regression of sensory blockade after spinal bupivacaine.

Yodying Punjasawadwong, Nutchanart Boonjeungmonkol, and Aram Phongchiewboon

Bispectral Index for Improving Anesthetic Delivery and Postoperative Recovery
Anesth Analg 2008 106: 1326. [Full Text] [PDF]  

M. Subirana, I. Solà, and S. Benito

Closed Tracheal Suction Systems Versus Open Tracheal Suction Systems for Mechanically Ventilated Adult Patients
Anesth Analg 2008 106: 1326. [Full Text] [PDF]  

LETTERS TO THE EDITOR:

Alexander J. C. Mittnacht

Prolonged Decrease of Regional Cerebral Saturation Readings with the INVOS® Device After Continuous Intravenous Methylene Blue Administration
Anesth Analg 2008 106: 1327. [Full Text] [PDF]  

Ronald A. Widman and Michael D. Wider

Prolonged Decrease of Regional Cerebral Saturation Readings with the INVOS® Device After Continuous Intravenous Methylene Blue Administration
Anesth Analg 2008 106: 1327. [Full Text] [PDF]  

Andre Choiniere

Could This Be Malignant Hyperthermia?
Anesth Analg 2008 106: 1327-1328. [Full Text] [PDF]  

Barbara W. Brandom, Lynn M. Broadman, John A. Ozolek, Aparna S. Phadke, and Peter J. Davis

Could This Be Malignant Hyperthermia?
Anesth Analg 2008 106: 1328-1329. [Full Text] [PDF]  

Medhat Hannallah, Ellen Gibby, and Vance Watson

Fluoroscopy-Guided, Small-Dose Spinal Anesthesia for Kyphoplasty: A Collaborative Effort Between the Anesthesiologist and Interventional Radiologist
Anesth Analg 2008 106: 1329-1330. [Full Text] [PDF]  

Ulf Linstedt, Kay Ulrich Langenheim, and Jan Peter Braun

An Unusual Bleeding-Related Complication Following Percutaneous Dilatational Tracheostomy
Anesth Analg 2008 106: 1330. [Full Text] [PDF]  

BOOK AND MULTIMEDIA REVIEWS:

Hugo A. Rocha

Irwin and Rippe's Intensive Care Medicine, 6th ed.
Anesth Analg 2008 106: 1331. [Full Text] [PDF]  

ERRATA:

Erratum
Anesth Analg 2008 106: 1283. [Full Text] [PDF]  

Erratum
Anesth Analg 2008 106: 1325. [Full Text] [PDF]  

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