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This Month in Anesthesiology  |   September 2007
This Month in Anesthesiology
Article Information
This Month in Anesthesiology
This Month in Anesthesiology   |   September 2007
This Month in Anesthesiology
Anesthesiology 9 2007, Vol.107, 5A. doi:10.1097/01.anes.0000282736.28933.00
Anesthesiology 9 2007, Vol.107, 5A. doi:10.1097/01.anes.0000282736.28933.00
Sedation and Anesthesia Care for Ophthalmologic Surgery during Local/Regional Anesthesia (Review Article) 502
Practices and trends in anesthesia care with respect to sedation for eye surgery under local/regional anesthesia.
Mechanical Ventilation in Healthy Mice Induces Reversible Pulmonary and Systemic Cytokine Elevation with Preserved Alveolar Integrity: An In Vivo  Model Using Clinical Relevant Ventilation Settings 419
Mechanical ventilation induces reversible cytokine increase and leukocyte influx while preserving tissue integrity.
Systemic Antiinflammatory Corticosteroid Reduces Mechanical Pain Behavior, Sympathetic Sprouting, and Elevation of Proinflammatory Cytokines in a Rat Model of Neuropathic Pain 469
Systemic injections of corticosteroid mitigate pain behaviors after spinal nerve ligation. See the accompanying Editorial View on  page 371 
Practicalities and Benefits of Continuous Wound Infusion of Local Anesthetics (Editorial View) 369
Theoretically, say authors Kehlet and Liu in their editorial view, administration of local anesthetics at the wound site is a rational approach to reduce pain and stress responses and enhance the postoperative recovery process. They believe that the randomized trial by Beaussier et al.  , also in this issue, uses an optimal design to assess local anesthetic wound infusion. However, the study also underlines the need for more trials that could assess the practicality, cost-savings, and patient benefits of the technique compared with other postoperative analgesic techniques.
Improving the EEG to Measure Consciousness 397
Because previous electroencephalographic analyses have shown limited reliability in discerning consciousness from unconsciousness, Jordan et al.  designed a new spectral parameter to improve the reliability of differentiating these states. Electroencephalographic data from two previous studies were analyzed to assess the reliability of the new parameters. Data had been obtained from induction of anesthesia until patients emerged from unconsciousness, as gauged by ability to follow verbal command. The authors designed a new parameter called weighted spectral median frequency  using the first data set. Their new parameter achieved a prediction probability of 0.79 with the second data set, a marked improvement over median frequency, spectral edge frequency, and the Bispectral Index.
Can Susceptibility to Delirium Be Predicted in Older Patients? 406
Certain genotypes have been linked to the risk of dementia and cognitive decline. Leung et al.  wondered whether the risk of developing delirium after general anesthesia might also be linked to a genetic predisposition. They conducted a nested cohort study including patients 65 years of age or older scheduled for noncardiac surgery, and drew blood for measurement of the apolipoprotein genotypes. A single interviewer also conducted pre- and postoperative interviews of all patients using the Confusion Assessment Method. After controlling for known demographic and clinical risk factors, the authors found that apolipoprotein e4 carrier status was associated with an increased risk for early postoperative delirium.
Understanding the GABAA-R Targets for Propofol Binding 412
The γ-aminobutyric acid type A receptor (GABAA-R) is a key site of action for intravenous anesthetics. Richardson et al.  selected a mutagenesis method to elucidate the propofol binding site on the GABAA-R. The team introduced various tryptophan mutations into the C-terminal end of the fourth transmembrane segment of the GABAA-R β2subunit, then transfected these subunits into human embryonic kidney 293 cells. The cells were exposed to GABA, propofol, etomidate, and pregnenolone. The authors found that one mutation selectively decreased the EC50for propofol potentiation from 2.4 to 7.6 μm, while normal sensitivity to etomidate and pregnenolone was retained. Specific sites of action for different intravenous anesthetics are suggested.
Continuous Preperitoneal Infusion of Ropivacaine Provides Effective Analgesia and Accelerates Recovery after Colorectal Surgery: A Randomized, Double-blind, Placebo-controlled Study 461
This article has been selected for the Anesthesiology CME Program. See the accompanying Editorial View on  page 369 
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