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This Month in Anesthesiology  |   April 2012
THIS MONTH IN Anesthesiology
Article Information
This Month in Anesthesiology
This Month in Anesthesiology   |   April 2012
THIS MONTH IN Anesthesiology
Anesthesiology 4 2012, Vol.116, A9. doi:10.1097/ALN.0b013e3182538a19
Anesthesiology 4 2012, Vol.116, A9. doi:10.1097/ALN.0b013e3182538a19
The μ-Opioid Receptor in Cancer Progression: Is There a Direct Effect? (Clinical Concepts and Commentary) 940
The concept that the μ-opioid receptor may be involved in tumor progression is discussed.
Leading into the Future: The 50th Annual Rovenstine Lecture (Special Articles) 758
This lecture promotes pursuing a redesign of perioperative healthcare.
Overexpression of the μ-Opioid Receptor in Human Non-Small Cell Lung Cancer Promotes Akt and mTOR Activation, Tumor Growth, and Metastasis 857
This study suggests that exploration of the μ-opioid receptor in non-small cell lung carcinoma merits further study both as a diagnostic and therapeutic option.
Nerve Injury after Knee Arthroplasty and Sciatic Nerve Block (Case Scenario) 918
Anesthetic- or surgical-related etiologies of perioperative nerve injury are reviewed.
Unresponsiveness ≠ Unconsciousness (Review Article) 946
Unbundling of consciousness, connectedness, and responsiveness is critical for the future development of anesthesia.
μ-Opioid Receptor Gene A118G Polymorphism Predicts Survival in Patients with Breast Cancer 896
Previous studies have suggested interactions between opioid genetics, tumor growth, and clinical effects of morphine. In this long term study, 2,039 patients with breast cancer were genotyped and followed for clinical outcomes. Patients genotyped with the A118G μ-opioid receptor polymorphism had less breast cancer–specific mortality at 10 yr. Breast cancer–specific mortality was significantly reduced in patients with one or more copies of the G allele (P  < 0.001) for invasive cases. Mortality was significantly decreased in patients with A/G and G/G phenotypes compared with A/A (P  = 0.006). This study supports further investigation between opioid genetics, pain management, and cancer survival.
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Systematic Criteria for Type and Screen Based on Procedure's Probability of Erythrocyte Transfusion 768
There is conflicting literature regarding a patient's need for preoperative blood typing and screening. This study reviewed anesthesia information management system data from 160,207 scheduled noncardiac adult cases at a single hospital. Procedures could be defined to have minimal estimated blood loss (< 50 ml) based on low incidence of transfusion and low incidence of hemoglobin being checked preoperatively. Type and screen was unnecessary when the confidence intervals for erythrocyte transfusion were less than 5%. These data may allow development of a new method for determining which patients require preoperative type and screen. See the accompanying Editorial View on  page 749 
A Comparison of Epidural Analgesia and Traditional Pain Management Effects on Survival and Cancer Recurrence after Colectomy: A Population-based Study 797
Use of perioperative epidural anesthesia and analgesia during cancer resections may avoid immunosuppressive recurrence triggers. Using the Medicare-Surveillance, Epidemiology, and End Results database, the authors compared survival and cancer recurrence rates for resection of colorectal cancer in patients who received perioperative epidural anesthesia and analgesia to those who did not. Of 42,151 patients, 5-yr survival was similar between groups (61% and 55% in the epidural group and the nonepidural groups, respectively). Although there was a significant association between epidural use and improved survival (hazard ratio = 0.91), after adjustment for covariates there was no significant reduction of recurrence in this group (odds ratio = 1.05). This study does not support an association between perioperative epidural use and decreased cancer recurrence in patients with nonmetastatic colorectal cancer undergoing resection.
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