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This Month in Anesthesiology  |   July 2007
This Month in Anesthesiology
Article Information
This Month in Anesthesiology
This Month in Anesthesiology   |   July 2007
This Month in Anesthesiology
Anesthesiology 7 2007, Vol.107, 5A. doi:10.1097/01.anes.0000270637.78821.af
Anesthesiology 7 2007, Vol.107, 5A. doi:10.1097/01.anes.0000270637.78821.af
Advances in and Limitations of Up-and-down Methodology (Review Article) 144
This paper details the sequential design methods for determination of the concentration or dose associated with the 50% point along the dose–response curve.
See the accompanying Editorial View onpage 1
Endotracheal Intubation in Patients with Cervical Spine Immobilization 53
The utility of the Airtraq and Macintosh laryngoscopes for tracheal intubation in patients with cervical spine immobilization was compared.
Adrenergic Receptor Genotype but Not Perioperative Bisoprolol Therapy May Determine Cardiovascular Outcome in At-risk Patients Undergoing Surgery with Spinal Block 33
Perioperative bisoprolol therapy was studied in elderly at-risk patients undergoing surgery with spinal block.
Are Ethnicity and Anesthetic Requirements Related? 9
To determine whether the minimum alveolar concentration or P50 for movement in response to skin incision differs as a function of ethnicity, Ezri et al. recruited 90 American Society of Anesthesiologists physical status I and II adult patients from three Jewish ethnic groups: European, Oriental (Middle Eastern and North African), and Caucasian (from the Caucasus Mountain region). After induction of anesthesia with 6–8% sevoflurane in 100% oxygen, and maintenance of an end-tidal concentration of sevoflurane of 2% for 10 min, skin incision was made. Investigators blinded to group observed each patient for movement and sevoflurane concentrations were adjusted according to the Dixon up-and-down method. Minimum alveolar concentration was greatest in the group of Jews from the Caucasus region, suggesting that anesthesia requirements do vary as a function of ethnicity. See the accompanying Editorial View onpage 4
Clinical Anesthesia in Infants and Children (Editorial View) 2
Controversy about exposing newborns to anesthesia has been stirred by findings in animals that N-methyl-d-aspartate receptor antagonists, such as ketamine, enhance apoptosis in immature neurons. In his editorial, Anand updates anesthesiologists on investigations of the neurotoxic effects of anesthesia, and discusses current methods and limitations for extrapolating neurodevelopmental data from animal models to humans. Limitations of current experimental models, coupled with the validated acute and long-term effects of unrelieved pain and surgical stress, in the author's opinion, justify the continued use of potent anesthesia for neonates and infants.
Profile of CNS 7056, a Novel Ultra–short-acting Benzodiazepine 60
CNS 7056, a new benzodiazepine derivative metabolized by esterases, was developed to provide an intravenous agent with a predictable fast onset, short duration of action, and rapid recovery profile. The strategy for developing this agent came from the discovery of the ultra–short-acting opioid analgesic remifentanil. Results showed that CNS 7056 is a high-affinity and selective ligand for the benzodiazepine site on the GABAA receptor, and a potent sedative in rodents with a short duration of action. Further investigation of CNS 7056 to explore its utility as a short-acting sedative and intravenous anesthetic is warranted.
Nerve Growth Factor Expression in Incisional Pain 128
To evaluate the role of nerve growth factor (NGF) in pain after incision, Wu et al. obtained skin tissue samples adjacent to hind paw plantar incisions in adult rats at specific intervals after incision. The NGF messenger RNA was measured by polymerase chain reaction, and NGF protein expression was detected by Western blot and immunohistochemistry in the incision. The authors observed an increase in NGF messenger RNA within 2–4 h after incision; large molecular weight NGF protein increased 4 h after incision and returned to baseline on postoperative day 7, and the greatest NGF expression appeared immediately adjacent to the incision. The study suggests some common mechanisms for neuropathic and incisional pain.
Protein C Concentrations Correlate with Organ Dysfunction and Predict Outcome Independent of the Presence of Sepsis 15
This article has been selected for the Anesthesiology CME Program. See the accompanying Editorial View onpage 6