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Dexmedetomidine supplemented with local anesthesia for awake laryngoplastyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Certain laryngeal procedures require a sedated patient who is responsive to allow for the assessment of vocalization. Dexmedetomidine as a single agent for sedation and anxiolysis for awake laryngoplasty in a patient with unilateral vocal fold paralysis is presented. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 9, 2009 Category: Anesthesiology Authors: Basem Abdelmalak, Larina Gutenberg, Robert R. Lorenz, Michael Smith, Ehab Farag, D. John Doyle Tags: Case Reports Source Type: journals

Pulse contour analysis demonstrates that phenylephrine provides an “endogenous” fluid challenge. Could it be used to judge fluid responsiveness in spontaneously breathing patients?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Michard and others have described and advocated the use of “dynamic indices” in predicting whether a fluid challenge will increase a patient's cardiac output (CO). The dynamic indices are systolic pressure variation (SPV), pulse pressure variation (PPV), and stroke volume variation (SVV), measured over the course of the respiratory cycle during positive pressure ventilation. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Thomas L. Archer Tags: Letters to the Editor Source Type: journals

Retained continuous lumbar plexus block catheterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
When shearing or breaking of catheters occurs, it is often during removal. A sheared peripheral nerve catheter that resulted from needle damage during subcutaneous tunneling is presented. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Gregory L. Rose, J. Thomas McLarney Tags: Letters to the Editor Source Type: journals

Sequential one-lung ventilation using one Arndt endobronchial blocker in a pediatric patient undergoing bilateral, video-assisted thoracoscopic surgery (VATS)Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Video-assisted throracoscopic surgery (VATS) is becoming an increasingly common surgical procedure . Bilateral VATS is not common, especially for pediatric patients . Our experience using only one Arndt 5-French (Fr) pediatric endobronchial blocker for bilateral one-lung ventilation (OLV) is presented. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Pei-ying Li, Hua-hua Gu, Wei-min Liang Tags: Letters to the Editor Source Type: journals

Operating room clothing: design and ergonomic conceptsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Despite major advancements in the development of surgical methods and technology in the operating room (OR), the clothing of the surgical team has remained essentially the same for many years. By and large, the entire surgical team—surgeons, anesthesiologists, nurses, and technicians—wears the same clothing, and there has been almost no effort to adapt the uniform to the changing needs and tasks of the team. Likewise, the scientific literature available on OR clothing is limited, mostly dealing with aseptic properties of the garments, gloves, hat, and mask , rather than ergonomic and design issues. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Anna Becker, Yoel Donchin, Noemi Bitterman Tags: Letters to the Editor Source Type: journals

Sugammadex: the first selective binding reversal agent for neuromuscular blockEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Sugammadex is a novel cyclodextrin, the first in a new class of selective binding reversal agents that terminates neuromuscular block (NMB) with the steroidal nondepolarizing agents, rocuronium and vecuronium. Sugammadex can reverse a moderate or deep NMB. The dose required depends on the level of NMB that needs to be reversed. Smaller doses are sufficient for a moderate versus deep NMB. In October 2007, a new drug application for sugammadex was submitted to the U.S. Food and Drug Administration (FDA). The FDA issued a not-approvable letter in July 2008. The manufacturer continues clinical trials. (Source: Journa...
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Anthony L. Kovac Tags: Review Article Source Type: journals

Rapid injection of rocuronium reduces withdrawal movement on injectionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Withdrawal response can be significantly reduced for rocuronium injection without lidocaine pretreatment, simply through rapid injection. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Yong Cheol Lee, Young Ho Jang, Jin Mo Kim, Sang Gyu Lee Tags: Original Contributions Source Type: journals

Restoration of pulmonary compliance after laparoscopic surgery using a simple alveolar recruitment maneuverEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Respiratory mechanics do not fully return to baseline levels after desufflation following laparoscopy; however, lung compliance can be fully restored using a simple alveolar recruitment maneuver. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Ozlem S. Cakmakkaya, Guner Kaya, Fatis Altintas, Mehmet Hayirlioglu, Birsel Ekici Tags: Original Contributions Source Type: journals

Lymphocyte apoptosis after major abdominal surgery is not influenced by anesthetic technique: a comparative study of general anesthesia versus combined general and epidural analgesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Epidural block could not suppress postoperative lymphocyte apoptosis, increases in cortisol, CRP, or ESR compared with general anesthesia. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 8, 2009 Category: Anesthesiology Authors: Artemisia Papadima, Maria Boutsikou, Emmanuel E. Lagoudianakis, Agapi Kataki, Manoussos Konstadoulakis, Loukas Georgiou, Vaggelogiannis Katergiannakis, Andreas Manouras Tags: Original Contributions Source Type: journals

Unexpected difficult intubation due to lingual tonsillar hyperplasia in a thoracotomy patient: intubation with the double-lumen tube using stylet and fiberoptic bronchoscopyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Lingual tonsillar hyperplasia is rare, and it may cause difficulty with tracheal intubation during induction of general anesthesia. A different orotracheal intubation technique was performed using a double-lumen endotracheal tube, flexible fiberoptic bronchoscope, and a stylet, in an unexpected difficult endobronchial intubation case due to massive lingual tonsillar hyperplasia. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 6, 2009 Category: Anesthesiology Authors: Mehmet E. Orhan, Alper Gözübüyük, Ali Sızlan, Umur Dere Tags: Case Reports Source Type: journals

Spread of spinal anesthesia in patients having perianal surgery in the jackknife position: effects of baricity of 0.5% bupivacaine and positioning during and after induction of spinal anesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Patient positioning, not baricity of bupivacaine, significantly affected the cephalad spread of spinal anesthesia, and a 10-minute period in the sitting position limits the maximum cephalad spread to T11. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - September 6, 2009 Category: Anesthesiology Authors: Jun Ariyama, Masakazu Hayashida, Yuji Sugimoto, Hirokazu Imanishi, Yoshiko To-oyma, Akira Kitamura Tags: Original Contributions Source Type: journals

Table of ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - August 31, 2009 Category: Anesthesiology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - August 31, 2009 Category: Anesthesiology Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 31, 2009 Category: Anesthesiology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 31, 2009 Category: Anesthesiology Source Type: journals

Does bilateral bispectral index monitoring (BIS) detect the discrepancy of cerebral reperfusion during carotid endarterectomy?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The case of a 70 year-old man undergoing bilateral carotid endarterectomy (CEA), for whom alterations in his bispectral index (BIS) values were noted during general anesthesia, is presented. Prior to bypass of the internal carotid artery (ICA), there were no significant differences in bilateral BIS values. After bypass of the left ICA, the left BIS increased to approximately 60, while the right BIS remained at 40. Four months later, no such phenomenon was found during a right CEA. BIS is useful in detecting cerebral hypoperfusion during a lower limit of autoregulation. Attaching bilateral BIS monitors may indicat...
Source: Journal of Clinical Anesthesia - July 21, 2009 Category: Anesthesiology Authors: Mitsuharu Kodaka, Yuki Nishikawa, Toshinari Suzuki, Kazumi Asano, Akihiko Maeyama, Hideki Miyao Tags: Case Reports Source Type: journals

Dexmedetomidine/ketamine for diagnostic cardiac catheterization in a child with idiopathic pulmonary hypertensionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The use of a combination of dexmedetomidine and ketamine to provide procedural sedation in a 12-year old boy with a diagnosis of idopathic pulmonary hypertension and a behavioral disorder, undergoing diagnostic cardiac catheterization, is presented. Following a loading dose of ketamine one mg/kg and dexmedetomidine one mcg/kg, an infusion of dexmedetomidine at one mcg/kg/hr was used with the patient breathing spontaneously. Stable hemodynamics were observed throughout the procedure and pulmonary vascular resistance was measured under three conditions. The dexmedetomidine infusion was continued for two hours post-...
Source: Journal of Clinical Anesthesia - July 20, 2009 Category: Anesthesiology Authors: Hamish M. Munro, Donald E. Felix, David G. Nykanen Tags: Case Reports Source Type: journals

Judgment notwithstanding the verdict: the anesthesiologist's duty to monitor head position in the perioperative periodEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
In early 2000, Dr F, a neurosurgeon, was treating patient SB, an obese woman, for pain from cervical disc protrusions. Dr F suggested that a cervical hemilaminotomy and foraminotomy at C3-4 and C4-5 would be an effective strategy to address SB's pain. SB agreed to the surgery, and SB was admitted to Hospital at 8 am. The surgery began at 10:15 am, with Dr L as the anesthesiologist and nurse anesthetist JS assisting. Dr L, with the assistance of JS, attached several monitors. After these monitors were attached, JS placed an oxygen mask on SB's face and began administering oxygen. General anesthesia was induced and an endotr...
Source: Journal of Clinical Anesthesia - July 20, 2009 Category: Anesthesiology Authors: Bryan A. Liang Tags: Doctor's docket Source Type: journals

Three concentrations of levobupivacaine for ilioinguinal/iliohypogastric nerve block in ambulatory pediatric surgeryEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: II/IH nerve block using 0.4 mL kg-1 of 0.25% levobupivacaine provided satisfactory postoperative pain relief after inguinal herniorraphy. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 16, 2009 Category: Anesthesiology Authors: Nicola Disma, Pietro Tuo, Sarah Pellegrino, Marinella Astuto Tags: Original Contributions Source Type: journals

Vasoactive mediastinal mass in an infantEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The case of a 6 week-old infant who presented with an anterior mediastinal mass that extended to the left neck is reported. During surgical dissection of the mass, the patient exhibited extreme hemodynamic instability consistent with a vasoactive tumor. The patient had a neuroblastoma with its origin in the posterior mediastinum, but with its mass effect in the anterior mediastinum and neck. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 16, 2009 Category: Anesthesiology Authors: Ann G. Bailey, Genevieve Mounce Tags: Case reports Source Type: journals

Introduction of new safety technologies into central venous accessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The American Society of Anesthesiologists, the Anesthesia Patient Safety Foundation, the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO), and the Patient Safety and Quality Improvement Act of 2005 encourage anesthesiology departments to institute systematic improvements in patient safety, including but not limited to integration of new safety technologies. The evaluation and method of use of the reciprocating procedure device in central venous access is presented. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 16, 2009 Category: Anesthesiology Authors: Neal S. Gerstein, Hugh B. Martin, Grigore Toma, Randy R. Sibbitt, Wilmer L. Sibbitt Tags: Case reports Source Type: journals

Bronchobiliary fistula: an anesthetic challenge!Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: A case of bronchobiliary fistula is reported in an adult following liver laceration repair. Since patients with bronchobiliary fistula usually have poor lung condition preoperatively, perioperative respiratory management and intraoperative double-lumen tube insertion assists in the management of these patients. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 15, 2009 Category: Anesthesiology Authors: Sukanya Mitra, Nidhi Bhatia, Nilanjan Dey, Usha Dalal Tags: Case reports Source Type: journals

Comparison of ropivacaine 0.2% and 0.25% with lidocaine 0.5% for intravenous regional anesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Longer tolerance times for the distal tourniquet, prolonged analgesia after tourniquet release, and lower analgesic requirements postoperatively make ropivacaine 0.2% and 0.25% an alternative to lidocaine for IVRA. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - July 13, 2009 Category: Anesthesiology Authors: Ibrahim Asik, Aysu Inan Kocum, Asutay Goktug, K. Sanem Cakar Turhan, Neslihan Alkis Tags: Original Contributions Source Type: journals

Results of a pilot study on the effects of propofol and dexmedetomidine on inflammatory responses and intraabdominal pressure in severe sepsisEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Dexmedetomidine infusion decreases TNF-a, IL-1, and IL-6 levels and IAP more than a propofol infusion. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 28, 2009 Category: Anesthesiology Authors: Muhittin Tasdogan, Dilek Memis, Necdet Sut, Mahmut Yuksel Tags: Original Contributions Source Type: journals

A retrospective analysis of airway management in obese patients at a teaching institutionEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: Patients selected for AFI were predominantly men, with a Mallampati Class III or IV airway, and BMI ≥ 60 kg/m2. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 28, 2009 Category: Anesthesiology Authors: Carin A. Hagberg, Christiane Vogt-Harenkamp, Junaid Kamal Tags: Original contributions Source Type: journals

Comparison of the EasyTube® and endotracheal tube during general anesthesia in fasted adult patientsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: Insertion of an EzT appears to reduce time and facilitate placement of an airway device when compared with direct laryngoscopy and tracheal intubation. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 28, 2009 Category: Anesthesiology Authors: Veit Lorenz, James M. Rich, Karl Schebesta, Sevak Taslakian, Michael Müllner, Michael Frass, Ernst Schuster, Udo M. Illievich, Alan D. Kaye, Sonia Vaida, Peter Krafft Tags: Original contributions Source Type: journals

Cosmetic anaphylaxis?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Baldo and Fisher have shown that substituted ammonium ions may serve as allergenic determinants in drug allergy . The widespread prevalence of quaternary and tertiary ammonium ions in cosmetics, foods, and disinfectants has been suggested as a source by which sensitization can take place. The use of cosmetics has been suggested as an explanation for the much higher incidence of allergy to muscle relaxants in women. Similarly, the sixfold greater incidence of allergy to relaxants in Norway (compared with Sweden) has been linked to pholcodine exposure and supports the suggestion that exposure to other compounds may sometimes...
Source: Journal of Clinical Anesthesia - June 21, 2009 Category: Anesthesiology Authors: W.J. Russell, S. George Tags: Letters to the Editor Source Type: journals

Warmflo® warming system overheats fluids in simulated clinical conditionsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The Warmflo® fluid warming system can overheat fluids at temperatures considerably above normal body temperatures. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 21, 2009 Category: Anesthesiology Authors: Eli Poppa, David Yona, Yeshayahu Katz, Michal Barak Tags: Original contributions Source Type: journals

Perioperative blood glucose management in patients undergoing tumor hepatectomyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: The modified Atlanta protocol is efficient and safe in controlling blood glucose levels in the perioperative period of hepatic tumor resection. Because of decreased insulin needs in the ICU, the use of a more liberal algorithm successfully reduced the risk of hypoglycemia. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 21, 2009 Category: Anesthesiology Authors: Guy Cammu, Koen Vermeiren, Patrick Lecomte, Steven De Gendt, Thierry Deloof, Luc Foubert Tags: Original contributions Source Type: journals

What is an anesthesiology resident worth?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusions: A CRNA is paid substantially more per OR hour worked, at all pay levels, than an anesthesiology resident. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - June 14, 2009 Category: Anesthesiology Authors: Marisa H. Ferrera, Shawn T. Beaman, David G. Metro, Linda J. Handley, James E. Walker Tags: Original contributions Source Type: journals

ContentsEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 31, 2009 Category: Anesthesiology Source Type: journals

Editorial BoardEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
(Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 31, 2009 Category: Anesthesiology Source Type: journals

Complications following large-volume epidural blood patches for postdural puncture headache. Lumbar subdural hematoma and arachnoiditis: initial cause or final effect?Email this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Significant complications following large-volume epidural blood patches (LEBPs) in two parturients following LEBP for postdural puncture headache are reported. A 39-year-old woman developed a spinal subdural hematoma causing both lumbar back and radicular pain following a single LEBP using 58 mL of blood. The second case was a 33-year-old woman who received three LEBPs over a 4-day period totaling 165 mL of blood. She developed arachnoiditis and chronic sacral radiculopathy with resolution 4 months later. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 20, 2009 Category: Anesthesiology Authors: Cara A. Riley, Joan E. Spiegel Tags: Case reports Source Type: journals

The value of a resident in anesthesiology: more than you would guessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
I read with interest the article in this issue of Journal of Clinical Anesthesia, “What's An Anesthesiology Resident Worth?” As a graduating resident, I was curious to learn of my value. I feel that the article grossly underestimates the true worth of an anesthesiology resident. The article considers only the total number of hours spent in the operating room (OR) providing anesthesia to determine the cost of replacing an anesthesiology resident with a certified registered nurse-anesthetist (CRNA). No consideration was given to the various other ways in which residents provide value to the anesthesia department, the hos...
Source: Journal of Clinical Anesthesia - May 20, 2009 Category: Anesthesiology Authors: Kevin Halbe Tags: Editorial Source Type: journals

Reliable block of the gag reflex in one minute or lessEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Our neuroanesthesia group performs frequent awake fiberoptic intubations due to a large number of cervical spine procedures. Patient tolerance of the awake intubation is greatly enhanced when the gag and cough reflexes are densely blocked. Not only is it a safety concern for the patient with an unstable cervical spine, but it eases the awake intubation performed for any indication. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 19, 2009 Category: Anesthesiology Authors: David L. Saliba, Thomas A. McCutchen, Melissa J. Laxton, Scott A. Miller, John E. Reynolds Tags: Letters to the Editor Source Type: journals

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Thank you for the opportunity to respond to the letter by Xue et al. The technique of using the endotracheal tube (ETT) as a conduit for the bougie is a rescue technique, to be used when the other manipulations mentioned in our letter have failed . It is not our intention that this technique be used if intubation proves easy. As such, this technique is likely to be quicker and less complex than the commonly used alternatives when passage of the ETT through the glottis proves difficult, such as reshaping the stylet or using a different tube. We agree that this technique is not really suitable for small pediatric patients, b...
Source: Journal of Clinical Anesthesia - May 17, 2009 Category: Anesthesiology Authors: Leonard M. Pott, Arne O. Budde Tags: Letters to the Editor Source Type: journals

Measures to facilitate smooth insertion of an endotracheal tube into the trachea with GlideScope videolaryngoscopyEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We read with interest the recent letter of Budde and Pott , regarding the endotracheal tube (ETT) as a guide for an Eschmann gum elastic bougie to aid tracheal intubation using the McGrath or GlideScope videolaryngoscope. Advancing the ETT through the glottis into the trachea is a problem during orotracheal or nasotracheal intubation using the video intubating device due to the significantly angulated blade and the fact that the ETT must be presented to the glottis, which may not be in the line of sight. When orotracheal intubation is performed, moreover, ETTs must have stylets inserted so that the ETT's distal tip can be ...
Source: Journal of Clinical Anesthesia - May 17, 2009 Category: Anesthesiology Authors: Fu S. Xue, He P. Liu, Xu Liao, Yan M. Zhang Tags: Letters to the Editor Source Type: journals

Insertion of a nasogastric tube using a modified ureteric guide wireEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Insertion of a nasogastric tube can be a difficult and frustrating experience in patients who are anesthetized . Ozer and Benumof have found that the most common sites of impaction of orogastric and nasogastric tubes are the pyriform sinuses and arytenoid cartilage, leading to coiling in the oropharynx . The basic design of the tube contributes to tube coiling in the oropharynx. The distal 6 cm of the gastric tube has multiple holes that are less firm . (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 14, 2009 Category: Anesthesiology Authors: Rajesh Mahajan, Rahul Gupta, Anju Sharma Tags: Letters to the Editor Source Type: journals

Check for carotid puncture: a simple equation to an old ruleEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
It is a common practice to check the placement of the central venous catheter (CVC) in the internal jugular vein (IJV) by attaching intravenous (IV) fluid tubing to the 14-gauge introducer needle and observing for free flow of fluid. However, this practice can be very misleading in certain special situations. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 14, 2009 Category: Anesthesiology Authors: Chakravarty Chandrashish, Khanna Puneet, Dehran Maya Tags: Letters to the Editor Source Type: journals

Suggested algorithm for management of the unexpected difficult airway in obstetric anesthesiaEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
We suggest a simplified algorithm for management of the unexpected difficult airway in the obstetric patient (). 1. Existing algorithms recommend the use of the Classic Laryngeal Mask Airway (cLMA; The Laryngeal Mask Airway Co., San Diego, CA), or Laryngeal Mask Airway (LMA; Laryngeal Mask Co., Ltd., Henley-on-Thames, UK) variants, as a rescue airway device for a "cannot ventilate, cannot intubate" situation. We suggest using the multiple use ProSeal LMA (PLMA; The Laryngeal Mask Airway Co.) or the single-use Supreme LMA (The Laryngeal Mask Airway Co.), as a primary rescue airway device in obstetric anesthesia. These devi...
Source: Journal of Clinical Anesthesia - May 14, 2009 Category: Anesthesiology Authors: Sonia J. Vaida, Leonard M. Pott, Arne O. Budde, Luis A. Gaitini Tags: Letters to the Editor Source Type: journals

Lateral femoral cutaneous neuropathy following lateral positioning on a bean bagEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Iatrogenic neuropathy of the lateral femoral cutaneous nerve (meralgia paresthetica) has been described after orthopedic procedures and following prone or lithotomy positioning. A patient who developed meralgia paresthetica after thoracoscopic surgery in the lateral position is presented. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 14, 2009 Category: Anesthesiology Authors: Lianne L. Stephenson, Nancy A. Webb, C. Jason Smithers, Susan L. Sager, Christian Seefelder Tags: Letters to the Editor Source Type: journals

Anesthesia for brain tumor resection using intraoperative magnetic resonance imaging (iMRI) with the Polestar N-20 system: experience and challengesEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: The Polestar N-20 Scanner (Medtronic Navigation, Louisville, CO) is an intraoperative magnetic resonance image (iMRI) guidance system designed for neurosurgery. Sixty-five patients underwent craniotomy for tumor resection using the iMRI during the period from April 2005 to December 2006. Anesthesiologists used an iMRI-compatible patient monitoring system (Veris MR, MEDRAD, Indianola, PA), anesthesia machine (Aestiva/5 MRI, Datex-Ohmeda, Madison, WI), and infusion pumps (Continuum; MEDRAD). Average setup time for each case (from intubation to incision) was one hour, 33 minutes and showed learning improvement over ...
Source: Journal of Clinical Anesthesia - May 14, 2009 Category: Anesthesiology Authors: Eric Barua, Jeffrey Johnston, Jeffrey Fujii, Roger Dzwonczyk, Ennio Chiocca, Sergio Bergese Tags: Special article Source Type: journals

Reinsertion of a ProSeal Laryngeal Mask Airway in the lateral position using a reinforced gastric tubeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Use of a reinforced gastric tube as a guide to replace the ProSeal Laryngeal Mask Airway (PLMA; The Laryngeal Mask Airway Co., Ltd., Henley-on-Thames, UK) in the lateral position is presented. A 55-year-old, ASA physical status I woman was scheduled for plating of a fractured humerus in the lateral position. Her airway examination showed a Mallampati class II airway, adequate neck extension and mouth opening, and a thyromental distance of 6.5 cm. Dental hygiene was poor, with missing and sharp-edged teeth. After induction of anesthesia with the patient placed supine and with easy facemask ventilation, neuromuscular block w...
Source: Journal of Clinical Anesthesia - May 13, 2009 Category: Anesthesiology Authors: Rajesh Mahajan, Vinod Kumar Grover, Rahul Gupta Tags: Letters to the Editor Source Type: journals

Avoiding adverse outcomes in patients with obstructive sleep apnea (OSA): development and implementation of a perioperative OSA protocolEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Obstructive sleep apnea (OSA) is associated with postoperative airway obstruction, hypoxemia, cardiac arrhythmias, cardiorespiratory arrest, hypoxic encephalopathy, and death. Three cases highlighting important issues in patients with OSA are presented that occurred prior to and after implementation of an OSA protocol. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 12, 2009 Category: Anesthesiology Authors: Norman Bolden, Charles E. Smith, Dennis Auckley Tags: Case reports Source Type: journals

Acute-recurrent subcutaneous emphysema after ventriculopleural shunt placementEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Ventriculopleural shunts are one of the alternatives to ventriculoperitoneal shunts for draining cerebrospinal fluid. They are used in patients who have failed multiple ventriculoperitoneal shunts because of peritonitis, loculated ascites, or pseudocyst formation, or those who are not optimal candidates for vascular shunts. A case of acute recurrent subcutaneous emphysema around the incision of a ventriculopleural shunt is presented. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 11, 2009 Category: Anesthesiology Authors: Denisa M. Haret, Anna Maria Onisei, Timothy W. Martin Tags: Case reports Source Type: journals

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I would like to thank Dr. Xue and his colleagues for their interest in our recent publication . I would also like to reply to some of their comments: Dr. Xue and his colleagues are concerned about the proposed technique to prevent pulmonary aspiration on induction of general anesthesia because of thickness of the GlideScope video laryngoscope (GVL; Diagnostic Ultrasound, Bothell, WA) blade relative to the size of the oral cavity and the fact that the GVL blade is inserted “along the midline of the mouth.” True, in some patients intraoral room may be limited and the maneuverability of multiple devices may be impaired. ...
Source: Journal of Clinical Anesthesia - May 11, 2009 Category: Anesthesiology Authors: Mirsad Dupanovic Tags: Letters to the Editor Source Type: journals

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The first comment regards the necessity of comparing the pain scores of the Esmarch bandage and limb elevation techniques. Based on our observation, application of an Esmarch bandage could increase pain compared with just simple elevation of a sensitized and injured limb; it could be a subject for another study . (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 11, 2009 Category: Anesthesiology Authors: Arash Farbood, Shahrbanoo Shahbazi Tags: Letters to the Editor Source Type: journals

Case report: postoperative analgesia and preserved motor function with clonidine and buprenorphine via a sciatic perineural catheterEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Two cases of posterolateral corner reconstruction of the knee with postoperative sciatic perineural analgesia using a mixture of clonidine and buprenorphine, are presented. Numeric rating scores for pain with movement were 0-2 out of 10 postoperatively after injection. Gross motor function below the knee was maintained in both cases. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 11, 2009 Category: Anesthesiology Authors: David J. Whiting, Brian A. Williams, Steven L. Orebaugh, Revathi R. Toshok Tags: Case reports Source Type: journals

Use of the video laryngoscopy for Combitube exchange in a difficult airwayEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Abstract: Following failed intubation attempts via conventional direct laryngoscopy, an Esophageal Tracheal Combitube was successfully placed in the esophagus of a 51-year-old man with a subdural hematoma and uncleared cervical spine. The decision was made to change the Combitube for an endotracheal tube (ETT). After deflation of the large oropharyngeal cuff of the Combitube, video laryngoscopy was performed with the Direct Coupled Interface (DCI) video intubation system, and the Combitube was exchanged for an ETT with the assistance of a gum elastic bougie. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 11, 2009 Category: Anesthesiology Authors: Nicholas C. Lam, Carin A. Hagberg, Lisa M. Bassili Tags: Case reports Source Type: journals

Tracheal intubation by non-anesthesia residents using the Pentax-AWS airway scope and Macintosh laryngoscopeEmail this article to a colleague. Save this article to My Clippings. Discuss or comment on this article.
Conclusion: The Pentax-AWS appears to require less operator skill than the Macintosh laryngoscope. Use of the Pentax-AWS may reduce the time to secure the airway and the incidence of failed tracheal intubation by non-anesthesia residents. (Source: Journal of Clinical Anesthesia)
Source: Journal of Clinical Anesthesia - May 11, 2009 Category: Anesthesiology Authors: Yoshihiro Hirabayashi, Norimasa Seo Tags: Original contributions Source Type: journals