In this issue of ANESTHESIOLOGY, Vaughn et al.  have assembled a Case Scenario that describes state-of-the art anesthetic management for patients requiring repair of thoracoabdominal aneurysms. The cover of this issue illustrates the arterial supply to the spinal cord that can be compromised during repair of the thoracic aorta, one of the significant considerations in optimizing anesthetic management. (After an original illustration by Gary J. Nelson appearing in Neal JM, Rathmell JP (Editors). Complications in Regional Anesthesia and Pain Medicine. Philadelphia, Saunders Elsevier, 2006.)

  • Vaughn et al. : Anesthetic Considerations for Thoracoabdominal Aortic Aneurysm Repair, p. 1093

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Translational Research: What Does It Mean? 909

Andrew Davidson 

Recombinant Human Erythropoeitin: Efficacy and Safety Considerations for Maximizing Blood Conservation in Cardiac Surgery 912

Amanda Fox 

Nonanesthetic Malignant Hyperthermia 915

Frank Lehmann-Horn, Werner Klingler, and Karin Jurkat-Rott 

What We Know: Precise Measurement Leads to Patient Comfort and Safety 918

Sorin J. Brull and Mohamed Naguib 

Hydrogen Sulfide: A Hot Molecule 921

Hamid Aslami, Marcus J. Schultz, and Nicole P. Juffermans 

Ventilator-induced Lung Injury in Healthy and Diseased Lungs: Better to Prevent than Cure! 923

Paolo Pelosi and Patricia R. M. Rocco 

A Sisyphean Task: Identifying Physiologic Risk and Improving Outcomes in Complex Congenital Heart Surgery 926

Eckehard A. E. Stuth and George M. Hoffman 

Effect of Single Recombinant Human Erythropoietin Injection on Transfusion Requirements in Preoperatively Anemic Patients Undergoing Valvular Heart Surgery 929

Young-Chul Yoo, Jae-Kwang Shim, Jong-Chan Kim, Youn-Yi Jo, Jong-Hoon Lee, and Young-Lan Kwak 

A single intravenous administration of erythropoietin and an iron supplement 1 day before surgery significantly reduced the perioperative transfusion requirement in anemic patients undergoing valvular heart surgery without complications.

Identical de novo  Mutation in the Type 1 Ryanodine Receptor Gene Associated with Fatal, Stress-induced Malignant Hyperthermia in Two Unrelated Families 938

Linda Groom, Sheila M. Muldoon, Zhen Zhi Tang, Barbara W. Brandom, Munkhuu Bayarsaikhan, Saiid Bina, Hee-Suk Lee, Xing Qiu, Nyamkhishig Sambuughin, and Robert T. Dirksen 

R3983C and D4505H ryanodine receptor variants were identified in a child who experienced a fatal, nonanesthetic awake episode. The impact of the two variants depends on whether they are located on common or separate alleles.

Intraoperative Acceleromyography Monitoring Reduces Symptoms of Muscle Weakness and Improves Quality of Recovery in the Early Postoperative Period 946

Glenn S. Murphy, Joseph W. Szokol, Michael J. Avram, Steven B. Greenberg, Jesse H. Marymont, Jeffery S. Vender, Jayla Gray, Elizabeth Landry, and Dhanesh K. Gupta 

Patients randomized to receive acceleromyography monitoring in the operating room had significantly lower overall weakness scores and fewer symptoms of muscle weakness in the postanesthesia care unit. In addition, global quality of recovery visual analog scale scores were improved in the acceleromyography group.

Role of the O-linked β-N -acetylglucosamine in the Cardioprotection Induced by Isoflurane 955

Kayo Hirose, Yasuo M. Tsutsumi, Rie Tsutsumi, Masayuki Shono, Erika Katayama, Michiko Kinoshita, Katsuya Tanaka, and Shuzo Oshita 

Modification of voltage-dependent anion channels with O-linked β-N -acetylglucosamine inhibits the formation of the mitochondrial permeability transition pore, which is involved in isoflurane-induced preconditioning of mouse cardiac myocytes.

Influence of Patient Comorbidities on the Risk of Near-miss Maternal Morbidity or Mortality 963

Jill M. Mhyre, Brian T. Bateman, and Lisa R. Leffert 

Approximately 1 in 760 hospitalizations for delivery is complicated by near-miss morbidity or mortality. Risk is substantially increased among an identifiable subset of pregnant women.

Invasive and Concomitant Noninvasive Intraoperative Blood Pressure Monitoring: Observed Differences in Measurements and Associated Therapeutic Interventions 973

David B. Wax, Hung-Mo Lin, and Andrew B. Leibowitz 

Blood pressure measured by oscillometric cuff was significantly different from that measured by radial artery catheter during noncardiac surgery. Simultaneous use of both monitors was associated with differences in therapies compared with invasive monitoring alone.

Neonatal Desflurane Exposure Induces More Robust Neuroapoptosis than Do Isoflurane and Sevoflurane and Impairs Working Memory 979

Mitsuyoshi Kodama, Yasushi Satoh, Yukiko Otsubo, Yoshiyuki Araki, Ryuji Yonamine, Kenichi Masui, and Tomiei Kazama 

Neonatal exposure of mice to desflurane is more neurotoxic than equipotent exposures of sevoflurane or isoflurane, as evidenced by greater neuroapoptosis and additional impaired cognitive function.

General Anesthesia Causes Long-term Impairment of Mitochondrial Morphogenesis and Synaptic Transmission in Developing Rat Brain 992

Victoria Sanchez, Shawn D. Feinstein, Nadia Lunardi, Pavle M. Joksovic, Annalisa Boscolo, Slobodan M. Todorovic, and Vesna Jevtovic-Todorovic 

Anesthesia causes an impairment of mitochondrial morphogenesis and function accompanied by alteration in their regional distribution in presynaptic neuronal profiles, where their presence is important for the normal development and functioning of synapses.

TASK Channel Deletion Reduces Sensitivity to Local Anesthetic-induced Seizures 1003

Guizhi Du, Xiangdong Chen, Marko S. Todorovic, Shaofang Shu, Jaideep Kapur, and Douglas A. Bayliss 

This study shows that local anesthetics (bupivacaine > ropivacaine ≫ lidocaine) inhibit cloned TASK background K+channels (TASK-1 ≫ TASK-1/TASK-3 > TASK-3); in addition, TASK knockout mice are less susceptible to local anesthetic-induced seizures.

Protective and Detrimental Effects of Sodium Sulfide and Hydrogen Sulfide in Murine Ventilator-induced Lung Injury 1012

Roland C. Francis, Katerina Vaporidi, Kenneth D. Bloch, Fumito Ichinose, and Warren M. Zapol 

Oxidative stress from mechanical ventilation can lead to serious pulmonary complications. This study assessed the protective effects of inhaled hydrogen sulfide (0, 1, 5, or 60 ppm) and intravascular sodium sulfide (Na2S) in anesthetized mice with high tidal volume (HVT) ventilation for 4 h. Low-dose hydrogen sulfide did not alter lung injury induced by HVT. The highest dose, 60 ppm hydrogen sulfide, accelerated ventilator-induced lung injury. In contrast, intravenous Na2S reduced pulmonary neutrophil infiltration and edema. Oxidative stress-induced depletion of glutathione was also prevented by sodium sulfide. This study suggests beneficial effects of Na2S in preventing lung injury during mechanical ventilation.

Evolution of the Inflammatory and Fibroproliferative Responses during Resolution and Repair after Ventilator-induced Lung Injury in the Rat 1022

Gerard F. Curley, Maya Contreras, Brendan Higgins, Cecilia O'Kane, Daniel F. McAuley, Daniel O'Toole, and John G. Laffey 

High-stretch ventilation causes severe lung injury, resulting in an inflammatory and fibroproliferative repair response that is maximal at 24 h and largely resolved by 96 h, resulting in restoration of normal lung architecture.

Prolonged Central Venous Desaturation Measured by Continuous Oximetry Is Associated with Adverse Outcomes in Pediatric Cardiac Surgery 1033

Ryan Crowley, Elizabeth Sanchez, Jonathan K. Ho, Kate J. Lee, Johanna Schwarzenberger, Jure Marijic, Michael Sopher, and Aman Mahajan 

Fifty-four pediatric patients undergoing cardiac surgery with continuous central venous oximetry (ScvO2) were prospectively studied. Progressively worsening central venous oxygen saturation (ScvO2) was associated with adverse clinical outcomes.

Interactions between Nitrous Oxide and Tissue Plasminogen Activator in a Rat Model of Thromboembolic Stroke 1044

Benoît Haelewyn, Hélène N. David, Nathalie Colloc'h, Denis G. Colomb, Jr., Jean-Jacques Risso, and Jacques H. Abraini 

The authors show that nitrous oxide alters tissue plasminogen activator-induced thrombolysis and reduction of ischemic brain damage, brain hemorrhages, and disruption of the blood–brain barrier in a rat model of thromboembolic acute ischemic stroke.

Pharmacological Consequence of the A118G μ Opioid Receptor Polymorphism on Morphine- and Fentanyl-mediated Modulation of Ca2+Channels in Humanized Mouse Sensory Neurons 1054

Saifeldin Mahmoud, Annika Thorsell, Wolfgang H. Sommer, Markus Heilig, Joan K. Holgate, Selena E. Bartlett, and Victor Ruiz-Velasco 

Homozygous humanized mouse lines expressing either 118A or 118G μ opioid receptor alleles were employed to examine the pharmacology of morphine and fentanyl on the coupling of the receptors with voltage-gated Ca2+channels in sensory neurons.

Offset Analgesia in Neuropathic Pain Patients and Effect of Treatment with Morphine and Ketamine 1063

Marieke Niesters, Elske Hoitsma, Elise Sarton, Leon Aarts, and Albert Dahan 

Offset analgesia, in which a large amount of analgesia becomes apparent upon a slight decrease in noxious heat stimulation, is decreased in patients with neuropathic pain in contrast to healthy persons (age 6 and up).

A 18F-fluorodeoxyglucose MicroPET Imaging Study to Assess Changes in Brain Glucose Metabolism in a Rat Model of Surgery-induced Latent Pain Sensitization 1072

Asunción Romero, Santiago Rojas, David Cabañero, Juan D. Gispert, José R. Herance, Ana Campillo, and Margarita M. Puig 

As a result of surgical injury, neuroplastic adaptations in brain opioid circuits involved in nociceptive processing and long-lasting pain sensitization are shown, using the microPET technique in rats.

ARA290, a Peptide Derived from the Tertiary Structure of Erythropoietin, Produces Long-term Relief of Neuropathic Pain: An Experimental Study in Rats and β-Common Receptor Knockout Mice 1084

Maarten Swartjes, Aurora Morariu, Marieke Niesters, Michael Brines, Anthony Cerami, Leon Aarts, and Albert Dahan 

Treatment with the nonhematopoietic erythropoietin analog ARA290 after peripheral nerve injury in mice and rats produces effective and long-term relief of tactile and cold allodynia because of activation of the erythropoietin receptor β-common receptor complex.

Case Scenario

Anesthetic Considerations for Thoracoabdominal Aortic Aneurysm Repair 1093

Stephen B. Vaughn, Scott A. LeMaire, and Charles D. Collard 

Images in Anesthesiology

Neonatal Craniosynostosis 1103

Amr E. Abouleish 

Ultrasonographic Identification of an Anomalous Femoral Nerve: The Fascia Iliaca as a Key Landmark 1104

Ki Jinn Chin, Cyrus Tse, and Vincent Chan 

Anesthesia Literature Review 1105

Review Article

Potential Adverse Ultrasound-related Biological Effects: A Critical Review 1109

Hariharan Shankar and Paul S. Pagel 

Increasing use of ultrasound by anesthesiologists require that the user be familiar with the potential ultrasound-related biologic effects. A review of the biologic effects of ultrasound as reported in animal and human studies is presented.

Mind To Mind

0600 1125

T. J. Conahan 

A Mother for All Seasons 1126

Kathryn E. McGoldrick 

A Life Well Lived 1129

Raeford E. Brown, Jr. 

Can Minimum Alveolar Concentrations in Immature Rodents Be a Single Number? 1132

Greg Stratmann and Rehan S. Alvi 

In Reply

George K. Istaphanous, John J. McAuliffe, and Andreas W. Loepke 

A Call for Caution Regarding Cervical and Ulnar Nerve Injuries and General Anesthesia 1135

Mitchel B. Sosis 

In Reply

William L. Lanier and Mark A. Warner 

Is It Dangerous to Quit Smoking Shortly before Surgery? 1137

David O. Warner and Yu Shi 

In Reply

Rita Katznelson and W. Scott Beattie 

Risk of Latex Allergy from Pharmaceutical Vial Closures 1138

James W. Heitz and Stephen O. Bader 

In Reply

Jerrold Lerman 

How Often Should Atenolol Be Dosed for Perioperative ß-Blockade? 1140

Robert G. Badgett, Valerie A. Lawrence, and Steven L. Cohn 

In Reply

Arthur W. Wallace, Selwyn Au, and Brian A. Cason 


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