To the Editor:—

I read with interest the Clinical Concepts and Commentary section of the January 2000 issue of Anesthesiology. 1It was useful, informative, educative, and of practical value in day-to-day anesthetic practice.

The evolving modern concept of “ischemic preconditioning” is emphasized rightly. I could not understand clearly why the authors, while explaining the shortcomings of general anesthesia, said that high concentrations of volatile anesthetics may cause increases in sympathetic activity, whereas in the next paragraph, they explained the cardioprotective effects of volatile anesthetics. 1I suppose that should be read as decreases in sympathetic activity, rather than increases in sympathetic activity.

Warltier DC, Pagel PS, Kersten JR: Approaches to the prevention of perioperative myocardial ischemia. A nesthesiology 2000; 92: 253–9