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Anesthesiology May 2014, Vol. 120, A13–A19. https://doi.org/10.1097/01.anes.0000446479.34895.00

Editorial Board

Anesthesiology May 2014, Vol. 120, A23–A24. https://doi.org/10.1097/01.anes.0000446478.96776.fe

This Month in Anesthesiology

Anesthesiology May 2014, Vol. 120, A1–A2. https://doi.org/10.1097/01.anes.0000446476.12024.b2

Science, Medicine, and the Anesthesiologist

Anesthesiology May 2014, Vol. 120, A27–A28. https://doi.org/10.1097/01.anes.0000446480.42518.e1

Infographics in Anesthesiology

Anesthesiology May 2014, Vol. 120, A29. https://doi.org/10.1097/01.anes.0000446481.19647.82

Anesthesiology CME Program

Anesthesiology May 2014, Vol. 120, A25. https://doi.org/10.1097/01.anes.0000446477.89152.2e

Editorial

Anesthesiology May 2014, Vol. 120, 1063–1064. https://doi.org/10.1097/ALN.0000000000000173
Anesthesiology May 2014, Vol. 120, 1065–1066. https://doi.org/10.1097/ALN.0000000000000227
Anesthesiology May 2014, Vol. 120, 1067–1068. https://doi.org/10.1097/ALN.0000000000000225
Anesthesiology May 2014, Vol. 120, 1069–1071. https://doi.org/10.1097/ALN.0000000000000219
Anesthesiology May 2014, Vol. 120, 1072–1074. https://doi.org/10.1097/ALN.0000000000000217
Anesthesiology May 2014, Vol. 120, 1075–1077. https://doi.org/10.1097/ALN.0000000000000223
Anesthesiology May 2014, Vol. 120, 1078–1079. https://doi.org/10.1097/ALN.0000000000000221

Perioperative Medicine: Clinical Science

Anesthesiology May 2014, Vol. 120, 1080–1097. https://doi.org/10.1097/ALN.0000000000000226

This meta-analysis found that accuracy and precision of continuous noninvasive arterial pressure monitoring devices are larger than what was defined as acceptable by the Association for the Advancement of Medical Instrumentation.

Anesthesiology May 2014, Vol. 120, 1098–1108. https://doi.org/10.1097/ALN.0000000000000224

In an observational study of 6,005 patients using propensity score matching, perioperative use of inotropes was independently associated with increased 1-yr mortality (adjusted hazard ratio of 2.5). The results indicate that the beneficial effects of current inotropic drugs may be limited to only short-term hemodynamic improvement in patients after cardiac surgery.

Anesthesiology May 2014, Vol. 120, 1109–1117. https://doi.org/10.1097/ALN.0000000000000189

In 1,627 patients undergoing coronary artery bypass graft surgery, those with a GNAS haplotype resulting in low expression and function of Gαs showed double the risk of death compared with other haplotypes. In this high-risk group, those who also received β-blockers showed triple the risk of death. SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT

Supplemental Digital Content is available in the text.

Anesthesiology May 2014, Vol. 120, 1118–1125. https://doi.org/10.1097/ALN.0000000000000141

The elimination clearance of dexmedetomidine was increased by 43% in subjects with seizure disorders taking phenytoin or carbamazepine. Patients taking phenytoin or carbamazepine may require higher than normal maintenance doses of dexmedetomidine to maintain the desired level of sedation/anesthesia.

Anesthesiology May 2014, Vol. 120, 1126–1136. https://doi.org/10.1097/ALN.0000000000000118

In a study of 300 parturients receiving intrathecal fentanyl and bupivacaine for labor analgesia, these drugs interacted in a clearly synergistic manner.

Anesthesiology May 2014, Vol. 120, 1137–1145. https://doi.org/10.1097/ALN.0000000000000122
Anesthesiology May 2014, Vol. 120, 1146–1151. https://doi.org/10.1097/ALN.0000000000000161

In a case-controlled open-labeled study of 53 chronic obstructive pulmonary disease patients, patients breathing 100% oxygen during emergence had lower arterial oxygen levels after 60 min compared with patients breathing 30% oxygen balanced with nitrogen.

Perioperative Medicine: Basic Science

Anesthesiology May 2014, Vol. 120, 1152–1159. https://doi.org/10.1097/ALN.0000000000000160

In animals with sensitized airway, combination of phosphodiesterase 4 inhibitors, particularly a new generation roflumilast, and sevoflurane exerted additive airway relaxation via an increase in airway smooth muscle cyclic adenosine monophosphate levels.

Anesthesiology May 2014, Vol. 120, 1160–1167. https://doi.org/10.1097/ALN.0000000000000045

Administration of the alarmin high-mobility group box 1 protein produced memory dysfunction in mice. A neutralizing antibody to high-mobility group box 1 protein reduced memory dysfunction and prevented the inflammatory response following tibial surgery, indicating a major initiating role for this mediator in postoperative memory dysfunction.

Critical Care Medicine: Clinical Science

Anesthesiology May 2014, Vol. 120, 1168–1181. https://doi.org/10.1097/ALN.0000000000000216

The investigators tested and refined the previously reported surgical lung injury prediction model in a multicenter cohort of 1,562 at-risk surgical patients. Sepsis, high-risk aortic vascular surgery, high-risk cardiac surgery, emergency surgery, cirrhosis, admission location other than home, increased respiratory rate (20–29 and ≥30 breaths/min), Fio2 greater than 35%, and Spo2 less than 95% were all significant predictors of acute respiratory distress syndrome.

Supplemental Digital Content is available in the text.

Anesthesiology May 2014, Vol. 120, 1182–1191. https://doi.org/10.1097/ALN.0000000000000201

Comparisons between 14 people with sepsis to 9 similar patients without sepsis documented a significant loss of diaphragm muscle volume compared with the psoas muscle volume in the septic patients. The loss of diaphragm muscle was associated with loss of strength

Critical Care Medicine: Basic Science

Anesthesiology May 2014, Vol. 120, 1192–1204. https://doi.org/10.1097/ALN.0000000000000218

Using a rat model of lesions of the nucleus tractus solitarii and various adrenergic antagonists, it was shown that α1- adrenoceptors are the cornerstone for this phenotype.

Anesthesiology May 2014, Vol. 120, 1205–1215. https://doi.org/10.1097/ALN.0000000000000222

A novel model of ventilator-associated pneumonia, caused by oropharyngeal instillation of Pseudomonas aeruginosa, was developed in tracheally intubated pigs, positioned in anti-Tredelenburg. SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT

Supplemental Digital Content is available in the text.

Pain Medicine: Clinical Science

Anesthesiology May 2014, Vol. 120, 1216–1224. https://doi.org/10.1097/ALN.0000000000000172

In a review of over 500,000 women enrolled in an insurance plan from 6 months before pregnancy through parturition, 14% received at least one dose of an opioid during pregnancy. Over 1 in 20 women received an opioid during the first trimester, and prevalence of opioid exposure varied several-fold across states, being generally lowest in the Northeast and highest in the South.

Anesthesiology May 2014, Vol. 120, 1225–1236. https://doi.org/10.1097/ALN.0000000000000220

Hypersensitivity to chemical, thermal, and mechanical stimuli was observed bilaterally in complex regional pain syndrome (CRPS) patients when compared with control unaffected subjects. Thermal and mechanical hyperalgesia were greater in the CRPS-affected compared with that in the contralateral hands. The results suggest that central sensitization may explain some pain symptoms in patients with CRPS

Anesthesiology May 2014, Vol. 120, 1237–1245. https://doi.org/10.1097/ALN.0000000000000108

In a review of over 22,000 German patients across a wide variety of surgical procedures, predictors of severity of acute postoperative pain were reproducible. Younger age, female sex, and preoperative pain intensity all were associated with statistically significant, but small increases in postoperative pain across procedures. SUPPLEMENTAL DIGITAL CONTENT IS AVAILABLE IN THE TEXT

Supplemental Digital Content is available in the text.

Anesthesiology May 2014, Vol. 120, 1246–1253. https://doi.org/10.1097/ALN.0000000000000133

In 16 patients scheduled for shoulder surgery, injection of solution 1 mm from a brachial plexus root resulted in low (8.2 psi) opening injection pressure, whereas injection of solution with the needle apposed to the root resulted in high (20 psi) opening injection pressure. These results suggest that high (>15 psi) opening injection pressure may indicate needle–nerve contact and avoiding injection in this condition might improve patient safety.

Education: Images in Anesthesiology

Anesthesiology May 2014, Vol. 120, 1254. https://doi.org/10.1097/ALN.0b013e31828f4fdf

Education: Clinical Concepts and Commentary

Anesthesiology May 2014, Vol. 120, 1255–1261. https://doi.org/10.1097/ALN.0000000000000228

Pulmonary thromboendarterectomy is the most effective therapy for chronic thromboembolic pulmonary hypertension. The pathophysiology, anesthetic management, and perioperative outcomes of patients with chronic thromboembolic pulmonary hypertension undergoing pulmonary thromboendarterectomy are reviewed.

Education: Review Article

Anesthesiology May 2014, Vol. 120, 1262–1274. https://doi.org/10.1097/ALN.0000000000000170

The current data suggest that buprenorphine–naloxone may provide pain relief in patients with chronic pain with opioid dependence or addiction. Studies are needed to assess the implication of buprenorphine–naloxone in clinical anesthesia and perioperative pain management.

Education: Mind to Mind

Anesthesiology May 2014, Vol. 120, 1275–1276. https://doi.org/10.1097/ALN.0b013e31829f6a17

Correspondence

Anesthesiology May 2014, Vol. 120, 1277–1278. https://doi.org/10.1097/ALN.0000000000000163
Anesthesiology May 2014, Vol. 120, 1278. https://doi.org/10.1097/ALN.0000000000000164
Anesthesiology May 2014, Vol. 120, 1278–1280. https://doi.org/10.1097/ALN.0000000000000168
Anesthesiology May 2014, Vol. 120, 1280–1281. https://doi.org/10.1097/ALN.0000000000000169
Anesthesiology May 2014, Vol. 120, 1281. https://doi.org/10.1097/ALN.0000000000000166
Anesthesiology May 2014, Vol. 120, 1281–1282. https://doi.org/10.1097/ALN.0000000000000167
Anesthesiology May 2014, Vol. 120, 1282–1283. https://doi.org/10.1097/ALN.0000000000000197
Anesthesiology May 2014, Vol. 120, 1283–1284. https://doi.org/10.1097/ALN.0000000000000198
Anesthesiology May 2014, Vol. 120, 1284–1285. https://doi.org/10.1097/ALN.0000000000000199
Anesthesiology May 2014, Vol. 120, 1286–1287. https://doi.org/10.1097/ALN.0000000000000195
Anesthesiology May 2014, Vol. 120, 1287–1288. https://doi.org/10.1097/ALN.0000000000000196
Anesthesiology May 2014, Vol. 120, 1288–1289. https://doi.org/10.1097/ALN.0000000000000185
Anesthesiology May 2014, Vol. 120, 1289–1290. https://doi.org/10.1097/ALN.0000000000000186
Anesthesiology May 2014, Vol. 120, 1291–1292. https://doi.org/10.1097/ALN.0000000000000187
Anesthesiology May 2014, Vol. 120, 1292–1297. https://doi.org/10.1097/ALN.0000000000000188
Anesthesiology May 2014, Vol. 120, 1297. https://doi.org/10.1097/ALN.0000000000000214
Anesthesiology May 2014, Vol. 120, 1297–1298. https://doi.org/10.1097/ALN.0000000000000215
Anesthesiology May 2014, Vol. 120, 1298. https://doi.org/10.1097/ALN.0000000000000212
Anesthesiology May 2014, Vol. 120, 1298–1299. https://doi.org/10.1097/ALN.0000000000000213

Reviews of Educational Material

Anesthesiology May 2014, Vol. 120, 1300. https://doi.org/10.1097/ALN.0000000000000178
Anesthesiology May 2014, Vol. 120, 1300–1301. https://doi.org/10.1097/ALN.0000000000000184

Anesthesiology Reflections from the Wood Library-Museum

Anesthesiology May 2014, Vol. 120, 1071. https://doi.org/10.1097/01.anes.0000446482.27271.88
Anesthesiology May 2014, Vol. 120, 1077. https://doi.org/10.1097/01.anes.0000446483.65389.26
Anesthesiology May 2014, Vol. 120, 1117. https://doi.org/10.1097/01.anes.0000446484.65389.e8
Anesthesiology May 2014, Vol. 120, 1191. https://doi.org/10.1097/01.anes.0000446485.73012.ec
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