Anesthesiology

Kopyeva, Tatyana; Sessler, Daniel I.; Weiss, Stephanie; Dalton, Jarrod E.; Mascha, Edward J.; Lee, Jae H.; Kiran, Ravi P.; Udeh, Belinda; Kurz, Andrea

Anesthesiology. 119(1):61-70, July 2013.

doi: 10.1097/ALN.0b013e318295262a

The choice of potent volatile anesthetic may prolong hospitalization, increasing the cost of patient care. The hypothesis that duration of hospitalization is longer in patients anesthetized with isoflurane than in patients anesthetized with sevoflurane was tested first in a propensity-matched retrospective analysis and subsequently in a prospective alternatingintervention trial. The retrospective study, which included 2,898 triplets matched on anesthetic used, found the duration of hospitalization was shorter in patients anesthetized with sevoflurane or desflurane than in those anesthetized with isoflurane. However, the prospective trial, which included 1,584 operations, found no difference in length-of-stay between patients anesthetized with isoflurane and those anesthetized with sevoflurane. This illustrates the importance of testing the results of even a very robust retrospective analysis with an appropriately designed prospective study.

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Nagele, Peter; Brown, Frank; Francis, Amber; Scott, Mitchell G.; Gage, Brian F.; Miller, J. Philip; for the VINO Study Team

Anesthesiology. 119(1):19-28, July 2013.

doi: 10.1097/ALN.0b013e31829761e3

In 500 patients with cardiac risk factors undergoing noncardiac surgery with nitrous oxide, methylenetetrahydrofolate reductase gene variant did not alter homocysteine concentration or the incidence of cardiac injury. Vitamin B12, although decreasing homocysteine concentration, did not alter the incidence of cardiac injury.

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Pongrácz, Adrienn; Szatmári, Szilárd; Nemes, Réka; Fülesdi, Béla; Tassonyi, Edömér

Anesthesiology. 119(1):36-42, July 2013.

doi: 10.1097/ALN.0b013e318297ce95

Residual rocuronium-induced neuromuscular blockade at the reappearance of the fourth twitch in response to train-offour stimulation can be reversed within 5 min by 1.0 and 2.0 mg/kg sugammadex. A sugammadex dose of 0.5 mg/kg can reverse such residual neuromuscular blockade in less than 10 min.

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McNally, J. Dayre; Menon, Kusum; Chakraborty, Pranesh; Fisher, Lawrence; Williams, Kathryn A.; Al-Dirbashi, Osama Y.; Girolamo, Tara; Maharajh, Gyaandeo; Doherty, Dermot R.

Anesthesiology. 119(1):71-80, July 2013.

doi: 10.1097/ALN.0b013e31828ce817

Most children are vitamin D deficient after congenital heart disease surgery, secondary to borderline preoperative levels and significant intraoperative decline. Lower vitamin D levels were associated with worse clinical outcome.

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Degos, Vincent; Westbroek, Erick M.; Lawton, Michael T.; Hemphill, J. Claude III; del Zoppo, Gregory J.; Young, William L.

Anesthesiology. 119(1):218-227, July 2013.

doi: 10.1097/ALN.0b013e318297c18a

This commentary seeks to clarify the recommendations and highlight the debate regarding the perioperative management of hemostasis in intracerebral hemorrhage.

David, Jean-Stephane; Godier, Anne; Dargaud, Yesim; Inaba, Kenji

Anesthesiology. 119(1):191-200, July 2013.

doi: 10.1097/ALN.0b013e31828fc627