AnesthesiaWeb - Useful Resources

Ultrasound guided central venous access
Muhm M. BMJ. 2002;325:1373-1374.
[http://bmj.com/cgi/content/full/325/7377/1373]
Faced with a complication rate of 10%, ultrasound guidance may be a useful backup for anesthesia specialists attempting central venous catheterization, according to the author. Several studies suggest that ultrasound devices may be most useful after failed attempts at blind cannulation and for patients in whom catheterization is likely to be difficult and complications serious.

In children, nitrous oxide decreases pain on injection of propofol mixed with lidocaine
Beh T, et al. Can J Anaesth. 2002;49:1061-1063.
[http://www.cja-jca.org/cgi/content/abstract/49/10/1061]
In a study of 54 healthy children undergoing IV induction of general anesthesia for elective surgery, patients receiving 50% nitrous oxide experienced a 4% incidence of pain due to administration of propofol mixed with lidocaine, compared with 36% of patients in the control group, who received oxygen.

A low-dose remifentanil infusion is well tolerated for sedation in mechanically ventilated, critically-ill patients
Cavaliere F, et al. Can J Anaesth. 2002;49:1088-1094.
[http://www.cja-jca.org/cgi/content/abstract/49/10/1088]
In a cohort of 10 critically-ill patients, the authors found that low doses of remifentanil (up to 0.05 mg/kg^-1/min^-1) can be useful in order to achieve calm and sedation. Higher doses can inhibit respiratory drive and require controlled mechanical ventilation.

A randomized, double-blind, placebo-controlled trial of a glycine antagonist in neuropathic pain
Wallace MS, et al. Neurology. 2002;59:1694-1700.
[http://www.neurology.org/cgi/content/abstract/59/11/1694]
In a double-blind, randomized, placebo-controlled study of 63 subjects with neuropathic pain, the glycine antagonist GV196771 showed no significant effect on spontaneous or evoked pain, quantitative sensory testing or patient global satisfaction. The authors concluded that the results may be due to insufficient penetration of GV196771 to central sites of action.