http://publicationslist.org/data/brull.sorin/atom.xml Sorin Brullhttp://publicationslist.org/brull.sorin$basepathfavicon.icoRecent additions to Sorin Brull's PublicationsList.org pagehttp://publicationslist.org/publications.png2007-11-18T14:22:06Z http://publicationslist.org/brull.sorin/refid2 2007-11-18T14:16:29Z

Crigler-Najjar syndrome is a hereditary condition of unconjugated hyperbilirubinemia due to a deficiency of the enzyme, uridine diphosphate glucuronosyltransferase. Exacerbations of the disease can occur whenever there is either an increase in free serum bilirubin and/or a decrease in serum albumin. The exacerbations can lead to bilirubin encephalopathy and severe brain damage. The goal of anesthe...<br/><br/>Christopher Robards, Sorin J Brull (2007) <i>Anesth Analg</i> <i></i> <i></i> 104: 2 435-436<br/>

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We report the management of a patient with Marfan's syndrome for labor analgesia and vaginal delivery using a combined spinal-epidural technique. The rapid onset of analgesia for the first stage of labor provided by the intrathecal opioid, combined with the slow and controlled onset of sensory anesthesia and sympathetic block provided by the dilute epidural local anesthetic, may make this techniqu...<br/><br/>R T Buser, M M Mordecai, S J Brull (2007) <i>Int J Obstet Anesth</i> <i></i> <i></i> 16: 3 274-276<br/>

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PURPOSE: Critically-ill patients who receive nondepolarizing neuromuscular blocking drugs (NMBDs) may be at risk of developing profound muscle weakness that may last for months after the NMBD is discontinued, especially when large cumulative doses of NMBDs and corticosteroids are co-administered to septic, mechanically ventilated patients. This review focuses on the etiology and clinical features ...<br/><br/>Michael J Murray, Sorin J Brull, Charles F Bolton (2006) <i>Can J Anaesth</i> <i></i> <i></i> 53: 11 1148-1156<br/>

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Volatile anesthetics potentiate the effects of non-depolarizing agents. This study investigated the interaction between the inhalational anesthetic desflurane and rocuronium. Forty ASA I and II patients randomly received desflurane/N2O/fentanyl, or propofol/ N2O/fentanyl anesthesia, and rocuronium 0.6 mg/kg. Neuromuscular block was assessed at the adductor pollicis muscle. Block onset and clinical...<br/><br/>R G Stout, T J Gan, P S A Glass, D G Silverman, S J Brull (2006) <i>Acta Anaesthesiol Belg</i> <i></i> <i></i> 57: 4 349-353<br/>

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BACKGROUND AND OBJECTIVE: Hypotension, the commonest side-effect of spinal anaesthesia, results from sympathetic denervation. This study compared patient positioning (supine vs. decubitus) on haemodynamic variables during spinal anaesthesia. METHODS: After intravenous crystalloid preloading with 5 mL kg(-1), hyperbaric bupivacaine 0.5% 2.5 mL was injected intrathecally at the L2-3 or L3-4 interspa...<br/><br/>J D Kelly, D McCoy, S H Rosenbaum, S J Brull (2005) <i>Eur J Anaesthesiol</i> <i></i> <i></i> 22: 9 717-722<br/>

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PURPOSE OF REVIEW: The aim of this article is to review current practice of spinal anesthesia regarding technique and medication use; review recent applications of spinal anesthesia to subspecialty care in outpatient, cardiac, and obstetrical anesthesia; and update risk assessment associated with spinal anesthesia. RECENT FINDINGS: Epidural volume extension enhances the spread of local anesthetics...<br/><br/>Monica M Mordecai, Sorin J Brull (2005) <i>Curr Opin Anaesthesiol</i> <i></i> <i></i> 18: 5 527-533<br/>

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Michael J Murrary, Sorin J Brull, Douglas B Coursin (2004) <i>J Cardiothorac Vasc Anesth</i> <i></i> <i></i> 18: 6 687-689<br/>

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Sorin J Brull (2004) <i>Health News</i> <i></i> <i></i> 10: 2 4-5<br/>

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PURPOSE: The present study was undertaken to evaluate onset, and early and late recovery of neuromuscular block after a combination of mivacurium (M) and rocuronium (R). METHODS: In this controlled, randomized study, 45 consenting ASA I-II patients were assigned to one of three treatment groups: 2.ED95 R alone (2R); 2.ED95 R plus 1.ED95 M (2R1M). or 2.ED95 R plus 2.ED95 M (2R2M). Neuromuscular mon...<br/><br/>Robert G Stout, Timothy S J Shine, David G Silverman, Sorin J Brull (2004) <i>Yale J Biol Med</i> <i></i> <i></i> 77: 5-6 149-154<br/>

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PURPOSE: Peripheral opioid receptors may result in antinociceptive effects when occupied by opioids. This study examined intradermally injected sufentanil (S), a highly lipid soluble opioid, administered with and without lidocaine (L), in a thermal pain model. METHODS: Nine volunteers were instructed on the method of magnitude estimation of pain before undergoing baseline testing with seven second...<br/><br/>Maximilian W B Hartmannsgruber, Peter G Atanassoff, Arne Budde, Sorin J Brull, Zeev N Kain, David G Silverman (2003) <i>Can J Anaesth</i> <i></i> <i></i> 50: 2 153-158<br/>

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Spontaneous activity originating in the injured nerve or the dorsal root ganglion (DRG) has been implicated in the development and maintenance of neuropathic pain. The inherent characteristics of spontaneous activity and the causal factors that modulate its firing pattern and frequency are not fully understood. We attempted to assess the thermosensitivity of spontaneous activity in dorsal root gan...<br/><br/>Huiqing Li, Bao-Gang Liu, Maxim Dobretsov, Sorin J Brull, Jun-Ming Zhang (2002) <i>Brain Res</i> <i></i> <i></i> 926: 1-2 18-26<br/>

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To study the role of inflammatory cytokines in the initiation and persistence of radiculopathy as seen in humans, tumor necrosis factor alpha (TNF-alpha) was administered either to normal, uninjured L5 dorsal root ganglia (DRG) of rats via a hole drilled through the transverse process, or to chronically compressed L5 DRG via a hollow stainless steel rod inserted into the intervertebral foramen. In...<br/><br/>Yuko Homma, Sorin J Brull, Jun-Ming Zhang (2002) <i>Pain</i> <i></i> <i></i> 95: 3 239-246<br/>

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Local perfusion of the dorsal root ganglion (DRG) with tumor necrosis factor alpha (TNF-alpha) in rats induces cutaneous hypersensitivity to mechanical stimuli. Thus we investigated the cellular mechanisms of TNF-alpha-induced mechanical hyperalgesia. The L(4) and L(5) DRGs with the sciatic nerves attached were excised from rats for in vitro dorsal root microfilament recording. After baseline reco...<br/><br/>Jun-Ming Zhang, Huiqing Li, Baogang Liu, Sorin J Brull (2002) <i>J Neurophysiol</i> <i></i> <i></i> 88: 3 1387-1392<br/>

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Proinflammatory cytokines may sensitize primary sensory neurons and facilitate development of neuropathic pain processes after peripheral nerve injury. The goal of this study was to determine whether responses of dorsal root ganglion (DRG) neurons to exogenous tumor necrosis factor alpha (TNF-alpha) are altered in a chronically compressed DRG (CCD) injury model. Extracellular recordings from tease...<br/><br/>Baogang Liu, Huiqing Li, Sorin J Brull, Jun-Ming Zhang (2002) <i>J Neurophysiol</i> <i></i> <i></i> 88: 3 1393-1399<br/>

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To investigate the neurologic mechanisms of acidic local anesthetic-induced low back pain in humans, we administered bupivacaine and buffered saline at acidic or alkalinized pH at the L5 dorsal root ganglion (DRG) of rats via a hole drilled through the transverse process covering the DRG. Behavioral changes were tested before and after bupivacaine or saline administration. Results indicate that ac...<br/><br/>J M Zhang, Y Homma, W E Ackerman, S J Brull (2001) <i>Anesth Analg</i> <i></i> <i></i> 93: 2 466-71, 4th contents page<br/>

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PURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included: analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; pat...<br/><br/>D J Kelly, M Ahmad, S J Brull (2001) <i>Can J Anaesth</i> <i></i> <i></i> 48: 10 1000-1010<br/>

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BACKGROUND: Local anesthetics, such as bupivacaine, have been reported to block calcium currents in primary sensory neurons and to interfere with the release of neurotransmitters in central nervous system neurons. However, it is unknown whether local anesthetics affect the calcium current activity of central nervous system neurons. METHODS: Using a traditional whole cell voltage clamp technique, e...<br/><br/>B G Liu, X L Zhuang, S T Li, G H Xu, S J Brull, J M Zhang (2001) <i>Anesthesiology</i> <i></i> <i></i> 95: 1 139-143<br/>

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PURPOSE: This two-part review summarizes the current knowledge of physiological mechanisms, pharmacological modalities and controversial issues surrounding preemptive analgesia. SOURCE: Articles from 1966 to present were obtained from the MEDLINE databases. Search terms included analgesia, preemptive; neurotransmitters; pain, postoperative; hyperalgesia; sensitization, central nervous system; path...<br/><br/>D J Kelly, M Ahmad, S J Brull (2001) <i>Can J Anaesth</i> <i></i> <i></i> 48: 11 1091-1101<br/>

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S Thapa, S J Brull (2000) <i>Anesth Analg</i> <i></i> <i></i> 91: 1 237-241<br/>

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The rat L(5) dorsal root ganglion (DRG) was chronically compressed by inserting a hollow perforated rod into the intervertebral foramen. The DRG was constantly perfused through the hollow rod with either lidocaine or normal saline delivered by a subcutaneous osmotic pump. Behavioral evidence for neuropathic pain after DRG compression involved measuring the incidence of hindlimb withdrawals to both...<br/><br/>J M Zhang, H Li, S J Brull (2000) <i>J Neurophysiol</i> <i></i> <i></i> 84: 2 798-805<br/>

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A longer acting local anesthetic such as ropivacaine may offer advantages over lidocaine for IV regional anesthesia (IVRA). The objective of this investigation was to determine whether the use of ropivacaine improves the quality and duration of IVRA. In a randomized, double cross-over design, 10 volunteers received lidocaine 0.5% or ropivacaine 0.2% for IVRA of the upper extremity on two separate ...<br/><br/>M W Hartmannsgruber, D G Silverman, T M Halaszynski, V Bobart, S J Brull, C Wilkerson, A W Loepke, P G Atanassoff (1999) <i>Anesth Analg</i> <i></i> <i></i> 89: 3 727-731<br/>

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Patients undergoing vascular surgery have a high risk of suffering major postoperative cardiac events. Preoperative myocardial ischemia as detected by Holter monitoring identifies a high-risk subgroup whose postoperative ischemia, similarly detected, seems to herald major cardiac events. In this study, we determined whether systematic, patient-specific postoperative heart rate control with beta-ad...<br/><br/>K E Raby, S J Brull, F Timimi, S Akhtar, S Rosenbaum, C Naimi, A D Whittemore (1999) <i>Anesth Analg</i> <i></i> <i></i> 88: 3 477-482<br/>

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L R Saberski, M Ahmad, M A Munir, S J Brull (1999) <i>Anesth Analg</i> <i></i> <i></i> 89: 6 1538-1540<br/>

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Pain reduces itch-a commonly known effect of scratching the skin. Experimentally produced itch from histamine is sometimes accompanied by secondary sensations of pain. The present study investigated the effects of eliminating this pain, by means of a local anesthetic, on the itch and the enhanced mechanically evoked itch and pain that occur after an intradermal injection of histamine. In ten human...<br/><br/>P G Atanassoff, S J Brull, J Zhang, K Greenquist, D G Silverman, R H Lamotte (1999) <i>Somatosens Mot Res</i> <i></i> <i></i> 16: 4 291-298<br/>

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OBJECTIVE: The Verbal Numerical Scale (VNS) for rating pain is bounded between 0 (= no pain) and 10 (= worst pain imaginable). We hypothesized that the limitations inherent to this boundary when rating extremely painful stimuli may be identified by integrating the VNS with an unbounded score such as magnitude estimation of relative change. METHODS: Volunteers received stimuli of increasing current...<br/><br/>M W Hartmannsgruber, C P Swamidoss, A Budde, S Qadir, S J Brull, D G Silverman (1999) <i>J Clin Monit Comput</i> <i></i> <i></i> 15: 7-8 455-459<br/>

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We investigated the effects of tactile allodynia on the itch and mechanically evoked dysesthesiae produced by an intradermal injection of histamine in human volunteers. After an intradermal injection of capsaicin into the volar surface of one forearm, there developed an area of tactile allodynia to stroking and hyperalgesia to pricking the skin. Histamine was then injected simultaneously into the ...<br/><br/>S J Brull, P G Atanassoff, D G Silverman, J Zhang, R H Lamotte (1999) <i>Somatosens Mot Res</i> <i></i> <i></i> 16: 4 299-303<br/>

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C P Swamidoss, S J Brull, G Watrous, P G Barash (1998) <i>Anesthesiology</i> <i></i> <i></i> 88: 3 809-819<br/>

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The use of both clinical medical and administrative databases is discussed in the context of an academic anesthesiology's transition from the tenets of quality assurance to those of continuous quality improvements. A historical framework is presented. The basic and aggregate models are introduced, and examples are used to illustrate the composite system.<br/><br/>C P Swamidoss, G Watrous, B S Dickson, P G Barash, S J Brull (1998) <i>Am J Med Qual</i> <i></i> <i></i> 13: 4 228-239<br/>

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D J Kelly, D E Wallace, S J Brull (1998) <i>Anesth Analg</i> <i></i> <i></i> 86: 6 1332-1333<br/>

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STUDY OBJECTIVE: To determine the differences in the onset time and duration of motor block produced by lidocaine 1% and lidocaine 2% via a quantitative and objective method, the measurement of compound muscle action potentials (CMAPs). STUDY DESIGN: Prospective study. SETTING: Main operating rooms of a university hospital. PATIENTS: 20 consecutive patients undergoing surgery not requiring intraop...<br/><br/>P G Atanassoff, D J Kelly, C M Ayoub, S J Brull (1998) <i>J Clin Anesth</i> <i></i> <i></i> 10: 8 641-645<br/>

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Endothelin-1 (ET-1) is an endogenously produced 21 amino acid peptide that can cause significant airway smooth muscle (ASM) constriction. Volatile anesthetics e.g. isoflurane, can attenuate ASM constriction. This investigation was undertaken to study the direct effects of isoflurane, at a clinically relevant dose, on endothelin-induced constriction in rat trachea. Five Sprague-Dawley female rats (...<br/><br/>S Akhtar, S J Brull (1998) <i>Pulm Pharmacol Ther</i> <i></i> <i></i> 11: 2-3 227-230<br/>

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Patient awareness under minimal anesthesia may include the painful impulses of a nerve stimulator used for the monitoring of muscle relaxation. We present a case where discomfort from nerve stimulation was greater than that caused by the surgical incision or the endotracheal tube.<br/><br/>M Watkins-Pitchford, S J Brull, S H Rosenbaum (1997) <i>J Clin Monit</i> <i></i> <i></i> 13: 1 51-52<br/>

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STUDY OBJECTIVE: To determine if posttetanic twitch following 100-Hz tetanic stimulation enables titration of a nondepolarizing relaxant infusion to a greater depth of block than that achieved with posttetanic twitch following 50 Hz. STUDY DESIGN: Prospective, observational study. SETTING: Operating rooms of a university tertiary care center. PATIENTS: 10 ASA physical status II and III patients fr...<br/><br/>L A Fernandes, R G Stout, D G Silverman, S J Brull (1997) <i>J Clin Anesth</i> <i></i> <i></i> 9: 1 48-51<br/>

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Opioids appear to exert a peripheral effect by gaining access to peripheral opioid receptors. It has been proposed that inflammatory processes and highly osmotic substances could alter the perineural barrier, thereby allowing easy access to opioid receptors. Although local anesthetics do not have osmotic activity, they are highly active on neural tissue and appear to work synergistically with opio...<br/><br/>P G Atanassoff, S J Brull, Y Printsev, D G Silverman (1997) <i>Anesth Analg</i> <i></i> <i></i> 84: 6 1340-1343<br/>

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S J Brull (1997) <i>Anesthesiology</i> <i></i> <i></i> 86: 4 755-757<br/>

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A case is presented to illustrate the need for technical care when handling blood gas samples. The physics of solubility are used to show hour samples changed their oxygen tension (pO2) during handling, while investigating a clinical case to show the effect of hyperlipidemia on blood gases. It appeared that inadvertent access to air allowed atmospheric oxygen to equilibrate with the sample. The ph...<br/><br/>M Watkins-Pitchford, D Kelly, S J Brull (1997) <i>J Clin Anesth</i> <i></i> <i></i> 9: 4 331-333<br/>

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STUDY OBJECTIVES: To examine the effect of timing of an intravenous (i.v.) dose (intraoperative vs. postoperative) of ketorolac tromethamine on pain scores and overall outcome after total abdominal hysterectomy (TAH) and myomectomy. DESIGN: Prospective, randomized, placebo-controlled study. PATIENTS: 248 ASA physical status I and II adult female patients scheduled for elective hysterectomy or myom...<br/><br/>P Balestrieri, G Simmons, D Hill, J Brown, A Jackson, S J Brull, T J Maneatis, A Shefrin, L Bynum, D A O'Hara (1997) <i>J Clin Anesth</i> <i></i> <i></i> 9: 5 358-364<br/>

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STUDY OBJECTIVE: To compare the safety and effectiveness of 0.25 mg divided doses of mivacurium chloride to succinylcholine for a 90-second tracheal intubation. DESIGN: Randomized, double-blind, multicenter study in two groups. SETTING: Operating rooms at four university medical centers. PATIENTS: 200 healthy ASA status I and II adult patients scheduled for elective surgery with general anesthesia...<br/><br/>H H Ali, C A Lien, T Witkowski, S J Brull, R G Stout, R Bartkowski, D G Silverman, S Patel, J A Ascher, N G Goudsouzian (1996) <i>J Clin Anesth</i> <i></i> <i></i> 8: 4 276-281<br/>

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PURPOSE: This study was designed to describe the early recovery characteristics, as well as the speed of onset of neuromuscular block, after a combination of mivacurium and vecuronium. METHODS: In this controlled, randomized study, 30 consenting ASA I-III patients were assigned to three treatment groups. The "2M2V" group received twice the dose necessary to cause 95% depression of the evoked twitc...<br/><br/>R G Stout, S J Brull, D Kelly, D G Silverman (1996) <i>Can J Anaesth</i> <i></i> <i></i> 43: 4 358-361<br/>

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Spinal anesthesia continues to be one of the major techniques in the arsenal of the modern anesthesiologist. Inadequate anesthesia may follow a spinal anesthetic for a variety of reasons. We report a case in which entry of a spinal needle into a subcutaneous cyst mimicked the free flow of cerebrospinal fluid seen with dural puncture. This was confirmed by microscopic examination of the fluid, whic...<br/><br/>D Kelly, J A Gudin, S J Brull (1996) <i>J Clin Anesth</i> <i></i> <i></i> 8: 7 603-604<br/>

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BACKGROUND: Nonsteroidal antiinflammatory drugs may be particularly effective against prostaglandin-mediated, post-injury hyperalgesia and related inflammatory pain. However, their usefulness may be limited by their systemic side effects. The current study determined if local effectiveness can be achieved by low-dose intradermal nonsteroidal antiinflamatory drug administration. METHODS: Ten health...<br/><br/>J C Lundell, D G Silverman, S J Brull, T Z O'Connor, L M Kitahata, J G Collins, R LaMotte (1996) <i>Anesthesiology</i> <i></i> <i></i> 84: 3 502-509<br/>

http://publicationslist.org/brull.sorin/refid39 2007-11-18T14:16:29Z

STUDY OBJECTIVES: To assess plasma levels and the potential toxicity of lidocaine following two different approaches to the obtruator nerve. DESIGN: Prospective, randomized, clinical trial. SETTING: Operating rooms of a university hospital. PATIENTS: 45 ASA physical status I, II and III patients over 40 years of age, and undergoing transurethral resection of urinary bladder tumors. INTERVENTIONS: ...<br/><br/>P G Atanassoff, B M Weiss, S J Brull (1996) <i>J Clin Anesth</i> <i></i> <i></i> 8: 7 535-539<br/>

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The purpose of this investigation was to establish an objective (quantitative) method for determining onset time of motor block induced by different local anesthetics. Twenty-four consenting patients undergoing transurethral surgery during spinal anesthesia were randomized to receive direct obturator nerve block with 10 mL of plain bupivacaine 0.5% (n = 12) or 10 mL of plain etidocaine 1% (n = 12)...<br/><br/>P G Atanassoff, B M Weiss, S J Brull, A Horst, D Külling, R Stein, I Theiler (1996) <i>Anesth Analg</i> <i></i> <i></i> 82: 2 317-320<br/>

http://publicationslist.org/brull.sorin/refid50 2007-11-18T14:16:29Z

The present study was undertaken to determine why visual assessment of thumb adduction in response to train-of-four (TOF) stimulation of the ulnar nerve commonly overestimates the ratio that is obtained mechanographically. In patients undergoing general endotracheal anesthesia plus vecuronium for relaxation, 73 data sets were collected at different depths of neuromuscular block in response to supr...<br/><br/>S J Brull, D G Silverman (1995) <i>Anesth Analg</i> <i></i> <i></i> 80: 3 548-551<br/>

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Continuous infusion of intravenous (i.v.) drugs is increasing in popularity, as technological advances in equipment (such as "smart" pumps) and pharmacologic improvements of drugs (such as ultra-short acting drugs) are introduced into clinical anesthesia practice. Such new technology, however, also introduces potential new complications. We report one such complication associated with the improper...<br/><br/>D Kelly, S J Brull (1995) <i>J Clin Anesth</i> <i></i> <i></i> 7: 1 80-81<br/>

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L R Saberski, S J Brull (1995) <i>Yale J Biol Med</i> <i></i> <i></i> 68: 1-2 7-15<br/>

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The present study was designed to determine the time-course of recovery of the train-of-four (TOF) ratio during spontaneous recovery from mivacurium-induced block. Fifteen patients, free of neuromuscular disease, undergoing general endotracheal anaesthesia with isoflurane were studied. After anaesthetic induction, patients received a bolus dose of mivacurium 0.15 mg.kg-1. The TOF was then recorded...<br/><br/>S J Brull, N R Connelly, D G Silverman (1995) <i>Can J Anaesth</i> <i></i> <i></i> 42: 1 28-31<br/>

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The effects on gastric pH of the H2-receptor antagonist ranitidine (R) with 0.3 molar (M) sodium citrate (SC) as an oral effervescent and those of plain SC were studied in 25 patients scheduled for elective surgery. Following induction of general anaesthesia, the gastric contents were evacuated via a nasogastric tube, and a pH electrode was placed in the stomach. Then, eight patients received R 30...<br/><br/>P G Atanassoff, R Rohling, E Alon, S J Brull (1995) <i>Can J Anaesth</i> <i></i> <i></i> 42: 5 Pt 1 382-386<br/>

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L R Saberski, S J Brull (1995) <i>Yale J Biol Med</i> <i></i> <i></i> 68: 1-2 17-18<br/>

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BACKGROUND: Although the intensity of neurostimulation (i.e., charge) is a product of current intensity and pulse duration, the effects of the latter on the amplitude of evoked response and subjective discomfort are unknown. Therefore, the authors investigated the effects of current intensity and pulse width, and their interaction with electrode placement and polarity, on force translation (FTR), ...<br/><br/>S J Brull, D G Silverman (1995) <i>Anesthesiology</i> <i></i> <i></i> 83: 4 702-709<br/>

http://publicationslist.org/brull.sorin/refid48 2007-11-18T14:16:29Z

The time-course of the effects of single-dose acid-reducing therapy in surgical patients is not known. Therefore, a prospective, randomized trial compared the effects of single-dose administration of omeprazole or ranitidine on gastric pH in 52 patients undergoing lower abdominal surgery. The two drugs were administered intravenously in random fashion after placement of a gastric electrode for con...<br/><br/>P G Atanassoff, S J Brull, B M Weiss, K Landefeld, E Alon, R Rohling (1995) <i>Anesth Analg</i> <i></i> <i></i> 80: 5 975-979<br/>

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Obturator nerve block during spinal, epidural, or general anesthesia without muscle relaxants has been recommended for transurethral surgery to prevent thigh adductor muscle contractions during operative electrocautery. We investigated the effectiveness of direct obturator and 3-in-1 nerve motor blocks in 44 patients undergoing transurethral surgery during spinal anesthesia with isobaric bupivacai...<br/><br/>P G Atanassoff, B M Weiss, S J Brull, A Horst, D Külling, R Stein, I Theiler (1995) <i>Anesth Analg</i> <i></i> <i></i> 81: 3 529-533<br/>

http://publicationslist.org/brull.sorin/refid47 2007-11-18T14:16:29Z

This retrospective study was undertaken to determine the usefulness of intravenous regional anesthetic (IVRA) blocks containing ketorolac and lidocaine in the management of sympathetically-mediated pain, and to determine what factors, if any, predicted success with this technique. Sixty-one patients with reflex sympathetic dystrophy presenting to a university-affiliated teaching hospital's pain ma...<br/><br/>N R Connelly, S Reuben, S J Brull (1995) <i>Yale J Biol Med</i> <i></i> <i></i> 68: 3-4 95-99<br/>

http://publicationslist.org/brull.sorin/refid44 2007-11-18T14:16:29Z

This report describes the perioperative management of a 70-year-old man undergoing bilateral pelvic lymphadenectomy. Because of concerns regarding this patient's high risk for myocardial ischemia, the four-hour surgical procedure, which included the formation of pneumoperitoneum, was performed during epidural anesthesia with minimal sedation. The anesthetic implications of pneumoperitoneum during ...<br/><br/>D Kelly, P A Kraus, S J Brull (1995) <i>J Clin Anesth</i> <i></i> <i></i> 7: 8 648-651<br/>

http://publicationslist.org/brull.sorin/refid58 2007-11-18T14:16:29Z

Advancement of a tracheal tube (TT) over a flexible fiberoptic bronchoscope (FOB) is often impeded by obstruction at the arytenoid cartilage or epiglottis. We tested the hypothesis that the use of a flexible, spiral-wound TT, rather than the standard, preformed TT would facilitate tube passage into the trachea over the FOB. Forty patients scheduled to undergo general anesthesia with tracheal intub...<br/><br/>S J Brull, R Wiklund, C Ferris, N R Connelly, J Ehrenwerth, D G Silverman (1994) <i>Anesth Analg</i> <i></i> <i></i> 78: 4 746-748<br/>

http://publicationslist.org/brull.sorin/refid57 2007-11-18T14:16:29Z

J Marino, D Kelly, S J Brull (1994) <i>Anesth Analg</i> <i></i> <i></i> 78: 6 1180-1181<br/>

http://publicationslist.org/brull.sorin/refid55 2007-11-18T14:16:29Z

We reviewed the records of 66 patients who underwent cardiopulmonary bypass; half of these patients received the plasmin inhibitor, tranexamic acid. The demographics were not different between the group who received tranexamic acid and the group who did not (control group). There was no difference in the heparin or protamine requirements between the two groups. There was a significantly greater am...<br/><br/>N R Connelly, B M Kiessling, S J Brull (1994) <i>Yale J Biol Med</i> <i></i> <i></i> 67: 5-6 265-268<br/>

http://publicationslist.org/brull.sorin/refid56 2007-11-18T14:16:29Z

Neuroleptic malignant syndrome (NMS) and malignant hyperthermia (MH) may have a common pathogenic mechanism; therefore, it has been suggested that known triggering agents for MH (such as succinylcholine) should be avoided in patients with NMS. Electroconvulsive therapy (ECT) continues to play a major therapeutic role in contemporary psychiatry, and succinylcholine has been the muscle relaxant of c...<br/><br/>D Kelly, S J Brull (1994) <i>Can J Anaesth</i> <i></i> <i></i> 41: 9 845-849<br/>

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We evaluated the effect of tetanic stimulation (5 s, 50 Hz, 60 mA) on the response to tetanic stimulation delivered 2 min (TET@2) and 5 min (TET@5) later in 22 anesthetized patients receiving a vecuronium infusion. Once a consistent mechanomyographic train-of-four ratio was obtained at the adductor pollicis muscle, the first (baseline) tetanic stimulus was delivered. Tetanic sequences were repeate...<br/><br/>D G Silverman, S J Brull (1993) <i>Anesth Analg</i> <i></i> <i></i> 76: 6 1284-1287<br/>

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S J Brull (1993) <i>J Clin Anesth</i> <i></i> <i></i> 5: 3 261-262<br/>

http://publicationslist.org/brull.sorin/refid68 2007-11-18T14:16:29Z

Oesophageal, rectal, bladder, tympanic and pulmonary artery sites are used intraoperatively to measure body temperature. However, the temperatures measured at each site have different physiological and practical importance. The present two-part study sought to compare liquid crystal (CR) skin temperature with other temperature monitors which are used routinely during surgery. The first part compar...<br/><br/>S J Brull, A J Cunningham, N R Connelly, T Z O'Connor, D G Silverman (1993) <i>Can J Anaesth</i> <i></i> <i></i> 40: 4 375-381<br/>

http://publicationslist.org/brull.sorin/refid64 2007-11-18T14:16:29Z

We compared fade measurements in response to double-burst stimulation (DBS) at 10 mA above the threshold for the second response (D2) to that for DBS at 60 mA in order to determine the utility of low-current DBS testing. In 20 healthy adults undergoing general endotracheal anesthesia with isoflurane 0.5-1% end-tidal, a vecuronium infusion (0.25-1.5 micrograms.kg-1 x min-1) was delivered until a st...<br/><br/>D G Silverman, S J Brull (1993) <i>Can J Anaesth</i> <i></i> <i></i> 40: 6 502-506<br/>

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Laparoscopic cholecystectomy is a relatively new surgical procedure, enjoying ever-increasing popularity and presenting new anesthetic challenges. The advantages of shorter hospital stay and more rapid return to normal activities are combined with less pain associated with the small limited incisions and less postoperative ileus compared with the traditional open cholecystectomy. Complications are...<br/><br/>A J Cunningham, S J Brull (1993) <i>Anesth Analg</i> <i></i> <i></i> 76: 5 1120-1133<br/>

http://publicationslist.org/brull.sorin/refid63 2007-11-18T14:16:29Z

N R Connelly, S J Brull (1993) <i>Anesth Analg</i> <i></i> <i></i> 76: 6 1365-1366<br/>

http://publicationslist.org/brull.sorin/refid59 2007-11-18T14:16:29Z

This paper will review the basics of neurostimulation in the perioperative period. Following a brief overview of neuromuscular physiology, the mechanism of action of depolarizing and non-depolarizing relaxants will be discussed. The principles of neurostimulation will then be applied clinically when different patterns of stimulation (single twitch, train-of-four, post-tetanic twitch count, double ...<br/><br/>D Kelly, S J Brull (1993) <i>Yale J Biol Med</i> <i></i> <i></i> 66: 5 473-489<br/>

http://publicationslist.org/brull.sorin/refid61 2007-11-18T14:16:29Z

D G Silverman, T Z O'Connor, S J Brull (1993) <i>Anesth Analg</i> <i></i> <i></i> 77: 1 168-170<br/>

http://publicationslist.org/brull.sorin/refid60 2007-11-18T14:16:29Z

The accuracy of visual and tactile assessment of the neuromuscular fade in response to train-of-four (TOF) and double-burst stimulation (DBS) were compared to assess their relative utility in the clinical setting. For each of 74 data sets with a mechanographic TOF ratio less than 0.70, an observer (blinded to the presence or degree of fade) performed visual and tactile assessments of fade in respo...<br/><br/>S J Brull, D G Silverman (1993) <i>Anesth Analg</i> <i></i> <i></i> 77: 2 352-355<br/>

http://publicationslist.org/brull.sorin/refid62 2007-11-18T14:16:29Z

We compared the depth of block attained after divided- and single-dose administration of mivacurium to evaluate our clinical impression that the former regimen resulted in a lesser depth of block. In 30 patients anesthetized with midazolam, fentanyl, thiopental, and nitrous oxide, adductor pollicis contraction was measured in response to train-of-four stimulation at 12-s intervals. Patients then r...<br/><br/>D G Silverman, S J Brull (1993) <i>Anesth Analg</i> <i></i> <i></i> 77: 1 164-167<br/>

http://publicationslist.org/brull.sorin/refid73 2007-11-18T14:16:29Z

S J Brull, J V Lieponis, M J Murphy, R Garcia, D G Silverman (1992) <i>Anesth Analg</i> <i></i> <i></i> 74: 1 145-147<br/>

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STUDY OBJECTIVE: To evaluate the consistency of times to 95% twitch height depression (T95%) in groups of patients receiving identical induction and relaxant regimens. DESIGN: Prospective, noncontrolled, blinded study. SETTING: Ambulatory surgical unit at a university medical center. PATIENTS: Seventy-five ASA physical status I and II patients undergoing general endotracheal anesthesia. INTERVENTI...<br/><br/>D G Silverman, C A Swift, H D Dubow, T Z O'Connor, S J Brull (1992) <i>J Clin Anesth</i> <i></i> <i></i> 4: 1 28-33<br/>

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STUDY OBJECTIVE: The present study was undertaken to determine the time courses of succinylcholine-induced fasciculations and adductor pollicis single-twitch responses at two stimulating frequencies. DESIGN: A prospective, randomized study. SETTING: The main operating room of a university teaching hospital. PATIENTS: Forty-four patients undergoing general anesthesia and requiring tracheal intubati...<br/><br/>N R Connelly, D G Silverman, S J Brull (1992) <i>J Clin Anesth</i> <i></i> <i></i> 4: 3 190-193<br/>

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The authors evaluated train-of-four (TOF) fade, as quantified by accelography, in response to neurostimulation at currents ranging from 10 to 60 mA. This was done to determine the range of currents over which measurements of fade remain consistent. In 31 patients (ASA Physical Status 1,2, and 3), anesthesia was induced with fentanyl, midazolam, and thiopental and was maintained with isoflurane and...<br/><br/>D G Silverman, N R Connelly, T Z O'Connor, R Garcia, S J Brull (1992) <i>Anesthesiology</i> <i></i> <i></i> 76: 1 34-38<br/>

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STUDY OBJECTIVE: To examine the efficacy of intramuscular (IM) ketorolac used in combination with intravenous (IV) patient-controlled analgesia (PCA) morphine for postoperative pain relief following intra-abdominal gynecologic surgery. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Patient care unit at a university medical center. PATIENTS: Thirty-five healthy women undergoin...<br/><br/>F B Sevarino, R S Sinatra, D Paige, T Ning, S J Brull, D G Silverman (1992) <i>J Clin Anesth</i> <i></i> <i></i> 4: 4 285-288<br/>

http://publicationslist.org/brull.sorin/refid70 2007-11-18T14:16:29Z

S J Brull (1992) <i>Crit Care Med</i> <i></i> <i></i> 20: 9 1362-1363<br/>

http://publicationslist.org/brull.sorin/refid69 2007-11-18T14:16:29Z

The current study evaluated the duration and magnitude of post-tetanic effects in 56 patients recovering from a bolus dose of nondepolarizing relaxant to assess the impact of tetanus on monitoring in a common clinical setting. After induction of general anesthesia (thiopental, fentanyl, oxygen, nitrous oxide, and isoflurane), a baseline response to train-of-four (TOF) stimulation was recorded usin...<br/><br/>S J Brull, D G Silverman (1992) <i>Anesthesiology</i> <i></i> <i></i> 77: 4 642-645<br/>

http://publicationslist.org/brull.sorin/refid79 2007-11-18T14:16:29Z

The current study evaluated the effects of tetanic stimulation on neuromuscular responses to serial train-of-four (TOF) and double-burst stimulation (DBS). For TOF monitoring (n = 13), a degree of neuromuscular blockade was achieved with an intravenous vecuronium infusion such that the ratio of fourth twitch (T4) to first twitch (T1), T4/T1, was stable at a value between 0.1 and 0.7. Four seconds ...<br/><br/>S J Brull, N R Connelly, T Z O'Connor, D G Silverman (1991) <i>Anesthesiology</i> <i></i> <i></i> 74: 1 64-70<br/>

http://publicationslist.org/brull.sorin/refid77 2007-11-18T14:16:29Z

We have measured spinal segmental levels of anaesthesia to light touch (LT), pinprick (PP) and cold temperature discrimination (TE) during 2% lignocaine extradural anaesthesia in 22 patients, to determine if zones of differential sensory block develop during extradural anaesthesia and, if so, the extent to which TE extends beyond PP or LT levels and how age affects differential block. The median t...<br/><br/>S J Brull, N M Greene (1991) <i>Br J Anaesth</i> <i></i> <i></i> 66: 6 651-655<br/>

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The present study employed train-of-four (TOF) stimulation at a current of 20 mA to assess the incidence and degree of residual neuromuscular blockade in 64 randomly selected Post Anesthesia Care Unit (PACU) patients. Group C (Control, n = 10) had received anaesthesia without nondepolarizing muscle relaxant; Group V (n = 25) had received vecuronium; and Group P (n = 29) had received pancuronium. A...<br/><br/>S J Brull, J Ehrenwerth, N R Connelly, D G Silverman (1991) <i>Can J Anaesth</i> <i></i> <i></i> 38: 2 164-168<br/>

http://publicationslist.org/brull.sorin/refid76 2007-11-18T14:16:29Z

The influence of current intensity on visual assessment of fade in response to train-of-four (TOF) and two modes of double-burst stimulation (DBS) was determined to assess the utility of low-current neurostimulation. Each of 150 sets of assessments (in 51 patients) included a mechanographic TOF at 60 mA followed by visual assessments of TOF, DBS3,3 (two minitetanic bursts of three stimuli each), a...<br/><br/>S J Brull, D G Silverman (1991) <i>Anesth Analg</i> <i></i> <i></i> 73: 5 627-632<br/>

http://publicationslist.org/brull.sorin/refid82 2007-11-18T14:16:29Z

The present study was undertaken to determine whether the discomfort associated with the sequential bursts of stimuli comprising the two recommended forms of double burst stimulation (DBS) is comparable to that associated with the repetitive stimuli of train-of-four (TOF). Twenty-one unmedicated volunteers rated on a visual analog scale the discomfort associated with randomly applied DBS and TOF s...<br/><br/>N R Connelly, D G Silverman, T Z O'Connor, S J Brull (1990) <i>Anesth Analg</i> <i></i> <i></i> 70: 6 650-653<br/>

http://publicationslist.org/brull.sorin/refid83 2007-11-18T14:16:29Z

The present study evaluated responses to train-of-four (TOF) stimulation at a range of stimulating currents. Traditionally TOF has been applied with a supramaximal stimulus but this may be quite uncomfortable for the awake patient. In the first part of this study, 12 healthy volunteers quantified (by 10-cm visual analog scale) the discomfort associated with TOF stimulation at 20, 30, and 50 mA. Th...<br/><br/>S J Brull, J Ehrenwerth, D G Silverman (1990) <i>Anesthesiology</i> <i></i> <i></i> 72: 4 629-632<br/>

http://publicationslist.org/brull.sorin/refid81 2007-11-18T14:16:29Z

To avoid possible trauma to the epidural venous plexus in a 56-year-old male who presented for abdominal aortic aneurysm resection, the authors preoperatively injected a single dose of epidural morphine rather than inserting an indwelling epidural catheter. The patient's intraoperative anesthetic requirements appeared to have been decreased, he was extubated shortly after the end of the procedure,...<br/><br/>N R Connelly, R DuBose, S J Brull (1990) <i>J Clin Anesth</i> <i></i> <i></i> 2: 4 272-275<br/>

http://publicationslist.org/brull.sorin/refid80 2007-11-18T14:16:29Z

The present study was undertaken to document the relationship between train-of-four (TOF) and double burst stimulation (DBS) at varying degrees of blockade, and to determine whether this relationship remained constant over a range of stimulating currents. The neuromuscular responses to the two most commonly employed modes of DBS stimulation, DBS3,3 and DBS3,2, and the responses to TOF nerve stimul...<br/><br/>S J Brull, N R Connelly, D G Silverman (1990) <i>Anesth Analg</i> <i></i> <i></i> 71: 5 489-492<br/>

http://publicationslist.org/brull.sorin/refid84 2007-11-18T14:16:29Z

The analgesic efficacy and adverse effects of morphine and oxymorphone in 32 patients who received traditional patient-controlled analgesia (PCA) following cesarean delivery were compared with those in 32 other patients receiving the same agents via PCA plus basal opioid infusion (PCA + BI). All patients were operated upon during epidural anesthesia with 2% lidocaine and 1:200,000 epinephrine to a...<br/><br/>R Sinatra, K S Chung, D G Silverman, S J Brull, J Chung, D M Harrison, D Donielson, A Weinstock (1989) <i>Anesthesiology</i> <i></i> <i></i> 71: 4 502-507<br/>

http://publicationslist.org/brull.sorin/refid85 2007-11-18T14:16:29Z

The purposes of this study were twofold: to compare bupivacaine and tetracaine spinal anesthesia with regard to the zones of differential sensory blockade and to evaluate the time-courses of the widths of the zones of differential sensory blockade during spinal anesthesia. In 51 patients, the most rostral levels of sensory denervation to light touch, pinprick, and temperature discrimination were m...<br/><br/>S J Brull, N M Greene (1989) <i>Anesth Analg</i> <i></i> <i></i> 69: 3 342-347<br/>