How readers perceive the quality of six anesthesia journals, their editors and reviewers: a European survey.

The aim of the present study was to evaluate six anesthesia journals and academic criteria, required for the editors and reviewers, as perceived by European anesthesiologists submitted to a questionnaire. The six journals were: Acta Anaesthesiologica Scandinavica (AAS), Anesthesia and Analgesia (AN/AN), Anesthesiology (ANESTH), British Journal of Anaesthesia (BJA), Canadian Journal of Anesthesia (CJA) and European Journal of Anaesthesiology (EJA). Anesthesiologists were questioned on number of articles read per issue, preferred category of article and type of subject addressed, usefulness of supplemental issues as well as to score each journal for quality, format and color. The academic background they would require for editors and reviewers was scored as the sum of the number of their published articles, citations and manuscripts they reviewed. AN/AN, ANESTH, BJA and EJA have higher number of articles read versus the AAS and the CJA. Article quality was estimated higher for AN/AN than for AAS, CJA and EJA, higher for ANESTH than AN/AN, AAS, CJA and EJA ( p < 0.0001 for all comparisons), and higher for BJA than for AAS, CJA and EJA. ANESTH received higher scores for format than EJA, and BJA than CJA. Finally AN/AN received higher scores for format than AAS, CJA and EJA and for color when compared to AAS, CJA, and EJA. Supplemental issues were considered useful by 77.3% of the respondents. General and original articles were preferred by the respondents. The overall scores of the estimated required academic background did not differ between editors and reviewers or between the different criteria. In conclusion, the six anesthesia journals demonstrated differences in all the variables included in the questionnaire addressed to their readers. In contrast the academic background criteria for editors and reviewers as scored by the readers did not show any differences.

Self-citations in six anaesthesia journals and their significance in determining the impact factor.

Self-citation of a journal may affect its impact factor. We investigated self-citations in the 1995 and 1996 issues of six anaesthesia journals by calculating the self-citing and self-cited rates for each journal. Self-citing rate relates a journal's self-citations to its total number of references. We defined self-cited rate as the ratio of a journal's self-citations to the number of times it is cited by the six anaesthesia journals. We also correlated self-citing rates with the impact factor of the six journals for 1997. Citations among the six journals differed significantly (P < 0.0001). Anesthesiology had the highest self-citing rate (57%). Anaesthesia, Anesthesia and Analgesia, British Journal of Anaesthesia, Canadian Journal of Anaesthesia and the European Journal of Anaesthesiology had self-citing rates of 28%, 28%, 30%, 11% and 4% respectively. The self-cited rates were 31%, 35%, 34%, 27%, 31% and 17% for Anaesthesia, Anesthesiology, Anesthesia and Analgesia, British Journal of Anaesthesia, Canadian Journal of Anaesthesia and the European Journal of Anaesthesiology, respectively. North America journals cited the North America literature. This also occurred, to a lesser extent, in the European anaesthesia journals. A significant correlation between self-citing rates and impact factors was found (r = 0.899, P = 0.015). A high self-citing rate of a journal may positively affect its impact factor.

Ventilatory adequacy and respiratory mechanics with laryngeal mask versus tracheal intubation during positive pressure ventilation.

The ventilatory adequacy and respiratory mechanics during positive pressure ventilation (PPV) via the laryngeal mask airway (LMA) are compared with the respiratory mechanics via the tracheal tube (TT). Thirty patients undergoing breast surgery were studied. After induction of anesthesia and muscle relaxation an LMA was inserted. Data were collected every 5 min for a 15 min period and included inspired (VTinsp) and expired (VTexp) tidal volumes, I:E ratio, peak airway pressure (Ppeak), plateau pressure (Pplat), total dynamic compliance (C), and the percentage of VT exhaled passively in the first second of expiration (V1.0%). Then the trachea was intubated and measurements were repeated as previously. Gas leak was calculated as the fraction (VTinsp- VTexp)/Vtinsp. VTinsp and VTexp did not differ significantly between the LMA or TT anesthesia at any time (P = 0.9318, P = 0.7071 for VTinsp and VTexp respectively), neither the Ppeak (P = 0.1382). Significant differences were found for Pplat (P = 0.000) and C (P = 0.0001). Individual comparisons showed a significant difference between the LMA Pplat at 5 min when compared with all the Pplat mean values recorded with the LMA or the TT (P < 0.05-0.01). The C mean value with the LMA at 5 min was significantly lower when compared with all the C mean values via the TT anesthesia (P < 0.05-0.01). Significant differences were found among the V1.0% measurements (P = 0.030) but not between individual comparisons. Leak was similar with the LMA or TT airway management. It is concluded that, in patients with normal airway pressure and compliance, PPV using the LMA is comparatively effective with the use of TT.

Assessment of the level of sensory block after subarachnoid anesthesia using a pressure palpator.

UNLABELLED: In a cross-over study, we compared two methods of assessing the level of sensory block during subarachnoid anesthesia: the traditional pinprick sensation or a novel pressure palpator exerting a pressure of 650 g. Fifty patients scheduled for transurethral surgery under subarachnoid anesthesia were randomly assigned to be tested for spread of sensory block. In Group 1, the pressure palpator was followed by pinprick; in Group 2, the reverse sequence was used. Evaluation was performed 15 and 25 min after the subarachnoid injection of 2 mL of 5% lidocaine hyperbaric solution. In Group 1, the level of sensory block assessed with the pressure palpator was 1.7 +/- 3.2 cm (0.5 +/- 1.2 dermatomes) higher than that with the pinprick at 15 min, and 2.2 +/- 3.4 cm (0.6 +/- 1.0 dermatomes) higher than that with the pinprick 25 min after the block. In Group 2, the difference was accentuated. The level of sensory block assessed by pinprick 15 min after subarachnoid lidocaine was 5.7 +/- 4.8 cm (1.2 +/- 0.9 dermatomes) lower than the level with the pressure palpator, and 4.2 +/- 3.3 cm (0.9 +/- 0.6 dermatomes) lower than that with the pressure palpator at 25 min. In all instances, the pressure palpator gave a significantly higher assessment than the pinprick. We conclude that the pressure palpator, when preceded by the pinprick test, is associated with an increased threshold. This method may be useful in assessing the sensory block produced by subarachnoid anesthesia. IMPLICATIONS: A novel pressure palpator that maintains the integrity of the epidermis was used to assess the level of sensory block after subarachnoid anesthesia and was compared with the standard method of the pinprick sensation. This method assessed the block consistently higher than the pinprick method, but it may have advantages as a noninvasive sensory test.

Skin application of isoflurane attenuates the responses to a mechanical and an electrical stimulation.

PURPOSE: This prospective randomized crossover study was performed to test the potential of an analgesic effect of isoflurane after its local application to the skin. METHODS: We evaluated the local analgesic effect of isoflurane solution in 31 healthy volunteers. The right or left forearm of each subject was exposed to isoflurane and the contralateral forearm to water for 30 min. Then, the response of both forearms to a mechanical stimulus of 650 gr and an electrical stimulus of 2 Hz was tested. The procedure was repeated the next day with the forearms exposed to anaesthetic or water in an inverse way. The averaged responses to the mechanical and electrical stimuli obtained from both forearms after exposure to isoflurane were expressed on a VAS scale and compared with the averaged responses obtained after exposure to water, using the Wilcoxon signed-ranks matched-pairs test. RESULTS: The average VAS scores obtained from both forearms after the mechanical stimulus were decreased after isoflurane compared with water (3.5 +/- 2.1 cm vs 4.3 +/- 2.2 cm, P < 0.0001). After the electrical stimulus local application of isoflurane was associated with a decrease in the VAS scores obtained from both the right and left forearms (3.6 +/- 2.0 cm) when compared with water, (5.2 +/- 2.1 cm, P < 0.0001). CONCLUSION: These data suggest that isoflurane may have an analgesic effect in the peripheral tissues, which may interfere with the MAC determination as well with decreased responses to other nociceptive stimuli.