April 1998 AANA Journal

Table of Contents


Legal Briefs
By Gene A. Blumenreich, JD
Do surgeons get sued when they work with anesthesiologists?
Print version: 1998;66(2):107-110.
Key words: Malpractice, supervision, vicarious liability.

Education News
By Kathleen P. Hanna, CRNA, EdD
Norman R. Wolford, CRNA, EdD
Suzanne G. James, PhD
Distance education and accreditation
Print version: 1998;66(2):113-116.
Key words: Distance education, nurse anesthesia accreditation, regional accreditation, specialized accreditation.

AANA Journal Course: Update for nurse anesthetists–A comprehensive review of remifentanil: The next generation opioid
By S. Deshlar Puckett, CRNA
J. Jeff Andrews, MD
In this Journal course, the authors discuss remifentanil, a new member of the fentanil family, which is an ultra-short-acting opioid that can be rapidly titrated and individualized for various levels of surgical stimuli. Included in the article are pharmacodynamics and relative potency, pharmacokinetics and metabolism, pharmacological effects, effects on special patient populations, common adverse effects, interactions/synergism, postoperative pain management dosage and administration, contraindications, and cost issues.
Print version: 1998;66(2):125-136.
Key words: Remifentanil, μ opioid agonist, ultra-short-acting opioid.

On Leadership
By Karlene Kerfoot, RN, CNAA, PhD, FAAN
Leadership principles: Lessons learned
Print version:
Key words: Healthcare, leadership, mentoring.

An economic analysis of the investment in nurse anesthesia education
By Kathleen A. Fagerlund, CRNA, PhD
The purpose of this study was to evaluate the economic investment in nurse anesthesia education by estimating the costs and the benefits to four entities: students, clinical institutions, academic institutions, and others, primarily the taxpayers who often subsidize nurse anesthesia education.
Print version: 1998;66(2):153-160.
Key words: Costs and benefits, economics of healthcare education, nurse anesthesia education.

Liquid ventilation innovations in ventilatory management
By Lindy Deatherage, CRNA, MS
Chuck Biddle, CRNA, PhD
The goal of mechanical ventilation is to maintain adequate gas exchange by opening and stabilizing alveolar units with minimal detriment to the pulmonary and circulatory systems. In this review article, the author discusses early studies in liquid ventilation, perflubron, total liquid ventilation, partial liquid ventilation, recent human trials of partial liquid ventilation, and combined therapies.
Print version: 1998;66(2):161-168.
Key words: Mechanical ventilation, partial liquid ventilation, perflubron, perfluorochemical, respiratory distress syndrome.

Interpretation of capnography
By Jonathan L. Benumof, MD
Monitoring and interpretation of the end-tidal carbon dioxide waveform are skills critical to the conduct of a modern anesthetic. In this review article, the author offers a systematic examination of the end-tidal carbon dioxide waveform and includes the relevant physiological and pathophysiological considerations.
Print version: 1998;66(2):169-176.
Key words: Capnogram, end-tidal CO2 concentration, ventilation.

The effect of epidural analgesia on the second stage of labor
By Cheryl E. McRae-Bergeron, CRNA, ND, RNCS
Claire M. Andrews, RN, PhD, CNM, FAAN
Patricia J. Lupe, MSN, ND, CNM

In this original research, the authors state that few studies have investigated the relationship of cervical dilation at the time of epidural analgesia administration to second-stage length. This study was designed to determine whether cervical dilation at the time of epidural analgesia was associated with length of the second stage of labor. Labor management and outcomes were compared with a nonepidural group.
Print version: 1998;66(2):177-182.
Key words: Cervical dilation, epidural analgesia, second-stage length.

A comparison of the recovery times of desflurane and isoflurane in outpatient anesthesia
By Lisa Bracamontes Rieker, CRNA, MSN
Michael P. Rieker, CRNA, MS
In this original research, the authors compare the recovery and discharge times of outpatients undergoing procedures greater than 2 hours in length. Thirty-three patients were randomized to receive either desflurane or isoflurane following a standard induction with propofol.
Print version: 1998;66(2):183-186.
Key words: Ambulatory surgery, desflurane, isoflurane, recovery time.

Anesthetic management of Takayasu's arteritis for extra-anatomic thoraco-abdominal aorto-aortic bypass: A case report
By Debra A. Barber, CRNA, MS
J.L. Reeves-Viets, MD

Althea Fox, CRNA, MS
Patrick Curling, MD
This case report discusses the pathophysiology of Takayasu's arteritis and the anesthetic considerations for aortic surgery. Takayasu's arteritis is a chronic inflammatory disease that affects the aorta and its main branches. Occurring worldwide, predominantly in persons of Asian descent, oriental females suffer from this disease nine times more frequently than men.
Print version: 1998;66(2):187-191.
Key words: Aortic surgery, chronic inflammatory disease, Takayasu's arteritis, vasculitis.

Books of Interest
Nurse Anesthesia
Reviewed by: Debra A. Goldstein, CRNA, MS
Print version: 1998;66(2):195.

AANA Journal Course No. 17 Examination
Print version: 1998;66(2):196-206.

Council on Accreditation List of Programs to be Reviewed During Fiscal Year 1999
Print version: 1998;66(2):207.

Index to Advertisers
Print version: 1998;66(2):208.

April 1998 AANA Journal
Volume 66 , Number 2
ISSN 0094-6354
On the Cover: