April 2007 AANA Journal

Table of Contents


Severe myoclonus prior to electroconvulsive therapy following intravenous etomidate

Krzysztof M. Kuczkowski, MD
Brian H. Hastings, CRNA, MSN
Print version: 2007;75:88.

Legal Briefs
Another article on the surgeon's liability for anesthesia negligence

Gene A. Blumenreich, JD
Print version: 2007;75:89-93.
Key words: Control, liability.

Books and Multimedia of Interest
Handbook of Neuroanesthesia

Reviewer: Cindy Kai Hsieh, BA, BSN

The ICU Book
Reviewer: Henry C. Talley V, CRNA, PhD, MSN
Print version: 2007;75:95-96.

Imagining in Time
Agatha Cobourg Hodgins: She only counted shining hours
Virginia Gaffey, CRNA-ret
Print version: 2007;75:97-100.
Key words: Agatha Hodgins, Lakeside Hospital School of Anesthesia, nurse anesthesia history, World War I. 

Print version: 2007;75:135-144.


The Icarus effect: The influence of diluent warming on dantrolene sodium mixing time
Kevin R. Baker, CRNA, MSNA
Donna Landriscina, CRNA, MSNA
Heather Kartchner, RN, BSN
David M. Mirkes, RN, BSN
Prompt administration of intravenous dantrolene sodium (DS) is the primary determinant of successful treatment of malignant hyperthermia (MH) syndrome. Because DS has a long reconstitution time for use in treating an MH crisis, the authors evaluated an alternative technique for hastening the reconstitution.
Print version: 2007;75:101-106.
Key words: Dantrolene sodium, diluent temperature, Icarus effect, particulate-free, malignant hyperthermia.

Anesthesia "Go Team" for trauma patients: Field based anesthesia
William O. Howie, CRNA, MS
Sedation, and even general anesthesia, is sometimes required in field settings. This article focuses on a unique CRNA-surgeon team that is able to provide definitive operative services to patients injured in the field who are unable to be rapidly transported to a trauma center or other medical facility. Basic considerations in establishing and maintaining such a system are addressed.
Print version: 2007;75:107-110.
Key words: Go Team, field anesthesia, prehospital, surgery, trauma.

The effect of spinal needle design, size, and penetration angle on dural puncture cerebral spinal fluid loss
Glenn O'Connor, CRNA, MS
Ryan Gingrich, CRNA, MS
Malini Moffat, CRNA, MS
Postdural puncture headache (PDPH) is a debilitating side effect of spinal anesthesia, the result of dural puncture and cerebrospinal fluid (CSF) leakage with an incidence of 3% to 75% in patient populations. The purpose of this study was to evaluate the relationship between spinal needle type (pencil tipped or cutting), needle size (22 or 25 gauge), and dura penetration angle from perpendicular (90° or 30°), with the resulting CSF leak measured after dural puncture.
Print version: 2007;75:111-116.
Key words: Cerebrospinal fluid leak, dural puncture, postdural puncture headache, spinal headache, spinal needle design.

Thoracoabdominal aneurysm repair: A case report
Lisa Adams, CRNA, MSN
Cara Malcotti, CRNA, MSN
Eric Petrunak, CRNA, MSN
Aneurysms that extend from the descending thoracic aorta into the abdomen, which can also involve the visceral segments of the upper abdominal aorta, are traditionally classified as thoracoabdominal. The patient in this case report presented for elective repair of a type IV thoracoabdominal aortic aneurysm, with utilization of standard invasive hemodynamic monitoring and cerebrospinal perfusion pressure monitoring as a neuroprotective measure.
Print version: 2007;75:117-121.
Key words: Aneurysm, spinal cord perfusion, thoracoabdominal aortic aneurysm.

The PAXpress airway causes more pharyngeal irritation than the reusable laryngeal mask airway
Evan J. Goodman, MD
E. Jane Ziegler, CRNA, MSN
Allen M. Douglas, CRNA
In this study, the authors sought to determine whether the PAXpress airway should replace the standard laryngeal mask airway in their practice. Records of patients who had been ventilated with a PAXpress airway or an laryngeal mask airway (LMA) were examined. The authors concluded that the PAXpress airway is more likely to cause irritation (often severe) of the airway and, therefore, should not replace the standard LMA in their practice.
Print version: 2007;75:123-125.
Key words: Laryngeal mask airway, PAXpress, reusable, reuse.

Spinal anesthesia for abdominoplasty with liposuction: A case report
Shari M. Burns, CRNA, MSN
N. Bradly Meland, MD, FACS
Currently, little information describing the use of spinal anesthesia for abdominoplasty in the office-based setting is available. This case report demonstrates the feasibility of spinal anesthesia for office-based plastic surgical procedures including abdominoplasty with liposuction in carefully selected patients. Further studies are recommended to evaluate the safe use of spinal anesthesia in office-based anesthesia settings.
Print version: 2007;75:126-128.
Key words: Abdominoplasty, ambulatory surgery, office-based surgery, spinal anesthesia.



AANA Journal Course Part 1
Update for nurse anesthetists --
The esophageal-tracheal double-lumen airway: Rescue for the difficult airway
Alan J. Smally, MD, FACEP
Although the laryngeal mask airway is often used in the operating room should endotracheal intubation fail, the esophageal-tracheal double-lumen airway represents another alternative rescue airway device. In this AANA Journal course, the author provides information on the Combitube, insertion, special circumstances, and orotracheal intubation after Combitube placement.
Print version: 2007;75:129-134.
Key words: Combitube, difficult airway, esophageal-tracheal double-lumen airway, failed intubation, rescue airway device.

April 2007 AANA Journal
Volume 75 , Number 2
ISSN 0094-6354
On the Cover:
AANA's founder and first president Agatha Hodgins at Lakeside Hospital, circa 1920s. Hodgins was the director of Lakeside's school of anesthesia from 1915 until her retirement in 1933. For more information, see the "Imagining in Time" column on page 97. (Photo courtesy of the Stanley A. Ferguson Archives, University Hospitals of Cleveland.)