April 2011 AANA Journal

April 2011 AANA Journal
April 2011
Volume 79, Number 2
ISSN 0094-6354​

​Table of Contents

Rozanna Penney, CRNA, MSNA, CEN
Print version: 2011;79(2):89-90.
Books, Etc.
The Doctor of Nursing Practice: A Guidebook for Role Development and Professional Issues
Reviewers: Terri S. Jones, CRNA, DNP
Mark Welliver, CRNA, DNP, ARNP
The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing
Reviewers: Bernadette T. Roche, CRNA, EdD
Gwendolynn D. Randall, CRNA, PhD, ARNP
Print version: 2011;79(2):91-92.
Guest Editorial
Studies Support Removing CRNA Supervision Rule to Maximize Anesthesia Workforce and Ensure Patient Access to Care
Lorraine Jordan, CRNA, PhD
Print version: 2011;79(2):101-105.
Keywords: Access to care, anesthesia, Certified Registered Nurse Anesthetists, Medicare, quality of care.
AANA Journal Course No. 30 Examination
Print version: 2011;79(2):161-170.

Anesthetic Management of Delayed Pressure Urticaria: A Case Report
William H. Paxton Jr, CRNA, MA, FAAPM
Delayed pressure urticaria is a rare form of physical urticaria. Because of the rarity of the disease, anesthetic implications have not been addressed in the literature. This case report is presented to offer suggestions on the perioperative management of delayed pressure urticaria including: minimizing pressure occurrence, perioperative staff education, and symptomatic treatment secondary to histamine release.
Print version: 2011;79(2):106-108.
Keywords: Angioedema, chronic urticaria, delayed pressure urticaria.
Evaluation of the Anxiolytic Properties of Myristicin, a Component of Nutmeg, in the Male Sprague-Dawley Rat
MAJ Emily Leiter, CRNA, MSN, ANC, USA MAJ Gavin Hitchcock, CRNA, MSN, FNP, ANC, USA
MAJ Stuart Godwin, CRNA, MSN, ANC, USA MAJ Michelle Johnson, CRNA, MSN, ANC, USA
MAJ William Sedgwick, CRNA, MSN, ANC, USA
CPT Wendy Jones, CRNA, MSN, ANC, USA Suzanne McCall
Thomas E. Ceremuga, CRNA, PhD, LTC (ret), ANC, USA
The purpose of this study was to investigate the anxiolytic effects of myristicin, a major compound found in nutmeg, and its potential interaction with the γ-aminobutyric acid (GABAA) receptor in male Sprague-Dawley rats. The authors’ data suggest that myristicin does not decrease anxiety by modulation of the GABAA receptor but may promote anxiogenesis. When myristicin was combined with midazolam, an antagonist-like effect similar to the flumazenil and myristicin combination was exhibited by a decrease in anxiolysis compared with the midazolam-only group.
Print version: 2011;79(2):109-114.
Keywords: Anxiolysis, elevated plus-maze, myristicin, nutmeg, rat.
Postoperative visual loss is a rare but catastrophic complication after nonocular surgery. A 3-year investigation of the relationship between intraocular pressure and ST procedures is reported. The findings of this research suggest a relationship between prolonged ST and reduced ocular perfusion pressure, challenging the accepted view that cerebral and ophthalmic circulatory autoregulation prevents elevated compartment pressures and reductions in perfusion.
Print version: 2011;79(2):115-121.
Keywords: Intraocular pressure, ischemic optic neuropathy, mean arterial pressure, ocular perfusion pressure, postoperative visual loss.
Stress and Burnout in Nurse Anesthesia
Anthony Chipas, CRNA, PhD
Dennis McKenna, CRNA, MSNA
The authors designed this study to determine the current level of stress and its physical manifestations in Certified Registered Nurse Anesthetists and student registered nurse anesthetists. It also looked at coping mechanisms individuals commonly employ to combat the effects of stress. Based on responses and comments, recommendations can be made for future wellness interventions for the Association and for individuals.
Print version: 2011;79(2):122-128.
Keywords: Burnout, stress, stressors, symptoms.
Combined Lipid Emulsion and ACLS Resuscitation Following Bupivacaine- and Hypoxia-Induced Cardiovascular Collapse in Unanesthetized Swine
CDR Brent A. Bushey, CRNA, MS, NC, USN Victor H. Auld, CRNA, MSN
LCDR John E. Volk, CRNA, MSN, NC, USN Charles A. Vacchiano, CRNA, PhD
This study examined whether combining lipid emulsion and advanced cardiac life support (ACLS) improves survival in an unanesthetized swine model of bupivacaine- and hypoxia-induced cardiovascular collapse. The authors found no significant difference in survival between the saline group and lipid emulsion group. Additionally, there was no significant difference between groups of surviving animals in the time to return of spontaneous circulation.
Print version: 2011;79(2):129-138.
Keywords: Bupivacaine, hypoxia, lipid emulsion, local anesthetic toxicity, resuscitation.

AANA Journal Course: Update for Nurse Anesthetists—Part 1— Anesthesia Case Management for Bariatric Surgery
Jennifer Thompson, CRNA, MSN
Sandra Bordi, CRNA, MSN
Michael Boytim, CRNA, EdD
Sass Elisha, CRNA, EdD
Jeremy Heiner, CRNA, MSN
John Nagelhout, CRNA, PhD, FAAN
An increasing number of bariatric surgeries are performed every year. A thorough understanding of the pathophysiologic changes, surgical procedure, and anesthesia case management for morbidly obese patients and of the pharmacology of weight-reduction and anesthetic drugs is essential to provide high-quality anesthetic care. In this course, the authors discuss the pathophysiologic changes of obesity, pharmacology of obesity-related drugs and anesthetics, types of gastric bypass procedures, preoperative evaluation, intraoperative anesthetic management, and postoperative management.
Print version: 2011;79(2):147-160.
Keywords: Bariatric surgery, gastric banding, gastric bypass, metabolic syndrome, obesity.