August 1999 AANA Journal

Table of Contents


Maintaining Intraoperative Normothermia:
Meta-analysis of Outcomes With Costs

Michael Fiedler, CRNA, MS
Christine Brown Mahoney RN, PhD, MS
Print version: 1999;67(4)307-308.

Voice and Touch: Florence Henderson on the Skills of an Ether Specialist
Nancy A. Harris, CRNA, MNA
Print version: 1999;67(4)307-308.

Legal Briefs
Litigation is too Important to be Entrusted to Lawyers
Gene A. Blumenreich, JD
Print version: 1999;67(4)311-314.
Keywords: Consent to settle, malpractice insurance.

Washington Scene
Understanding and Communicating with US Congress
David Hebert, JD
Dena Zenti, BA
Print version: 1999;67(4)319-321.
Keywords: Grassroots, legislators, lobbying, politics, US Congress.

Research in Action
Abstracts Presented at the 1999 AANA Annual Meeeting in Boston, Massachusetts
Print version: 1999;67(4)369-377.

Answers to the AANA Journal Course No. 18 Examination
Print version: 1999;67(4)379-384.


Heart Block After Induction of Anesthesia in a Child
Thomas E. Schultz, CRNA, MS
Bradycardia is a well-known adverse effect of halothane anesthesia in children. This case report describes a case of complete heart block after induction of halothane anesthesia in a previously healthy child. Because the patieint in this case was free of cardiac disease, hypoxemia, and surgical stimulation, halothane is implicated as the cause of the comlplete heart block.
Print version: 1999;67(4)326-328.
Keywords: Bradycardia, halothane, heart block, pediatric.

Evaluation of Lidocaine and Tetracaine Mixture in Axillary Brachial Plexus Block
LCDR Jeanette S. Berry, CRNA, MS, NC, USN
CDR Louis Heindel, CRNA, ND, NC, USN

The mixture of lidocaine and tetracaine, so-called supercaine, has been used extensively for axillary brachial plexus blockade for several decades before falling into relative disuse since the advent of bupivacaine. This study describes the anesthetic characteristics of supercaine, evaluating the duration of sensory block, motor block, and overall patient satisfaction.
Print version: 1999;67(4)329-334.
Keywords: Brachial plexus block (axillary), lidocaine, local anesthetic pharmacology, local anesthetic toxic effects, tetracaine.

Effects of Intrathecal Fentanyl on Duration of Bupivacaine Spinal Blockade for Outpatient Knee Arthroscopy
LT John R. Roussel, CRNA, MS, NC, USN
CDR Louis Heindel, CRNA, ND, NC, USN
The purpose of this study was to determine if intrathecal fentanyl speeds the onset and prolongs the duration of sensory and motor block, prolongs the duration of postoperative analgesia, or increases the incidence of adverse effects in patients undergoing spinal anesthesia for outpatient knee arthroscopy. Results indicate that fentanyl does not enhance the onset and duration of sensory or motor block produced by 12 mg of intrathecal bupivacaine. Fentanyl, however, prolongs postoperative analgesia and increases the risk of pruritus.
Print version: 1999;67(4)337-343.
Keywords: Analgesics, bupivicaine, intrathecal fentanyl, local anesthestics.

The Pathophysiology of Pain
LTC Normalynn Garrett, CRNA, MHS, AN, USA
MAJ Franklin McShane, CRNA, MSN, AN, USA
Beginning with a brief survey of several theories of the origin of pain, this article describes the anatomical and physiological basis of pain, focusing on the phenomenon of central sensitizaton and the role of ionotropic glutamate receptors. An exploration of several recent pharmacological studies targeting N-methyl-D-aspartate receptors concludes the review.
Print version: 1999;67(4)349-357.
Keywords: Acupuncture, glutamate receptors, pain. 

AANA Journal Course: Update for Nurse Anesthetists – Part 3 – Anesthetic Considerations for Minimally Invasive Direct Vision Coronary Artery Bypass Grafting
Noel Creager, CRNA, MS
Stella Kraska, CRNA, MS
Vicki L. Struebing, CRNA, MSN

Compared with customary coronary artery bypass graft surgery, the minimally invasive direct vision coronary artery bypass (MIDCAB) procedure has a smaller modified incision, requires less operative time, eliminates the risk of cardiopulmonary bypass, and is, as the name implies, far less invasive. This review addresses the differences between MIDCAB and conventional customary coronary artery bypass graft surgery and discusses the challenges of anesthetic management.
Print version: 1999;67(4)361-367.
Keywords: Coronary artery bypass grafting, coronary revascularization, minimally invasive cardiac surgery, minimally invasive direct vision coronary artery bypass, off-pump bypass.

August 1999 AANA Journal
Volume 67 , Number 4
ISSN 0094-6354
On the Cover: