August 2007 AANA Journal

Table of Contents


Education News
Upgrading nurse anesthesia educational requirements (1933-2006) – Part 2: Curriculum, faculty and students
Betty J. Horton, CRNA, PhD
Print version: 2007;75:247-251.
Key words: AANA Doctoral Task Force, education history, nurse anesthesia.

Answers to the AANA Journal Course No. 26
Print version: 2007;75:297-301.



A study comparing chloroprocaine with lidocaine for skin infiltration before intravenous catheter insertion
MAJ Richard Ales, CRNA, MSN, AN, USA
CPT Dorianne May, CRNA, MSN, AN, USA
CPT Lori Whitney, CRNA, MSN, AN, USA
In this original research, the authors conducted a prospective, double-blind, mixed, crossover study to determine the perception of pain associated with intradermal lidocaine and chloroprocaine for insertion of an 18-gauge intravenous catheter. They report that, although the use of lidocaine is the most economical choice, both local anesthetics are relatively inexpensive and are effective in reducing the pain associated with an 18-gauge catheter insertion and should be implemented to reduce the pain.
Print version: 2007;75:255-258.
Key words: Chloroprocaine, lidocaine, local anesthetics, visual analog scale.

Anesthetic management in a pediatric patient with Noonan syndrome, mastocytosis, and von Willebrand disease: A case report
Lynn Fitzgerald Macksey, CRNA, MSN
Beth White, CRNA, MSN
This case report describes anesthetic considerations for a 6-year-old boy, admitted for adenoidectomy under general anesthesia, who had a complicated medical history, including mastocytosis, Noonan syndrome, and von Willebrand disease. Each affected the anesthetic plan and was addressed preoperatively among all surgical and anesthesia providers. Discussion included the clinical and anesthetic management of the case with a review of pertinent literature.
Print version: 2007;75:261-264.
Key words: Anesthetic, Noonan syndrome, mastocytosis, pediatric, von Willebrand disease.

Closed claims studies in anesthesia: A literature review and implications for practice
Meghan G. MacRae, RN, PhD
Historically, closed malpractice claims have been used to identify and examine potential causes for adverse anesthesia outcomes. In the United States, the American Association of Nurse Anesthetists and the American Society of Anesthesiologists have compiled and analyzed such data. The author concludes that although some researchers have cited closed claims studies as evidence of anesthesia risk trends, the nature of the data makes it inappropriate for calculation or comparison of risk. Further work is needed to elucidate some mechanisms of injury and to develop interventions to maximize patient safety.
Print version: 2007;75:267-275.
Key words: Adverse outcomes, anesthesia risk, closed claims, malpractice.

Anesthetic implications for surgical correction of scoliosis
Melissa A. Gambrall, CRNA, MSN, ARNP
This literature review focuses on key considerations for anesthetists, including common comorbidities in patients with scoliosis, the need for induced hypotension, large surgical blood loss, the need for transfusion of blood and blood products, possible autologous blood donation and acute normovolemic hemodilution, patient positioning, possible intraoperative wake-up testing to assess motor function, spinal cord monitoring, and hypothermia.
Print version: 2007;75:277-285.
Key words: Anesthesia, scoliosis, spinal fusion.



AANA Journal Course Part 3
Update for nurse anesthetists --
Cyclodextrin introduction to anesthesia practice: Form, function, and application
Mark Welliver, CRNA, MS, ARNP
Cyclodextrins are some of the select molecules exhibiting properties that are beneficial across multiple industries. The author states that cyclodextrins, though known and studied for more than 100 years, have only recently been explored for specific application to anesthesia. In this AANA Journal course, the author includes discussion on pharmacologic benefits, form, function, clinical application, and clinical considerations.
Print version: 2007;75:289-296.
Key words: Anesthesia, cyclodextrins, encapsulation, host-guest assembly/inclusion complex, modified cyclodextrins/derivatives.

August 2007 AANA Journal
Volume 75 , Number 4
ISSN 0094-6354
On the Cover:
Denver, the "Mile High City," will be home to nurse anesthetists, nurse anesthesia students, exhibitors, and guests attending the 74th Annual Meeting of the American Association of Nurse Anesthetists, August 4-8, 2007. Throughout the meeting, participants will have opportunities to benefit from quality educational programs, the exhibit hall, and social activities, as well as all the things Denver has to offer, such as abundant outdoor recreation, a wide selection of restaurants, and endless shopping possibilities. (Photo courtesy of Denver Metro Convention & Visitors Bureau.)