December 2010 AANA Journal

Table of Contents



Imagining in Time 
The Hunt for 1LT Kenneth R. Shoemaker Jr, CRNA
Cathryn Hodson, BA
Print version: 2010;78(6):439-443.
Keywords: Nurse anesthesia history, Kenneth R. Shoemaker, US Army, Vietnam.
Crew Resource Management or Crisis Resource Management: Which Term is Correct?
Terri S. Jones, CRNA, DNP
Print version: 2010;78(6):444.

Index to Volume 78 of the AANA Journal
Print version: 2010;78(6):503-514.


Use of Dexmedetomidine and Ketamine Infusions During Scoliosis Repair Surgery With Somatosensory and Motor-Evoked Potential Monitoring: A Case Report
Rozanna Penney, CRNA, MSNA, CEN
In this case report, dexmedetomidine and ketamine infusions were the main anesthetic for a 15-year-old girl, who underwent scoliosis repair surgery with intraoperative wake-up test, somatosensory evoked potential (SSEP), and motor-evoked potential (MEP) monitoring. This case report discusses the use of dexmedetomidine and ketamine infusions as an alternative to propofol-based total intravenous anesthesia during scoliosis repair surgery with intraoperative SSEP and MEP monitoring.
Print version: 2010;78(6):446-450.
Keywords: Dexmedetomidine, ketamine, motor-evoked potential, scoliosis repair surgery, somatosensory evoked potential.
The Effect of Ellagic Acid on Platelet Activation as Measured by the Quantification of P-Selectin Using Flow Cytometry
CPT Peter Attilio, CRNA, MS, ANC, USA
CPT Corey Merritt, CRNA, MS, ANC, USA
CPT Janet Sims, CRNA, MS, ANC, USA
CPT Nancy Kane, CRNA, MS, ANC, USA
LTC Joseph O’Sullivan, CRNA, PhD, ANC, USA
Ellagic acid is a major compound found in certain fruits and nuts. It has been attributed as having anti-inflammatory, free radical scavenging, and coagulation properties, as
well as effects on tumor genesis in multiple forms of cancer. The purpose of this study was to investigate the effects of ellagic acid on platelet expression via the cyclooxygenase (COX) pathway by examining its effects on platelet activation and comparing them with known COX inhibitors in male Sprague-Dawley rats.
Print version: 2010;78(6):453-459.
Keywords: COX inhibitors, ellagic acid, flow cytometry, platelets, Sprague-Dawley rats.
Bilateral Tension Pneumothoraces and Subcutaneous Emphysema Following Colonoscopic Polypectomy: A Case Report and Discussion of Anesthesia Considerations
John C. Kipple, CRNA, MS, CCRN
This case examines the consequences of colonic perforation and the anesthetic management for the definitive surgical treatment of a posterior sigmoid wall perforation. Anesthesia providers’ awareness of the risk factors for colonic perforation due to colonoscopy, early signs and symptoms of perforation, and knowledge of the surgical and anesthetic management of perforation could lead to early recognition and intervention and likely to improved patient outcomes.
Print version: 2010;78(6):462-467.
Keywords: Colonic perforation, pneumomediastinum, pneumoretroperitoneum, polypectomy, tension pneumothorax.
Use of Propofol and Emergence Agitation in Children: A Literature Review
K. Logan Key, CRNA, MSN
Christopher Rich, RN, MSN, MHS
Claire DeCristofaro, MD
Shawn Collins, CRNA, DNP
Emergence agitation (EA) is an important issue in pediatric anesthesia and has increased in occurrence with the use of sevoflurane inhalational anesthesia. This literature review compared 3 general anesthesia techniques in children—sevoflurane inhalational general anesthetic, propofol as an adjunct to sevoflurane inhalational general anesthetic, and propofol total intravenous anesthesia—and their associated incidence of EA. The authors conclude, based on the current evidence, that the use of propofol is associated with a reduction in the incidence of EA.
Print version: 2010;78(6):468-473.
Keywords: Pediatric emergence agitation, pediatric emergence delirium, propofol.
Exploring Student Nurse Anesthetist Stressors and Coping Using Grounded Theory Methodology
Joy Kieffer Phillips, RN, PhD, MSN
The purpose of this qualitative study was to examine the challenges that recent graduates of nurse anesthesia programs coped with during their anesthesia curriculum. The initial research questions for this study were: From the graduates’ perspective, what were the stressors that they encountered during their nurse anesthesia program? And how did they successfully negotiate those stressors in order to graduate from their program? The author states this phenomenon was studied using grounded theory methodology.
Print version: 2010;78(6):474-482.
Keywords: Graduate student stress, grounded theory, nurse anesthesia and stress, stress and coping, student nurse anesthetist.

AANA Journal Course: Update for Nurse Anesthetists – Part 5 – Ventricular Assist Devices and Anesthetic Implications for Noncardiac Procedures
Kristin A. Khoo, RN, BSN
Approximately 5 million Americans experience heart failure, which affects 10 in every 1,000 people older than 65 years. Ventricular assist devices (VADs) are a type of mechanical circulatory support that aids in systemic perfusion by maintaining unidirectional flow while reducing the oxygen demand of the failing ventricle. This course includes history and review of the literature, the function of VADs, the types of VADs, indications for use, anesthesia considerations, and preoperative and postoperative care.
Print version: 2010;78(6):483-488.
Keywords: Anticoagulation, congestive heart failure, hemodynamics, ventricular assist device.
December 2010 AANA Journal
Volume 78 , Number 6
ISSN 0094-6354
On the Cover:
A 10-year-old boy is ventilated via rigid bronchoscopy by Shaun Mendel, CRNA, while an emergency tracheostomy is performed. “The boy attempted to ingest a large foreign body. Two days later, he was in respiratory distress,” explained Mendel, a staff nurse anesthetist at Le Bonheur Children’s Hospital, Memphis, Tennessee. “In the operating room, we found a large plastic foreign body embedded into and almost totally occluding his airway and esophageal inlet. The boy suffered no long-term sequelae from this event.” (Photo was taken by Terry Yancey, RN.)