February 2010 AANA Journal

Table of Contents


Books, Etc.
McGraw-Hill’s I.V. Drug Handbook
Reviewer: Vicki C. Coopmans, CRNA, PhD
Print version: 2010;78(1):9.
Education News
A Model for Utilization of Academic Resources: The Philadelphia Area Nurse Anesthesia Educational Programs’ Shared Curriculum Consortium
Michael Kost, CRNA, DNP, MSN, MS
Bette Wildgust, CRNA, MS, MSN
Joan Woods, CRNA, MS
Print version: 2010;78(1):14-17.
Keywords: Collaborative efforts, consortium, nurse anesthesia education, shared teaching model.
Council on Accreditation of Nurse Anesthesia Educational Programs to be Reviewed During Fiscal Year 2011
Print version: 2010;78(1):42.

A Modified Approach to Intubation and Single-lung Ventilation for Lobectomy in a 2-Year-Old Child: A Case Report
Dino F. Kattato, CRNA, MS
It is important to recognize that with each individual pediatric patient there are specific and unique considerations that must be made when choosing a method for single-lung ventilation. In the case reported, the original planned method to obtain single-lung ventilation was not possible. This emphasizes the need to always have a backup plan, so that if the original plan fails, achieving success will not be time-consuming or detrimental to the patient.
Print version: 2010;78(1):24-27.
Keywords: Parapneumonic empyema, pediatric single-lung ventilation, video-assisted thoracic surgery.
Nonopioid Anesthesia for Awake Craniotomy: A Case Report
Diane L Wolff, CRNA, MS
Robert Naruse, MD
Michele Gold, CRNA, PhD
This case report discusses the clinical and anesthetic management for awake craniotomy and reviews the literature. Awake craniotomy is becoming more popular as a neurosurgical technique that allows for increased tumor resection and decreased postoperative neurologic morbidity. The procedure requires appropriate patient selection, knowledge of the surgeon’s skill, and a thorough anesthesia plan.
Print version: 2010;78(1):29-32.
Keywords: Anesthesia, awake craniotomy, opioid, propofol.
Management of Trauma-Induced Coagulopathy: Trends and Practices 
Matthew R. D’Angelo, CRNA, DNP
Richard P. Dutton, MD, MBA
Traumatic injury is a challenging and growing phenomenon. The authors of this review article report that one-fourth of all trauma admissions present in varying degrees of coagulopathy. This article discusses the pathology of trauma-induced coagulopathy and current trends in management, and it closely examines the data surrounding the use of recombinant factor VII for the treatment of trauma-induced coagulopathy.
Print version: 2010;78(1):35-40.
Keywords: Coagulopathy, trauma.
Massive Hemoptysis During Monitored Anesthesia Care for Esophagogastro-duodenoscopy with Percutaneous Endoscopic Gastrostomy Tube Placement: A Case Report
Melissa Wiehe, RN, BSN, CCRN
This case illustrates the effects of hemoptysis during anesthesia on a patient with an already compromised pulmonary status. Although rare, hemoptysis is a frightening and potentially life-threatening complication of cystic fibrosis that may sometimes occur during anesthesia. The author cautions that anesthesia providers should be aware of this complication and know how to promptly and effectively manage it if encountered.
Print version: 2010;78(1):43-46.
Keywords: Cystic fibrosis, hemoptysis, monitored anesthesia care.
Anesthetic Implications for the Patient With Osteogenesis Imperfecta
Ingrid Oakley, CRNA, DVM
Lauren Pilleteri Reece, CRNA, MNA
In this review article, the authors state that osteogenesis imperfecta is an inherited disorder of the connective tissue stemming from gross abnormalities in collagen formation and structure. Current literature exposes many potential anesthetic complications associated with osteogenesis imperfecta. The authors conclude that proper preparation and preoperative assessment is important, as is the choice of anesthetic technique.
Print version: 2010;78(1):47-53.
Keywords: Anesthesia, collagen, osteogenesis imperfecta.
Biphasic Dosing Regimen of Meclizine for Prevention of Postoperative Nausea and Vomiting in a High-Risk Population 
LT Eric J. Bopp, CRNA, MS, NC, USN
LT Jose L. Estrada, CRNA, MS, NC, USN
LT Jeremy M. Kilday, CRNA, MS, NC, USN
LT James C. Spradling, CRNA, MS, NC, USN
CDR Carole Daniel, CRNA, MS, NC, USN
Joseph E. Pellegrini, CRNA, PhD, CAPT(ret), NC, USN
Based on the findings of this study, the authors recommend that anesthesia practitioners should consider administration of 50 mg meclizine the night before and on the day of surgery using general anesthesia to patients who have been identified as high risk for PONV, to decrease the incidence and severity of PONV, and to increase overall patient satisfaction with their anesthesia experience.
Print version: 2010;78(1):55-62.
Keywords:Antiemetics, meclizine, ondansetron, postoperative nausea and vomiting.
Emergency Repair of Aortic Dissection in a 37-week Parturient: A Case Report
Sarah Ham, CRNA, MS
Aortic dissection is a life-threatening condition with a 50% mortality rate in the first 48 hours and a 3-month mortality rate of 90% in untreated patients. It is a rare complication of pregnancy, but there is significant morbidity and mortality for the mother and infant. The purpose of this article is to highlight successful management of aortic dissection in a parturient and to broaden the body of literature on the topic.
Print version: 2010;78(1):63-68.
Keywords: Aortic, anesthesia, dissection, pregnancy,thoracic.

AANA Journal Course: Update for Nurse Anesthetists—Part 6—Lipid Infusion as a Treatment for Local Anesthetic Toxicity: A Literature Review
Mihaela V. Manavi, CRNA, MSNA, BSN, CCRN
Current evidence suggests that infusion of lipid emulsion should be considered among the primary treatments for local anesthetic toxicity and be made readily available in every facility’s operating or procedure room, and hospital staff should be trained in its use when local anesthetic toxicity is suspected. In this course, the author discusses history and review of the literature, discovery of lipid rescue, lipid sink theory, trials in dogs, case studies, complications of lipid therapy, and lipid therapy compared with vasopressin and epinephrine.
Print version: 2010;78(1):69-78.
Keywords: Intralipid, lipid emulsion, lipid infusion, lipid sink, local anesthetic toxicity. 
February 2010 AANA Journal
Volume 78 , Number 1
ISSN 0094-6354
On the Cover:
Randall W. Klotz, CRNA, MEd, MSN, is shown placing an interscalene block on a patient scheduled for shoulder arthroscopy for rotator cuff repair and acromioclavicular joint resection at Far Hills Surgical Center. Klotz practices with Anesthesiology Services Network, Ltd., at Far Hills Surgical Center and Miami Valley Hospital, Dayton, Ohio. (Photo taken by Cheryl Wilkey, RN.)