June 1994 AANA Journal

Table of Contents


Spinal narcotics: What should be the standard for monitoring?; Congestive heart failure associated with endoscopic cholecystectomy.
Print version: 1994;62(3):198,204.

Guest Editorial
By Chuck Biddle, CRNA, PhD
The mark of an educated anesthetist
Print version: 1994;62(3):205-206.
Keywords: Critical thinking, education, professionalism.

Legal Briefs
By Gene A. Blumenreich, JD
Harris v Miller
Print version: 1994;62(3):207-211.
Keywords: Independent contractor, negligence, vicarious liability.

Management Briefs
By Christine S. Zambricki, CRNA, MS
Joint Commission Anesthesia Clinical Indicators: An update
Print version: 1994;62(3):212-213.
Keywords: Clinical indicators, Indicator Measurement System (IMSystem), Joint Commission on Accreditation of Healthcare Organizations.

Practice Issues
By Suzanne T. Brown, CRNA, BSN
Third World anesthesia
Print version: 1994;62(3):214-220.
Keywords: Anesthesia equipment overseas, Third World anesthesia, Third World medicine, volunteer anesthesia.

Washington Scene
By Kathleen A. Michels, RN, JD, FAAN
Analysis of House Ways and Means Health Subcommittee's Healthcare Reform Bill
Print version: 1994;62(3):229-233.
Keywords: Healthcare reform, House Ways and Means Health Subcommittee, President Clinton.

Education News
By Betty J. Horton, CRNA, MA, MSN
Gregg R. Revak
Lorraine M. Jordan, CRNA, MS
The computer database for nurse anesthesia education programs
Print version: 1994;62(3):234-236.
Keywords: Accreditation and education computer database, CRNA shortage, nurse anesthesia education.

Ethical dilemmas and decisions concerning the do-not-resuscitate patient undergoing anesthesia
By Gary D. Clark, CRNA, MS
Karen Lucas, CRNA, BSN
Larry Stephens, CRNA, BSN
The term do not resuscitate (DNR) is confusing to many, including healthcare professionals. In this review article, the topic of DNR orders is addressed as well as some of the moral and ethical dilemmas they pose for the CRNA.
Print version: 1994;62(3):253-256.
Keywords: Anesthesia ethics, do-not-resuscitate (DNR), ethical decisions.

Atropine and ephedrine adsorption to syringe plastic
By Bill Lewis, CRNA, PharmD
Eric Jarvi, PhD
Paul Cady, PhD

The authors of this original research discourage the practice of storing medication in plastic syringes for days. The purpose of this study was to compare daily changes in the concentration of atropine or ephedrine sulphate solutions that had been stored up to 4 days in plastic or glass syringes.
Print version: 1994;62(3):257-260.
Keywords: Adsorption, atropine, ephedrine, plastic, syringe.

The effects of total intravenous anesthesia using propofol, ketamine, and vecuronium on cardiovascular response and wake up time
By CPT Madeline Dunnihoo, CRNA, MS, USA, AN
CPT Annette Wuest, CRNA, MS, USA, AN
CPT Michael Meyer, CRNA, MS, USA, AN
Michael Robinson, CRNA, MS, USA, AN
The purpose of this study was to determine if total intravenous anesthesia using propofol, ketamine, and vecuronium would provide stable hemodynamics in normotensive ASA physical status I and II patients and allow rapid awakening upon completion of surgery.
Print version: 1994;62(3):261-266.
Keywords: General anesthesia, hemodynamics, ketamine, propofol, total intravenous anesthesia.

Spinal anesthesia with meperidine: Will epinephrine prolong its duration?
By Maggie A. Bostrom, CRNA, MA
Anita M. Pakiz, CRNA, MA
Dean L. Melnyk, PhD, MD
Gary Benke, MD
Shep Cohen, MD
Meperidine has local anesthetic properties separate from its opioid receptor agonist effect, and unlike morphine, it is structurally similar to local anesthetics. In this double-blinded investigation, low-dose meperidine was used as the sole intrathecal agent to determine the effect of epinephrine on the duration of sensory blockade in 30 male patients undergoing transurethral resection of the prostate or of bladder tumors.
Print version: 1994;62(3):267-272.
Keywords: Continuous spinal, local anesthetic, meperidine, transurethral resection of the prostate (TURP).

Retropharyngeal dissection: A rare complication of nasotracheal intubation revisited–A case report
By William W. Landess, CRNA, MS, JD
Nasotracheal intubation, a common method of airway control, is generally accomplished without difficulty or untoward sequelae for the patient. This case report describes the management of a patient who exhibited a traumatic retropharyngeal dissection associated with nasotracheal intubation.
Print version: 1994;62(3):273-277.
Keywords: Complications, nasotracheal intubation, retropharyngeal dissection.

Book Reviews
Professional Aspects of Nurse Anesthesia Practice
Reviewed by: Michael Kremer, CRNA, MSN

Pediatric Cardiac Anesthesia
Reviewed by: Richard Gillerman, MD
Print version: 1994;62(3):278-279.

AANA Journal Course: Update for nurse anesthetists–Patient positioning
By Judy Walsh, RN, CNOR
The objectives of patient positioning are to provide maximum exposure of the operative site, allow adequate access to the patient for the safe administration of anesthesia, and ensure optimal functioning of all body systems. This AANA Journal course reviews the physiological effects/potential complications of surgical positions on the patient.
Print version: 1994;62(3):289-298.
Keywords: Complications, nerve injury, positioning.

General and Subscription Information
Print version: 1994;62(3):198.

AANA Annual Meeting Quickview
Print version: 1994;62(3):201.

Index to Advertisers
Print version: 1994;62(3):304.

June 1994 AANA Journal
Volume 62 , Number 3
ISSN 0094-6354
On the Cover: