October 2002 AANA Journal

Table of Contents


Columns

Letters
Print version
: 2002;70:343-344.

Continuous spinal anesthesia for cesarean section for a morbidly obese patient
Evan Koch, CRNA, MSN

Response
Lanny L. Coker, CRNA, MSN

Prevention of postoperative nausea and vomiting
Carol L. Norred, CRNA, MHS

Legal Briefs
Fairness in credentialing and the Certified Registered Nurse Anesthetist
Gene A. Blumenreich, JD
Print version: 2002;70:347-350.
Key words: Contracts, credentials, due process, privileges.

Education News
A proposal for an international accreditation process
Betty J. Horton, CRNA, DNSc
Kathleen P. Kinslow, CRNA, EdD
Print version: 2002;70:353-356.
Key words: International accreditation, nurse anesthesia, World Congress.

Features

The perceived influence of financial risk factors on the viability of nurse anesthesia educational programs
Sonja J. Myers, CRNA, MS
Denise Martin-Sheridan, CRNA, PhD
Curtailing of expenditures and reestablishing profit can include managed care, mergers, changing profit status, and aggressive competition. The purpose of this study was to evaluate whether directors of nurse anesthesia programs (NAPs) perceived these items as being detrimental to their NAPs.
Print version: 2002;70:359-366.
Key words: Healthcare delivery reform, hospital mergers, managed care, nurse anesthesia education, program closure.

A comparison of rocuronium and lidocaine for the prevention of postoperative myalgia after succinylcholine administration
LT Dennis Spence, CRNA, MS, NC, USN
LCDR Ramona Domen-Herbert, CRNA, MS, NC, USN
LCDR Elizabeth Boulette, CRNA, MS, NC, USN
CDR R. Lee Olson, CRNA, MS, NC, USN
CDR Charles Vacchiano, CRNA, PhD, NC, USN
LCDR John Maye, CRNA, PhD, NC, USN
The incidence of postoperative myalgia (POM) after succinylcholine administration has been reported to range from 5% to 83%. The purpose of this investigation was to compare the severity of POM in subjects receiving pretreatment with rocuronium and lidocaine.
Print version: 2002;70:367-372.
Key words: Fasciculations, lidocaine, postoperative myalgia, rocuronium, succinylcholine.

Chronic gastroesophageal reflux disease and its effect on laryngeal visualization and intubation: A case report
Lorraine Stevens, CRNA, EdD
This case report discusses a condition that is common but often overlooked in many instances during the evaluation process. The author states that the incidence of gastroesophageal reflux disease is increasing in the general population, and it is of utmost importance that it be considered during any airway assessment.
Print version: 2002;70:373-375.
Key words: Airway edema, difficult airway, gastroesophageal reflux, subglottic stenosis.

Costs and risks of weekend anesthesia staffing at 6 independently managed surgical suites
Franklin Dexter, MD, PhD
Richard H. Epstein, MD
H. Michael Marsh, MBBS

In this study, the authors used their previously developed statistical method to review nurse anesthetist weekend staffing at 6 surgical suites that were part of a healthcare system with a cost-conscious management team. The statistical method determines the optimal combination of shifts specified as being appropriate for providing operating room care.
Print version: 2002;70:377-381.
Key words: Economics, organization and administration; operating room information systems; operating rooms; operations research; personnel staffing and scheduling.

The process of evaluating and regulating a new drug: Phases of a drug study
Christine C. Cowan, CRNA, MSN
In this article, the author reviews the process every new drug must go through before it can be marketed in the United States, from the chemist's bench to the pharmacist's shelf, and the primary institution and laws that govern this process.
Print version: 2002;70:385-390.
Key words: Clinical human trials, investigational new drug, phases of a drug study, preclinical trials.

A study of clinical decision making Certified Registered Nurse Anesthetists
Michael J. Kremer, CRNA, DNSc
Margaret Faut-Callahan, CRNA, DNSc, FAAN
Frank D. Hicks, RN, PhD

In this study, the cognitive psychology framework of information-processing theory and literature pertaining to the use of heuristics, or rules of thumb, and clinical biases, were used to analyze cases from the AANA Foundation closed malpractice claims database.
Print version: 2002;70:391-397.
Key words: Closed claims, clinical decisions.


AANA Journal Course, Part 4
Update for nurse anesthetists --
Functional residual capacity: The human windbag

Penelope S. Villars, CRNA, RRT, MSN
Joseph T. Kanusky, CRNA, MS
Michael G. Levitzky, PhD

In this Journal course, the authors review the basic anatomy and physiology of functional residual capacity (FRC) during the perioperative period. The course include determinants of FRC structure and function of surface forces, role of pulmonary surfactant, structure and function of chest wall components, and anesthesia and the FRC.
Print version: 2002;70:399-407.
Key words: Alveolar architecture, anesthesia, atelectasis, functional residual capacity.
(Editor's Note: Figure 3 was published in Foundations of Anesthesia: Basic and Clinical Sciences, Papadakos P, Chapter 49, Artificial ventilation, pp. 507-514, Hemmings HC and Hopkins PM, eds, 2000, by permission of the publisher Mosby. Copyright Elsevier, 2002. Reprinted with permission.)

October 2002 AANA Journal
Volume 70 , Number 5
ISSN 0094-6354
On the Cover:
John Aker , CRNA, MS, verbally comforts a Philippino child during a halothane anesthetic induction in preparation for the correction of the child's cleft lip. Aker was an anesthesia team member with Operation Smile at the J.P. Rizal Hospital in Cavite, Philippines, in March of 1999 and 2000. Each year, hundreds of nurse anesthetists donate their time, expertise, and often pay their own expenses in order to join various surgical missions throughout the world.