October 2004 AANA Journal

Table of Contents

Print version
: 2004;72:334-336.
Expert testimony
Charles A. Griffis, CRNA, MS
Rave drugs: Pharmacological considerations
By Carl S. Hornfeldt, PhD, RPh
Mary Klein, RN, BSN
Frances Kramer, CRNA, ND, MSN
Rural anesthesia: A pilot study
Jack Norris, CRNA, MS
Elizabelth Monti Seibert, CRNA, MSN
Judith W. Alexander, RN, PhD
Alfred E. Lupien, CRNA, PhD
Education News
Economics and the education of nurse anesthetists, Part 1
Cormac T. O'Sullivan, CRNA, MSN
Edward S. Thompson, CRNA, PhD
Print version: 2004;72:329-332.
Key words: Costs of nurse anesthesia education, economics, economic principles in anesthesia, rate of return for CRNA education.
Diagnosis and treatment of negative pressure pulmonary edema in a pediatric patient: A case report
Susan Davidson, RN, EdD
Cherry Guinn, RN, EdD
Daniel Gacharna, CRNA, MSN

In this case report, the authors describe a pediatric patient who presented for elective correction of a speech impediment via a frenuloplasty. The events surrounding the development and diagnosis of negative pressure pulmonary edema and the treatment modalities are discussed.
Print version: 2004;72:337-338.
Key words: Extubate, negative pressure pulmonary edema, ventilation.
Analgesia and effectiveness of levobupivacaine compared with ropivacaine in patients undergoing an axillary brachial plexus block
LT Erik Cline, CRNA, MSN, NC, USN
LCDR Robert D. Polley, CRNA, MSN, NC, USN
LCDR John Maye, CRNA, PhD, NC, USN
LCDR Joseph Burkard, CRNA, DNSc, NC, USN
CDR Joseph Pellegrini, CRNA, DNSc, NC, USN

The authors of this research article conclude that when contemplating the use of levobupivacaine and ropivacaine for brachial plexus anesthesia, levobupivacaine should be considered when postoperative analgesia is a concern but not when an early return of motor activity is required.
Print version: 2004;72:339-345.
Key words: Analgesia, brachial plexus block, levobupivacaine, ropivacaine, transarterial axillary block.
The use of the laryngeal mask airway with mechanical positive pressure ventilation
Carrie Chmielewski, CRNA, MSN
Suzanne Snyder-Clickett, CRNA, MSN

The benefits, safety, and efficacy of the laryngeal mask airway (LMA) are discussed in this review article. In addition, the authors identify the risks and misconceptions associated with LMAs when used with positive pressure ventilation and they point out that the LMA is a safe, effective means of delivering ventilation under anesthesia.
Print version: 2004;72:347-351.
Key words: Laryngeal mask airway, positive pressure ventilation, safe use of laryngeal mask airways.
Continuous subcutaneous insulin infusion during general anesthesia: A case report
William A. White, Jr, CRNA, MS
Helen Vontalvo, CRNA, BA
Joshua M. Monday, CRNA, MS  

With the advent of continuous subcutaneous insulin infusion (CSII) pumps, the anesthesia practitioner has another tool to assist in providing high quality care to the patient with diabetes. In this case report, the patient wore a CSII during general anesthesia for surgical repair of a herniated lumbar disk.
Print version: 2004;72:353-357.
Key words: Continuous subcutaneous insulin infusion, diabetes mellitus, general anesthesia, insulin lispro.
The risks of blood transfusions and the shortage of supply leads to the quest for blood substitutes
Nicole-Soraya Nouwairi, RN, BSN
The purpose of this article is to help the reader understand the necessity of blood substitutes and to briefly describe blood substitutes that are in clinical trials. The author states that more research is needed to develop alternatives to allogeneic blood transfusions that are free of complications.
Print version: 2004;72:359-364.
Key words: Blood substitutions, Hemolink, Oxygent, perfluorocarbon.

AANA Journal Course, Part 4
Update for nurse anesthetists -- 
Preoperative cardiac evaluation
Bob Halliburton, CRNA, DNSc
Donald Bell, CRNA, DNSc
John Preston, CRNA, DNSc

As the percentage of Americans older than 65 years continues to grow, so does the prevalence of cardiac disease in this population. This AANA Journal course discusses the American College of Cardiology (ACC) and American Heart Association (AHA) guideline on perioperative cardiovascular evaluation for noncardiac surgery. The intent of the ACC/AHA guideline is to assist clinicians in clinical decision making by describing a range of generally acceptable approaches for the diagnosis, management, and prevention of cardiac diseases.
Print version: 2004;72:365-371.
Key words: Cardiac, noncardiac surgery, risk.
October 2004 AANA Journal
Volume 72 , Number 5
ISSN 0094-6354
On the Cover:
An infant receives a preoperative evaluation, which is mandatory prior to the administration of anesthesia. In general practice, most nurse anesthetists administer anesthesia to all age groups; however, 1.6% of nurse anesthetists report that they specialize in pediatric anesthesia (source: 2003 AANA Practice Survey)