On The Cover

From the archives: Lucy E. Richards, AANA President 1946-1948, gives anesthesia to a patient in 1956. This photograph appeared on the cover of a 1956 brochure titled “Nurse Anesthetist…Career,” which debuted at the Annual Meeting in Chicago celebrating the AANA’s 25th anniversary.

Articles

  • The Concept of Reentry in the Addicted Anesthesia Provider Substance abuse among healthcare providers is a serious issue affecting patient care and patient outcomes. Successful reentry is sometimes rare, and providers are plagued with the stigma of abuse, shame, and a high incidence of relapse. Tenets of successful reentry are discussed.
    Keywords: Addiction, concept analysis, reentry, substance abuse in anesthesia.
    Version: 2014;82(2):95-100. Authors: Jorge A. Valdes, CRNA, DNP
  • An Update: Use of Laryngeal Mask Airway Devices in Patients in the Prone Position Some providers advocate using laryngeal mask airways (LMAs) for procedures performed in the prone position to meet the demands of quicker operating room turnover time requirements and staffing reductions. An update to a 2010 systemic review examining the use of LMAs in patients in the prone position is provided.
    Keywords: Adult, laryngeal mask airway, LMA, prone.
    Version: 2014;82(2):101-107. Authors: William Whitacre, CRNA, DNAP, Loraine Dieckmann, PhD, Paul N. Austin, CRNA, PhD
  • Anesthetic Management of Costello Syndrome: A Case Report A scarcity of literature for the anesthetic management of Costello syndrome exists. Utilizing an overview of the pertinent literature, clinical practice recommendations are suggested for the anesthetic implications of managing a pediatric patient with this rare syndrome.
    Keywords: Anesthesia, Costello syndrome, faciocutaneoskeletal syndrome, rare genetic disorder.
    Version: 2014;82(2):108-113. Authors: Christol Williams, CRNA, DNAP
  • Ventilation With Increased Apparatus Dead Space vs Positive End-Expiratory Pressure: Effects on Gas Exchange and Circulation During Anesthesia in a Randomized Clinical Study Atelectasis formation can be reduced by positive end expiratory pressure (PEEP), but resulting increases in intrathoracic pressure could affect circulation. Thirty patients, with ASA physical status 1 or 2, scheduled for elective open colon surgery were randomly assigned to be ventilated with either PEEP at 10 cm H2O or increased tidal volumes achieved with larger apparatus dead space but with zero end-expiratory pressure.
    Keywords: Cardiac output, pulmonary gas exchange, sevoflurane.
    Version: 2014;82(2):114-120. Authors: Bruno Enekvist, CRNA, PhD, Mikael Bodelsson, MD, Michelle Chew, MD, Anders Johansson, CRNA
  • Comparison of 3 Ultrasound-Guided Brachial Plexus Block Approaches for Cubital Tunnel Release Surgery in 120 Ambulatory Patients The authors wanted to determine whether 1 of 3 brachial plexus blocks was best for one of their most common surgeries, the cubital tunnel release with or without transposition of the ulnar nerve. This article suggests that increasing the volume of the intercostobrachial nerve block may improve success.
    Keywords: Brachial plexus block, cubital tunnel release, ultrasound.
    Version: 2014;82(2):121-126. Authors: John Roussel, CRNA, MS, Sunil Thirkannad, MD
  • Utility of Thromboelastography During Neuraxial Blockade in the Parturient With Thrombocytopenia No consensus exists on when it is safe to administer neuraxial blockade in a patient with a low platelet count. This study analyzes the incidence of neurologic complications, if any, related to regional anesthesia in parturients with a platelet count less than 100,000 mm-3 and especially those with less than 80,000 mm-3 and normal thromboelastography values.
    Keywords: Complications, platelet count, regional anesthesia, thromboelastography.
    Version: 2014;82(2):127-130. Authors: Jeffrey Huang, MD Nicholas McKenna, BA Noah Babins, MD
  • Evaluation of Postprocedure Cognitive Function Using 3 Distinct Standard Sedation Regimens for Endoscopic Procedures This investigation evaluates postprocedure cognitive function associated with 3 distinct standard sedation regimens used for endoscopic procedures. A secondary aim was to identify complications requiring provider interventions.
    Keywords: Colonoscopy, patient outcomes, physician outcomes, postoperative cognitive dysfunction, provider interventions.
    Version: 2014;82(2):133-139. Authors: Tobie J. Watkins, CRNA, MSN, Raymond L. Bonds, CRNA, MSN, DNP, Kedrin Hodges, CRNA, MSN, Brooks B. Goettle, CRNA, MHS, D. Anne Marie Dobson, MD, John P. Maye, CRNA, PhD
  • Cytoreductive Surgery With Hyperthermic Intraperitoneal Chemotherapy: A Case Report Cytoreductive surgery with hyperthermic intraperitoneal chemotherapy (HIPEC) is a complex procedure used for the treatment of various types of cancer. A knowledge of what to anticipate anesthetically guides the practitioner to achieve successful management. In this case report, a 71-year-old was treated for stage III peritoneal and ovarian cancer by cytoreductive surgery with HIPEC.
    Keywords: Cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, ovarian cancer, peritoneal cancer.
    Version: 2014;82(2):140-143. Authors: LCDR Shannan Rotruck, RN, BSN, USN, MAJ John T. Wilson, CRNA, PhD, USA, CDR Jason McGuire, CRNA, PhD, USN
  • AANA Journal Course: Update for Nurse Anesthetists – Part 1 – Anesthesia Case Management for Endovascular Aortic Aneurysm Repair With the advent of endovascular aortic repair, patients who were not considered surgical candidates for abdominal aortic aneurysmectomy because of their tenuous physical status can undergo corrective treatment. A thorough understanding of the surgical procedure, perioperative process, and anesthetic considerations is vital.
    Keywords: Endoleak, endovascular aortic repair, endovascular stent graft, EVAR.
    Version: 2014;82(2):145-152. Authors: Sass Elisha, CRNA, EdD, John Nagelhout, CRNA, PhD, FAAN, Jeremy Heiner, CRNA, EdD, Mark Gabot, CRNA, MSN,