On The Cover

Student registered nurse anesthetists Luke Hubbard and Aaron Archer in a simulator session at the Goldfarb School of Nursing at Barnes-Jewish College, St. Louis, Missouri. (Photo taken by Matthew O’Shea.)

Articles

  • Evaluation of the Anxiolytic and Antidepressant Effects of Asiatic Acid, a Compound from Gotu Kola or Centella asiatica, in the Male Sprague Dawley Rat Herbal medication use continues to rise and interactions with existing medications propose risks and may have significant effects and consequences on the administration of anesthesia. The purpose of this study was to investigate the anxiolytic and antidepressant effects of asiatic acid and its potential modulation of the γ-aminobutyric acid (GABAA) receptor.
    Keywords: Anxiolysis, asiatic acid, elevated plus maze, forced swim test, Sprague Dawley rat.
    Version: 2015;83(2):91-98. Authors: Tomás Eduardo Ceremuga, CRNA, PhD CPT Debra Valdivieso, BSN, ANC, USA CPT Catherine Kenner, BSN, ANC, USA CPT Amy Lucia, BSN, ANC, USA CPT Keith Lathrop, BSN, ANC, USA CPT Owen Stailey, BSN, ANC, USA CPT Heather Bailey, BSN, ANC, USA Capt Jonathan Criss, BSN, AN, USAF Capt Jessica Linton, BSN, AN, USAF Capt Jordan Fried, BSN, AN, USAF Capt Andrew Taylor, BSN, AN, USAF Gina Padron, BSN, BS Arthur Don Johnson, PhD, RN
  • Core Temperature—The Intraoperative Difference Between Esophageal Versus Nasopharyngeal Temperatures and the Impact of Prewarming, Age, and Weight: A Randomized Clinical Trial Unplanned perioperative hypothermia is a well-known complication to anesthesia. This study compares esophageal and nasopharyngeal temperature measured in the same patient for a period of 210 minutes of anesthesia. Results demonstrate a difference between the 2 measurement techniques and that prewarming, age, and body mass index have an impact on measured temperatures.
    Keywords: Anesthesia, core temperature, esophageal, nasopharyngeal, prewarming.
    Version: 2015;83(2):99-105. Authors: Anne Erdling, CRNA, MSc Anders Johansson, CRNA, PhD
  • Worldwide Experience With Sugammadex Sodium: Implications for the United States Experience gained through worldwide clinical use of sugammadex offers US anesthesia providers the opportunity to better understand this drug and its clinical applications. The seminal and current literature concerning clinical use of sugammadex is reviewed, and considerations for its incorporation into practice are provided.
    Keywords: Blocking agent, in vivo administration, sugammadex.
    Version: 2015;83(2):107-114. Authors: Mark Welliver, CRNA, DNP, ARNP Dennis Cheek, PhD, RN Juergen Osterbrink, PhD, DHL, (h.c.) RGN John McDonough, CRNA, EdD, ARNP
  • Bivalirudin in Off-Pump Coronary Artery Bypass Graft in a Patient With Heparininduced Thrombocytopenia: A Case Report of its Use Heparin-induced thrombocytopenia (HIT) is an antibodymediated reaction in which heparin administration causes a person to enter a pathological and highly prothrombotic state. When patients with known HIT undergo coronary artery bypass and grafting procedures, they must be appropriately anticoagulated. The case describes the successful use of bivalirudin for procedural anticoagulation during an off-pump coronary artery bypass and grafting.
    Keywords: Bivalirudin, CABG, coronary artery bypass and grafting, heparin-induced thrombocytopenia, off-pump artery bypass and grafting.
    Version: 2015;83(2):116-122. Authors: Misty Dawn Audette, CRNA, MSN, ARNP Derrick C. Glymph, CRNA, DNAP
  • Call-Shift Fatigue and Use of Countermeasures and Avoidance Strategies by Certified Registered Nurse Anesthetists: A National Survey Call-shift fatigue is a common problem among Certified Registered Nurse Anesthetists (CRNAs) and is associated with medical errors and negative health consequences. This study surveyed CRNA members of the American Association of Nurse Anesthetists on their frequency of call-shift fatigue, fatigue symptoms, medical errors associated with fatigue, and use of fatigue countermeasures and avoidance strategies.
    Keywords: Anesthesia, call shift, countermeasures, fatigue, nurse anesthetists.
    Version: 2015;83(2):123-131. Authors: CAPT Ramona Domen, CRNA, PhD, NC, USN Cynthia D. Connelly, PhD, RN, FAAN CDR Dennis Spence, CRNA, PhD, NC, USN
  • Self-Efficacy, Stress, and Social Support in Retention of Student Registered Nurse Anesthetists Many studies document the presence of stress and the need for social support in nurse anesthesia students. By addressing these challenges, one can increase students’ self-efficacy, which is related to beliefs in one’s ability to accomplish an objective. This article reviews the literature on this topic and makes recommendations for increasing student self-efficacy.
    Keywords: Retention, self-efficacy, social support, stress, student registered nurse anesthetists.
    Version: 2015;83(2):133-138. Authors: Megan Conner, CRNA, MSN
  • AANA Journal Course: Update for Nurse Anesthetists—Part 1—Anesthesia and the Developing Brain Despite the profound evolution in the safety and efficacy of neonatal and pediatric anesthesia, questions remain concerning the long-term neurotoxic and neurocognitive effects of the drugs used in anesthetic care. A variety of prospective animal models and retrospective human studies exist that inconsistently demonstrate a detrimental effect of early life exposure to anesthetic drugs and subsequent learning performance. Limitations associated with both non-human and human observational studies are critiqued. Research currently underway is briefly described. A framework for discussing the relevant issues with concerned parents is presented.
    Keywords: Apoptosis, neurocognitive effect of anesthetic drugs, neurotoxicity of anesthetic drugs, pediatric anesthesia.
    Version: 2015;83(2):139-147. Authors: John Aker, CRNA, DNAP Robert I. Block, PhD Chuck Biddle, CRNA, PhD