On The Cover

At Robert Wood Johnson University Hospital in New Brunswick, NJ, Tracy Castleman, CRNA, MS,hangs blood as part of an effort to resuscitate a patient who suffered life-threatening gunshot wounds. Nurse anesthetists working alone or as a member of an anesthesia on-call team provide emergency care in level-one trauma centers across the United States every day.

Articles

  • Effects of preincisional ketamine treatment on natural killer cell activity and postoperative pain management after oral maxillofacial surgery Poorly controlled pain may lead to increased risk of cancer metastasis by supressing natural killer (NK) cell activity. Ketamine may be beneficial by potentiating opiad-induced analgesia. The purpose of this study was to explore the effects of precisional ketamine on postoperative pain perception and attenuating surgery-induced suppression of NK cell activity.
    Keywords: Ketamine, natural killer cell, postoperative pain.
    Version: 2005;73:427-436. Authors: CPT Michael W. Bently, CRNA, MSN, AN, USA CPT John M. Stas, CRNA, MSN, AN, USA CPT Jimmire M. Johnson, CRNA, MSN, AN, USA COL Normalynn Garrett, CRNA, PhD, AN, USA
  • Hyperkalemia-induced residual neuromuscular blockade: A case-report In this case report, the authors describe the anesthetic management of a patient who experienced postoperative residual muscle weakness secondary to hyperkalemia. A discussion of the role of potassium in membrane excitability and factors that must be considered in the differential diagnosis of residual neuromuscular weakness is included.
    Keywords: Electrolytes, hyperkalemia, postoperative complications, residual neuromuscular blockade.
    Version: 2005;73:437-441. Authors: Bryan A. Wilbanks, CRNA, MSN Judith Wakim, RN, EdD Barbara Daicoff, RN, PhD Scott Monterde, CRNA, MSN
  • A study of occupational stress, scope of practice,and collaboration in nurse anesthetists practicing in anesthesia care team settings In this research article, the author examines the relationships among CRNA scope of practice in anesthesia care team (ACT) settings, collaboration, and role-related occupational stress. Implications for future studies include exploring strategies that achieve consensus beteween CRNAs and anesthesiologists in ACTs, emphasizing clearly defined roles and optimizing productivity.
    Keywords: Anesthesia care team, nurse anesthesia, occupational stress.
    Version: 2005;73:443-452. Authors: Steve L. Alves, CRNA, PhD
  • AANA Journal Course, Part 5 Update for nurse anesthetists -- Anesthetic considerations for patients with amyloidosis Amyloidosis is a rare disease that has multiple implications for anesthesia providers due to the possibility of multiorgan involvement. Each amyloidosis case is unique, and the anesthetic must be determined on a case-by-case basis and tailored to the individual signs and symptoms the patient is experiencing. This course describes 2 cases of amyloidosis and anesthetic implications.
    Keywords: Amyloidosis, anesthesia, hemodynamics, sedation, transplant.
    Version: 2005;73:453-458. Authors: Jill M. Nisbit, CRNA, MNA Bradly J. Narr, MD Mary E. Shirk Marienau, CRNA, MS Christopher K. Dietz, CRNA, MNA