AANA Journal Issue Details

On The Cover

A 10-year-old boy is ventilated via rigid bronchoscopy by Shaun Mendel, CRNA, while an emergency tracheostomy is performed. “The boy attempted to ingest a large foreign body. Two days later, he was in respiratory distress,” explained Mendel, a staff nurse anesthetist at Le Bonheur Children’s Hospital, Memphis, Tennessee. “In the operating room, we found a large plastic foreign body embedded into and almost totally occluding his airway and esophageal inlet. The boy suffered no long-term sequelae from this event.” (Photo was taken by Terry Yancey, RN.)


  • Use of Dexmedetomidine and Ketamine Infusions During Scoliosis Repair Surgery With Somatosensory and Motor-Evoked Potential Monitoring: A Case Report In this case report, dexmedetomidine and ketamine infusions were the main anesthetic for a 15-year-old girl, who underwent scoliosis repair surgery with intraoperative wake-up test, somatosensory evoked potential (SSEP), and motor-evoked potential (MEP) monitoring. This case report discusses the use of dexmedetomidine and ketamine infusions as an alternative to propofol-based total intravenous anesthesia during scoliosis repair surgery with intraoperative SSEP and MEP monitoring.
    Keywords: Dexmedetomidine, ketamine, motor-evoked potential, scoliosis repair surgery, somatosensory evoked potential.
    Version: 2010;78(6):446-450. Authors: Rozanna Penney, CRNA, MSNA, CEN
  • The Effect of Ellagic Acid on Platelet Activation as Measured by the Quantification of P-Selectin Using Flow Cytometry Ellagic acid is a major compound found in certain fruits and nuts. It has been attributed as having anti-inflammatory, free radical scavenging, and coagulation properties, as well as effects on tumor genesis in multiple forms of cancer. The purpose of this study was to investigate the effects of ellagic acid on platelet expression via the cyclooxygenase (COX) pathway by examining its effects on platelet activation and comparing them with known COX inhibitors in male Sprague-Dawley rats.
    Keywords: COX inhibitors, ellagic acid, flow cytometry, platelets, Sprague-Dawley rats.
    Version: 2010;78(6):453-459. Authors: CPT Peter Attilio, CRNA, MS, ANC, USA CPT Corey Merritt, CRNA, MS, ANC, USA CPT Janet Sims, CRNA, MS, ANC, USA CPT Nancy Kane, CRNA, MS, ANC, USA LTC Joseph O’Sullivan, CRNA, PhD, ANC, USA
  • Bilateral Tension Pneumothoraces and Subcutaneous Emphysema Following Colonoscopic Polypectomy: A Case Report and Discussion of Anesthesia Considerations This case examines the consequences of colonic perforation and the anesthetic management for the definitive surgical treatment of a posterior sigmoid wall perforation. Anesthesia providers’ awareness of the risk factors for colonic perforation due to colonoscopy, early signs and symptoms of perforation, and knowledge of the surgical and anesthetic management of perforation could lead to early recognition and intervention and likely to improved patient outcomes.
    Keywords: Colonic perforation, pneumomediastinum, pneumoretroperitoneum, polypectomy, tension pneumothorax.
    Version: 2010;78(6):462-467. Authors: John C. Kipple, CRNA, MS, CCRN
  • Use of Propofol and Emergence Agitation in Children: A Literature Review Emergence agitation (EA) is an important issue in pediatric anesthesia and has increased in occurrence with the use of sevoflurane inhalational anesthesia. This literature review compared 3 general anesthesia techniques in children—sevoflurane inhalational general anesthetic, propofol as an adjunct to sevoflurane inhalational general anesthetic, and propofol total intravenous anesthesia—and their associated incidence of EA. The authors conclude, based on the current evidence, that the use of propofol is associated with a reduction in the incidence of EA.
    Keywords: Pediatric emergence agitation, pediatric emergence delirium, propofol.
    Version: 2010;78(6):468-473. Authors: K. Logan Key, CRNA, MSN Christopher Rich, RN, MSN, MHS Claire DeCristofaro, MD Shawn Collins, CRNA, DNP
  • Exploring Student Nurse Anesthetist Stressors and Coping Using Grounded Theory Methodology The purpose of this qualitative study was to examine the challenges that recent graduates of nurse anesthesia programs coped with during their anesthesia curriculum. The initial research questions for this study were: From the graduates’ perspective, what were the stressors that they encountered during their nurse anesthesia program? And how did they successfully negotiate those stressors in order to graduate from their program? The author states this phenomenon was studied using grounded theory methodology.
    Keywords: Graduate student stress, grounded theory, nurse anesthesia and stress, stress and coping, student nurse anesthetist.
    Version: 2010;78(6):474-482. Authors: Joy Kieffer Phillips, RN, PhD, MSN
  • AANA Journal Course: Update for Nurse Anesthetists – Part 5 – Ventricular Assist Devices and Anesthetic Implications for Noncardiac Procedures Approximately 5 million Americans experience heart failure, which affects 10 in every 1,000 people older than 65 years. Ventricular assist devices (VADs) are a type of mechanical circulatory support that aids in systemic perfusion by maintaining unidirectional flow while reducing the oxygen demand of the failing ventricle. This course includes history and review of the literature, the function of VADs, the types of VADs, indications for use, anesthesia considerations, and preoperative and postoperative care.
    Keywords: Anticoagulation, congestive heart failure, hemodynamics, ventricular assist device.
    Version: 2010;78(6):483-488. Authors: Kristin A. Khoo, RN, BSN