Michael Rieker, CRNA, DNP, director of the Nurse Anesthesia Program at Wake Forest University Baptist Medical Center, Winston-Salem, NC, begins a combined spinal-epidural block on a patient for her cesarean section. The photo was taken at Methodist Medical Center in Peoria, Ill, where Dr Rieker was formerly the lead nurse anesthetist for Obstetrics. (Photo taken by Angie Symonds, RN.)
The Universal Oxygen ConnectorPatients benefit from the administration of supplemental oxygen in the perioperative period. Supplemental oxygen has been shown to decrease postoperative hypoxemia, infection, and in some cases, nausea and vomiting. In this article, the authors describe the benefits of using the Universal Oxygen Connector, that is, how it decreases material waste, decreases hospital costs, saves time and effort and, most importantly, promotes patient safety by providing a versatile system for oxygen delivery.
Off-pump coronary artery bypass grafting: A case reportThis article briefly outlines the historical evolution of cardiac surgery that led to the development of the technology necessary to perform off-pump coronary artery bypass grafting (OPCAB). A case report of a 72-year-old female who underwent OPCAB is outlined. Included is a discussion of some of the benefits and potential complications of coronary artery bypass grafting and OPCAB, along with anesthetic considerations for OPCAB procedures.
Gorham disease: An intraoperative case studyGorham disease is a rare chronic disorder that is characterized by the abnormal proliferation of thin-walled capillaries and small lymphatic vessels that results in the massive osteolysis of adjacent bone. The case presented involves a 47-year-old man with Gorham disease complicated by unilateral chylothorax who was treated with thoracic duct ligation. The anesthetic implications associated with Gorham disase are discussed, and nonsurgical primary and adjunctive treatments for chylothorax are summarized.
Keywords: Chylothorax, Gorham disease, osteolysis, vanishing bone disease.
Version: 2006;74:45-48.Authors: James Underwood, CRNA, MSN
John Buckley, CRNA, MSN
Bill Manning, CRNA, MSN
The role of COX-2 inhibitors in the perioperative setting: Efficacy and safety—A systematic reviewA new class of nonsteroidal anti-inflammatory drugs (NSAIDs) selective for cylooxygenase-2 (COX-2) offers new options for managing perioperative pain; however, new and conflicting data have emerged regarding all nonsteroidal anti-inflammatory drugs, including those selective for COX-2. This article reviews 30 prospective studies on the role of COX-2 selective inhibitors in the perioperative setting. The studies examined a variety of variables, including efficacy, perioperative opioid reduction, and effects on platelet aggregation and renal function.
AANA Journal Course, Part 6 Update for nurse anesthetists -- Migraine development, treatments, research advances, and anesthesia implicationsThe purpose of this AANA Journal course is to update anesthesia providers on the phenomenology and biological mechanisms underlying migraines. As experts in pain management who encounter this common ailment, anesthesia providers frequently are consulted to assist in patient care. Effective assessment and treatment of migraine will lead to better anesthesia management. Discussion includes age of onset and prevalence of migraines, clinical diagnoses of headaches, major factors in migraine development, pharmacological intervention, anesthesia management, and recent pharmacological research.