Susan Parry McMullan, CRNA, MSN, chief nurse anesthetist at Hinsdale Anesthesia Associates, Hinsdale, Illinois, uses transesophageal echocardiography to evaluate preoperative heart function in a patient scheduled for coronary artery bypass graft surgery. McMullan is director of region 2 of the Illinois Association of Nurse Anesthetists. She is a doctoral student at Rutgers, The State University of New Jersey, and a didactic instructor in the Rosalind Franklin University of Medicine and Science, Nurse Anesthesia Program, North Chicago, Illinois. (Photo taken by John Wheeler.)
Anesthetic Management of a Pregnant Patient With an Automatic Implantable Cardioverter-Defibrillator: A Case ReportThere is little data currently available for the obstetric anesthetist to use as a reference for the anesthetic management of laboring women with automatic implantable cardioverter-defibrillators (AICDs). This case report involves a parturient with an AICD and a history of serious cardiac events. The information contained in this case report may be used by anesthesia providers in the obstetric suite confronted with this unique subset of patients that require in-depth anesthetic management. A review of the literature that contains information on safe and effective anesthesia used for laboring women with AICDs is described.
Investigation of the Anxiolytic Effects of Luteolin, a Lemon Balm Flavonoid in the Male Sprague-Dawley RatThe purpose of this study was to investigate the anxiolytic effects of luteolin and its potential interaction with the gamma-aminobutyric acid (GABAA) receptor in male Sprague-Dawley rats. Lemon balm has traditionally been used as an herbal remedy in the treatment of many medical conditions, including anxiety. Luteolin is a major component of the essential oil lemon balm. The data suggest that luteolin does not produce anxiolysis by modulation of the GABAA receptor; however, luteolin may modulate motor movements and locomotion.
Keywords: Anxiolysis, elevated plus-maze, lemon balm, luteolin, rat.
Version: 2009;77(1):33-36.Authors: CPT Terry Raines, CRNA, MSN, ANC, USA CPT Paul Jones, CRNA, MSN, ANC, USA CPT Naomie Moe, CRNA, MSN, ANC, USA CPT Robert Duncan, RN, BSN, ANC, USA Suzanne McCall
LTC Thomas E. Ceremuga, CRNA, PhD, ANC, USA
Perceived Deprivation in Active Duty Military Nurse AnesthetistsThere is a shortage of military Certified Registered Nurse Anesthetists (CRNAs). Relative deprivation is a perception of unfairness due to discrepancies between what one has and what one could or should have that is dependent on feelings and facts. Feelings of relative deprivation could contribute to the military CRNA shortage. The purposes of this study were to measure relative deprivation in active duty military CRNAs and explore variables that correlate with relative deprivation. Further research is indicated to identify definitive factors that can be modified to improve feelings of deprivation as they relate to retention and recruitment of military CRNAs.
Keywords: Military nurse anesthetists, nurse anesthesia workforce, relative deprivation, retention.
Version: 2009;77(1):42-48.Authors: Julie A. Pearson, CRNA, PhD, CAPT(ret), NC, USNR
Michael D. Fallacaro, CRNA, DNS
Joseph E. Pellegrini, CRNA, CAPT(ret), PhD, NC, USN
Factors at Admission Associated With 4 Months Outcome in Elderly Patients With Hip FractureThe purpose of this descriptive cohort study was to describe patients with hip fracture on the basis of ASA physical status and to identify preoperative risk factors associated with postoperative outcome up to 4 months after surgery. Data were collected prospectively through the Swedish National Hip Fracture and Anesthetic registers and retrospectively from medical and nursing records. Risk factors for a poorer 4-month survival after hip fracture were ASA physical status 3 and 4, more extensive fractures, 85 years or older, male sex, and dependency in living. Elderly patients with hip fracture should be identified immediately at admission regarding risk factors leading to a poorer survival and more complications.
Update for Nurse Anesthetists—Part 6—Should I Continue or Discontinue That Medication?Patients are admitted for surgery while taking a wide array of medications, and nurse anesthetists must evaluate their effectiveness and compatibility with anesthesia. Anesthetists must be familiar with the basic pharmacology of each drug and the potential adverse effects and possible drug interactions that may occur when anesthetic drugs are administered. If a medication requires discontinuation, it must be ensured that the patient’s disease remains controlled throughout the perioperative period. This course reviews the current literature regarding the anesthetic management of several commonly encountered drug classes.