AANA Journal Issue Details

On The Cover

Randall W. Klotz, CRNA, MEd, MSN, is shown placing an interscalene block on a patient scheduled for shoulder arthroscopy for rotator cuff repair and acromioclavicular joint resection at Far Hills Surgical Center. Klotz practices with Anesthesiology Services Network, Ltd., at Far Hills Surgical Center and Miami Valley Hospital, Dayton, Ohio. (Photo taken by Cheryl Wilkey, RN.)


  • A Modified Approach to Intubation and Singlelung Ventilation for Lobectomy in a 2-Year-Old Child: A Case Report It is important to recognize that with each individual pediatric patient there are specific and unique considerations that must be made when choosing a method for single-lung ventilation. In the case reported, the original planned method to obtain single-lung ventilation was not possible. This emphasizes the need to always have a backup plan, so that if the original plan fails, achieving success will not be time-consuming or detrimental to the patient.
    Keywords: Parapneumonic empyema, pediatric single-lung ventilation, video-assisted thoracic surgery.
    Version: 2010;78(1):24-27. Authors: Dino F. Kattato, CRNA, MS
  • Nonopioid Anesthesia for Awake Craniotomy: A Case Report This case report discusses the clinical and anesthetic management for awake craniotomy and reviews the literature. Awake craniotomy is becoming more popular as a neurosurgical technique that allows for increased tumor resection and decreased postoperative neurologic morbidity. The procedure requires appropriate patient selection, knowledge of the surgeon’s skill, and a thorough anesthesia plan.
    Keywords: Anesthesia, awake craniotomy, opioid, propofol.
    Version: 2010;78(1):29-32. Authors: Diane L Wolff, CRNA, MS Robert Naruse, MD Michele Gold, CRNA, PhD
  • Management of Trauma-Induced Coagulopathy: Trends and Practices Traumatic injury is a challenging and growing phenomenon. The authors of this review article report that one-fourth of all trauma admissions present in varying degrees of coagulopathy. This article discusses the pathology of trauma-induced coagulopathy and current trends in management, and it closely examines the data surrounding the use of recombinant factor VII for the treatment of trauma-induced coagulopathy.
    Keywords: Coagulopathy, trauma.
    Version: 2010;78(1):35-40. Authors: Matthew R. D’Angelo, CRNA, DNP Richard P. Dutton, MD, MBA
  • Massive Hemoptysis During Monitored Anesthesia Care for Esophagogastroduodenoscopy with Percutaneous Endoscopic Gastrostomy Tube Placement: A Case Report This case illustrates the effects of hemoptysis during anesthesia on a patient with an already compromised pulmonary status. Although rare, hemoptysis is a frightening and potentially life-threatening complication of cystic fibrosis that may sometimes occur during anesthesia. The author cautions that anesthesia providers should be aware of this complication and know how to promptly and effectively manage it if encountered.
    Keywords: Cystic fibrosis, hemoptysis, monitored anesthesia care.
    Version: 2010;78(1):43-46. Authors: Melissa Wiehe, RN, BSN, CCRN
  • Anesthetic Implications for the Patient With Osteogenesis Imperfecta In this review article, the authors state that osteogenesis imperfecta is an inherited disorder of the connective tissue stemming from gross abnormalities in collagen formation and structure. Current literature exposes many potential anesthetic complications associated with osteogenesis imperfecta. The authors conclude that proper preparation and preoperative assessment is important, as is the choice of anesthetic technique.
    Keywords: Anesthesia, collagen, osteogenesis imperfecta.
    Version: 2010;78(1):47-53. Authors: Ingrid Oakley, CRNA, DVM Lauren Pilleteri Reece, CRNA, MNA
  • Biphasic Dosing Regimen of Meclizine for Prevention of Postoperative Nausea and Vomiting in a High-Risk Population Based on the findings of this study, the authors recommend that anesthesia practitioners should consider administration of 50 mg meclizine the night before and on the day of surgery using general anesthesia to patients who have been identified as high risk for PONV, to decrease the incidence and severity of PONV, and to increase overall patient satisfaction with their anesthesia experience.
    Keywords: Antiemetics, meclizine, ondansetron, postoperative nausea and vomiting.
    Version: 2010;78(1):55-62. Authors: LT Eric J. Bopp, CRNA, MS, NC, USN LT Jose L. Estrada, CRNA, MS, NC, USN LT Jeremy M. Kilday, CRNA, MS, NC, USN LT James C. Spradling, CRNA, MS, NC, USN CDR Carole Daniel, CRNA, MS, NC, USN Joseph E. Pellegrini, CRNA, PhD, CAPT(ret), NC, USN
  • Emergency Repair of Aortic Dissection in a 37-week Parturient: A Case Report Aortic dissection is a life-threatening condition with a 50% mortality rate in the first 48 hours and a 3-month mortality rate of 90% in untreated patients. It is a rare complication of pregnancy, but there is significant morbidity and mortality for the mother and infant. The purpose of this article is to highlight successful management of aortic dissection in a parturient and to broaden the body of literature on the topic.
    Keywords: Aortic, anesthesia, dissection, pregnancy,thoracic.
    Version: 2010;78(1):63-68. Authors: Sarah Ham, CRNA, MS
  • AANA Journal Course: Update for Nurse Anesthetists—Part 6—Lipid Infusion as a Treatment for Local Anesthetic Toxicity: A Literature Review Current evidence suggests that infusion of lipid emulsion should be considered among the primary treatments for local anesthetic toxicity and be made readily available in every facility’s operating or procedure room, and hospital staff should be trained in its use when local anesthetic toxicity is suspected. In this course, the author discusses history and review of the literature, discovery of lipid rescue, lipid sink theory, trials in dogs, case studies, complications of lipid therapy, and lipid therapy compared with vasopressin and epinephrine.
    Keywords: Intralipid, lipid emulsion, lipid infusion, lipid sink, local anesthetic toxicity.
    Version: 2010;78(1):69-78. Authors: Mihaela V. Manavi, CRNA, MSNA, BSN, CCRN