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 ReportIt 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.
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.
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
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: 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 ReportAortic 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.