AANA Journal Issue Details

On The Cover

Greg Humbracht, CRNA (left), administers propofol to a patient undergoing an esophagogastroduodenoscopy, which is being performed by John Poulos, MD (right), at Fayetteville Gastroenterology Endoscopy Center. Amy Inman, CST, provides assistance during the procedure. This issue features an article titled “Propofol Compared With Combination Propofol or Midazolam/Fentanyl for Endoscopy in a Community Setting,” by John Poulos, MD, MSci, FACG, AGAF, FACP; Peter Kalogerinis, MMS, PA-C; and Jeffrey Caudle, CRNA, MSN. (Photo taken by Jennifer Thomas.)


  • Ultrasound-Guided Placement of Combined Superficial Cervical Plexus and Selective C5 Nerve Root Catheters: A Novel Approach to Treating Distal Clavicle Surgical Pain Treating the pain that patients experience from repair of distal clavicle fracture can be a challenge for the anesthesia provider. This article describes the first successful use of 2 separate ultrasound-guided perineural catheters placed for the purpose of treating distal clavicle pain and maintaining the analgesia.
    Keywords: Distal clavicle repair, perineural catheter, selective C5 nerve root block, superficial cervical plexus block, ultrasound guidance.
    Version: 2013;81(1):19-22. Authors: Jonathan P. Kline, CRNA, MSNA
  • Evidence for Using Air or Fluid When Identifying the Epidural Space Lumbar epidural analgesia is frequently employed to provide pain relief for women during labor. Anesthesia providers use various methods to identify the epidural space. Some use air, some use fluid, and others use a combination of air and fluid during the loss of resistance technique. This article illustrates how providers should consider other factors when selecting loss of resistance medium.
    Keywords: Air, epidural space, identification, loss of resistance.
    Version: 2013;81(1):23-28. Authors: Curtis L. Sanford II, CRNA, DNAP, Ricardo E. Rodriguez, PhD, James Schmidt, PhD, Paul N. Austin, CRNA, PhD
  • Propofol Compared With Combination Propofol or Midazolam/Fentanyl for Endoscopy in a Community Setting This study evaluated procedural efficiency and patient satisfaction in patients who had received propofol, mid­azolam/fentanyl/propofol (MFP), or midazolam/fentanyl, as sedation for either esophagogastroduodenoscopy or colo­noscopy. Patients receiving propofol felt less discomfort and need for adjustment in the sedation, and remembered less of the procedure compared with the MFP group.
    Keywords: Balanced sedation, conscious sedation, endoscopy, endoscopy unit efficiency, propofol.
    Version: 2013;81(1):31-36. Authors: John E. Poulos, MD, MSci, FACG, AGAF, FACP Peter T. Kalogerinis, MMS, PA-C Jeffrey N. Caudle, CRNA, MSN
  • Survey of Syringe and Needle Safety Among Student Registered Nurse Anesthetists: Are We Making Any Progress? The goal of this study was to determine the extent of unsafe injection practices that exist among student anesthesia pro­viders. The results demonstrate that additional education on injection safety must take place to improve practice, increase patient safety, and reduce healthcare costs.
    Keywords: Anesthesia practice, infection control, injection safety, needle and syringe use, syringe reuse.
    Version: 2013;81(1):37-42. Authors: Kelli Ford, CRNA, MSHS
  • Implementing a Perpetual Anesthesia Setup Standardized for the Trauma Room in a Level I Trauma Center The trauma room in a level I trauma center is a dynamic environment that provides little room for error. Significant variability can exist if anesthesia providers do not provide a setup that is consistent, reliable, and cost-effective. This study examines the process of creating and implementing a standardized anesthesia setup in the trauma room of a level I trauma center.
    Keywords: Anesthesia, level I trauma center, prefilled syringes, standardization, Theory of Reasoned Action.
    Version: 2013;81(1):43-49. Authors: Amanda C. Faircloth, CRNA, DNAP, Mary B. Ford, CRNA, PhD
  • Aortic Valve Bypass: A Case Summary and Discussion of Anesthesia Considerations Aortic valve replacement (AVR) is a common surgical intervention for symptomatic aortic stenosis. For many high-risk patients with severe symptomatic aortic stenosis, AVR is not an option. Aortic valve bypass (AVB) can offer surgical intervention for candidates unable to undergo AVR. This case summary reviews the anesthetic management of a patient undergoing AVB.
    Keywords: Aortic stenosis, aortic valve, aortic valve bypass, apicoaortic conduit, surgery.
    Version: 2013;81(1):50-54. Authors: Elizabeth Pelkey, CRNA, MSNA
  • Cochlear Implant in an Ambulatory Surgery Center Cochlear implants are especially useful for those with severe-to-profound hearing loss. The population is aging, so the demand for cochlear implantation in ambulatory surgery centers will likely increase. Ambulatory surgery centers can provide a more convenient and less expensive location for cochlear implant surgery than hospital-based operating facilities.
    Keywords: Ambulatory surgery, anesthesia, cochlear implant, elderly population, hearing loss.
    Version: 2013;81(1):55-59. Authors: Aimee M. Joseph, CRNA, DNAP, L. Frederick Lassen, MD, FACS
  • von Willebrand Disease and Cardiopulmonary Bypass: A Case Report The anesthetic management of patients undergoing cardiac surgery on cardiopulmonary bypass can be challenging. Contact of blood with extracorporeal surfaces results in altered coagulational integrity and increased risk of bleeding. Patients with preexisting bleeding disorders are particularly vulnerable. The authors discuss the anesthetic management of a patient with von Willebrand disease undergoing mitral valve replacement on cardiopulmonary bypass.
    Keywords: Antihemophilic factor/von Willebrand factor complex [human], cardiopulmonary bypass, desmopressin, von Willebrand, vWF/FVIII.
    Version: 2013;81(1):60-64. Authors: Oxana L. Teppone-Martin, CRNA, MS Manxu Zhao, MD, MS Teresa E. Norris, CRNA, EdD
  • AANA Journal Course: Update for Nurse Anesthetists – Part 6 – Anesthesia Case Management for Video-Assisted Thoracoscopic Surgery As the population ages, the number of patients in whom lung disease develops and who require surgical interven­tion will continue to rise. When compared with open thoracotomy, video-assisted thoracoscopic surgery offers patients significant advantages. Decreased invasiveness results in less blood loss, lower infection rates, and less postoperative pain.
    Keywords: Double-lumen endotracheal tube, one-lung ventilation, video-assisted thoracoscopic surgery.
    Version: 2013;81(1):65-72. Authors: Loretta Kitabjian, CRNA, MSN, Sandy Bordi, CRNA, MSN, Sass Elisha, CRNA, EdD, Mark Gabot, CRNA, MSN, Jeremy Heiner, CRNA, MSN, John Nagelhout, CRNA, PhD, FAAN, Jennifer Thompson, CRNA, MSN,