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.)
Evidence for Using Air or Fluid When Identifying the Epidural SpaceLumbar 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
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.
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.
von Willebrand Disease and Cardiopulmonary Bypass: A Case ReportThe 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.