On The Cover

Florida International University (Miami) professor Derrick Glymph, DNAP, CRNA, seated in the simulation control room, observes student Shalene Blake, BSN, during an objective structured clinical examination. Students are shown here utilizing the latest anesthesia equipment and high-fidelity simulators in one of four mock OR suites at the Nicole Wertheim College of Nursing and Health Sciences. (Photo by Jeffrey Groom, PhD, CRNA)

Articles

  • Nonpharmacologic Neuraxial Interventions for Prophylaxis of Postdural Puncture Headache in the Obstetric Patient Postdural puncture headache due to accidental dural puncture during epidural catheter placement is a source of morbidity for new mothers. It can interfere with maternal-newborn bonding and increase the length of hospitalization. This evidence-based article examined the question: For obstetric patients experiencing an accidental dural puncture during epidural placement, which nonpharmacologic prophylactic neuraxial interventions safely and effectively decrease the incidence of postdural puncture headache?
    Keywords: Anesthesia, complication, epidural, obstetric, postdural puncture headache.
    Version: 2016;84(1):15-22. Authors: Heather Suescun, DNAP, CRNA, Paul Austin, PhD, CRNA, Dion Gabaldon, DHA, CRNA
  • Intrathecal Opioid-Induced Hypothermia Following Subarachnoid Block With Morphine Injection for Elective Cesarean Delivery: A Case Report Opioids have been administered intrathecally with subarachnoid block for postoperative pain relief in parturients undergoing elective cesarean deliveries. This case report presents the uncommon occurrence of intrathecal opioid-induced hypothermia in the latent phase of recovery following elective cesarean delivery.
    Keywords: Cesarean delivery, hypothermia, morphine injection (Duramorph), postanesthesia care, subarachnoid block.
    Version: 2016;84(1):23-26. Authors: John Mach, MSNA, CRNA, Teresa Van Havel, MSNA, CRNA, John Gadwood, MS, CRNA, Andrew Biegner, MSNA, CRNA, FAAPM
  • A Hypotensive/Bradycardic Episode Leading to Asystole in a Patient Undergoing Shoulder Arthroscopy in the Sitting Position With Interscalene Block and Intravenous Sedation: A Case Report Anesthesia for shoulder surgery is often accomplished by means of an interscalene block and intravenous sedation, with the patient subsequently placed in the sitting position for surgical access. Despite the advantages of this popular technique, sudden unheralded and severe hypotensive/bradycardic episodes have been reported in this population, with an incidence of 13% to 24%.
    Keywords: Bradycardic, hypotensive, interscalene block, shoulder arthroscopy, sitting.
    Version: 2016;84(1):27-33. Authors: Shannon Harper, CRNA
  • Effective Ventilation Strategies for Obese Patients Undergoing Bariatric Surgery: A Literature Review Obesity causes major alterations in pulmonary mechanics. Obese patients undergoing bariatric surgery present mechanical ventilation-related challenges that may lead to perioperative complications. Databases were systematically searched for clinical trials of ventilation maneuvers for obese patients and bariatric surgery.
    Keywords: Bariatric surgery, noninvasive positive pressure ventilation, obesity, positive end-expiratory pressure, recruitment maneuver.
    Version: 2016;84(1):35-45. Authors: Xin Yan Hu, MA, MSN, CRNA
  • Effect of a Nontechnical Skills Intervention on First-Year Student Registered Nurse Anesthetists' Skills During Crisis Simulation Simulation-based education provides a safe place for student registered nurse anesthetists to practice nontechnical skills before entering the clinical arena. An anesthetist's lack of nontechnical skills contributes to adverse patient outcomes. The purpose of this study was to determine whether an educational intervention on nontechnical skills could improve the performance of nontechnical skills during anesthesia crisis simulation with a group of first-year student registered nurse anesthetists.
    Keywords: Educational intervention, nontechnical skills, simulation-based education.
    Version: 2016;84(1):46-51. Authors: Linda L. Wunder, PhD, CRNA, ARNP
  • Anesthesia Considerations for the Patient With Cyclic Vomiting Syndrome Cyclic vomiting syndrome (CVS) is characterized by intense vomiting, recurrent emergency department visits, and return to usual health status between episodes. This syndrome was first described in 1882 in a case series of pediatric patients, but there is growing understanding that CVS may occur in other age groups. This case report describes a 23-year old with a history of CVS diagnosed in adolescence presenting for revision of a tibial plateau fracture.
    Keywords: Anesthesia, cannabinoid hyperemesis syndrome, cyclic vomiting syndrome, migraine.
    Version: 2016;84(1):52-55. Authors: Jennifer Garces, DNAP, CRNA
  • AANA Journal Course: Update for Nurse Anesthetists-Part 6-Residual Neuromuscular Blockade This article provides an update on residual neuromuscular blockade for nurse anesthetists. The neuromuscular junction pharmacology for producing and reversing neuromuscular blockade, monitoring sites and methods, and patient implications relating to incomplete reversal of neuromuscular blockade are reviewed.
    Keywords: Neuromuscular blockade, peripheral nerve stimulator, residual neuromuscular blockade.
    Version: 2016;84(1):57-65. Authors: Anna L. Plummer-Roberts, MSN, CRNA Christina Trost, MSN, CRNA Shawn Collins, DNP, PhD, CRNA Ian Hewer, MSN, MA, CRNA