Hemorrhage After the Preoperative use of Complementary and Alternative Medicine: A Case ReportWidely self-prescribed complementary and alternative medicines are often considered to be safe food supplements because of minimal federal product labeling requirements, although some herbal products may cause adverse effects or interact with prescription medications. This case report describes a patient who underwent breast surgery and had extensive postoperative bleeding. Preoperatively the patient consumed vitamin E and several herbs with potential to alter the hemostatic process combined with the drugs quinine sulfate and sertraline hydrochloride.
Keywords: Anesthesia, complementary and alternative medicine, drug interaction, herbs, surgical patient.
Version: 2000;68(3):217-220.Authors: Carol L. Norred, CRNA, MHS
Christina A. Finlayson, MD
Laryngoscope Handles: A Potential for InfectionIn this original research, the author describes the incidence and types of microbes on laryngoscope handles after their use in the operating rooms of a 502-bed medical center. The author states that recognizing the existence of potential pathogens on laryngoscope blades and handles necessitates development of institution policies to promote cleaning, as well as use of disposable covers, high-level disinfection, or sterilization for blades and handles after each use.
Bilateral Tension Pneumothorax During Jet Ventilation: A Case ReportAnesthetic management for the patient undergoing jet ventilation (high-pressure ventilation for upper laryngeal laser procedures) can be challenging, as complications of jet ventilation can include subcutaneous emphysema and tension pneumothorax. The authors use this case report to discuss the pathophysiology related to tension pneumothorax and anesthetic implications for management of cases involving jet ventilation.
CRNA Awareness and Experience with DNR OrdersDespite 2 decades of experience with do-not-resuscitate (DNR) orders, some controversy regarding their use still remains. The purpose of this study was to determine nurse anesthetists' level of awareness of their institution's perioperative DNR policy and their experiences and opinions regarding surgical candidates with DNR orders.
Xenon: Anesthesia for the 21st CenturyAs a result of the environmental concerns surrounding the use of nitrous oxide, both microscopically and globally, investigation of the use of xenon (a naturally occurring element in the earth's atmosphere) as a replacement for nitrous oxide has been renewed. This review article presents a historical perspective, environmental issues, and the advantages and disadvantages of the use of xenon.