Early Postoperative Takotsubo Cardiomyopathy: A Case ReportTakotsubo cardiomyopathy (TC), also called stress-induced cardiomyopathy, is a rare type of nonischemic cardiomyopathy accompanied by a transient ballooning and akinesis of the left ventricle. This case report describes a premenopausal woman in whom TC developed in the immediate postoperative period following general anesthesia.
Predicting Academic Progression for Student Registered Nurse AnesthetistsThe purpose of this quantitative correlational study was to determine if a relationship existed between admission criteria (grade point average, science grade point average, Graduate Record Examination scores, and critical care experience) and academic progression (current academic status and grade point average). Key findings revealed that statistically significant relationships exist between the admission selection criteria and academic progression.
Ultrasound Guidance in AnesthesiaSonography addresses a variety of concerns, such as patient safety and comfort, cost-effectiveness, time to complete a procedure, and success rates associated with invasive anesthesia procedures. The general terms and application of ultrasound to the practice of anesthesia are discussed in this article, as well as the general principles and the interpretation of basic images. Common procedures that include its use are also reviewed.
Prevention of Emergence Agitation in Seven Children Receiving Low-dose Ketamine and Propofol Total Intravenous Anesthesia The authors of this research article state that low-dose ketamine infused in combination with propofol total intravenous anesthesia appears to be associated with prevention of emergence agitation recurrence in young children who undergo repetitive anesthesia for radiation therapy. They conclude that clear determination of cause and effect cannot be made on the basis of our retrospective analysis; prospective randomized controlled trials are needed to confirm the efficacy of ketamine in preventing emergence agitation and compare it to other adjuvant agents.
Anesthesia Considerations in a Patient With McArdle Disease: A Case ReportMcArdle disease is a rare skeletal muscle disorder affecting approximately 1 in 100,000 people. In this case report, a patient with McArdle disease underwent bowel surgery with general anesthesia and was successfully managed. The author cautions that when a patient with McArdle disease presents for any surgical procedure, a variety of anesthesia implications should be discussed and incorporated into the overall management of his or her care.
Keywords: McArdle disease, myophosphorylase C, rhabdomyolysis, thermoregulation, type V glycogen storage disease.
Version: 2011;79(3):243-247.Authors: Abbie J. Choleva, CRNA, MSNA
Severe Preeclampsia, Pulmonary Edema, and Peripartum Cardiomyopathy in a Primigravida PatientPeripartum cardiomyopathy (PPCM) is a rare life-threatening cardiomyopathy of unknown cause that occurs in the peripartum period in previously healthy women. This case report demonstrates the need for vigilance and a high index of suspicion for PPCM in parturients with subtle symptoms of heart failure, such as shortness of breath and edema. The authors conclude that early diagnosis, intervention, and treatment may prevent or, at least, lessen symptoms of PPCM and improve maternal and fetal outcomes.
AANA Journal Course: Update for Nurse Anesthetists—Part 2—Radiation Safety for Anesthesia ProvidersMany modern diagnostic and surgical procedures rely heavily on the use of ionizing radiation. These procedures include computed tomography, nuclear medicine procedures, interventional radiology, and cardiac catheterization and electrophysiology procedures. An overview of some of the basic principles of radiation biology, radiation physics, and radiation protection and specific guidelines related to radiation exposure and pregnancy are described. The authors of this course state that the effects of radiation exposure are cumulative and permanent, and an understanding of these principles and practices will help anesthesia providers keep their occupational exposure to a minimum.
Keywords: ALARA (as low as reasonably achievable), anesthesia provider, electromagnetic radiation, inverse square law, ionizing radiation, radiation safety, x-rays.
Version: 2011;79(3):257-267.Authors: Gillian Phillips, CRNA, MS, MSN
W. Patrick Monaghan, PhD, CLS, SBB