On The Cover

Scott Urigel, CRNA, MSN, performs a TAP block using the ilioinguinal-iliohypogastric approach on a patient undergoing an open inguinal hernia repair. He is a member of Western Reserve Anesthesia Associates, which provides TAP blocks to patients undergoing a variety of abdominal surgical procedures at the Findlay Surgery Center in Findlay, Ohio. (Photo taken by Jeff Molter, CRNA.)

Articles

  • Novel Preoperative Pharmacologic Methods of Preventing Postoperative Sore Throat due to Tracheal Intubation Postoperative sore throat is usually self-limiting but was rated by patients as one of the top 10 most undesirable anesthetic outcomes. We sought evidence for using nonsteroidal, nonlocal anesthetic, topical pharmacologic interventions conveniently implemented preoperatively to decrease its incidence.
    Keywords: Adult, anesthesia, endotracheal intubation, postoperative sore throat.
    Version: 2014;82(3):188-197. Authors: David M. Kalil, CRNA, DNAP, Loraine S. Silvestro, PhD, Paul N. Austin, CRNA, PhD
  • Effects of Intraosseous Transfusion of Whole Blood on Hemolysis and Transfusion Time in a Swine Model of Hemorrhagic Shock: A Pilot Study This prospective, experimental, mixed study determined whether there were differences in intraosseous and intravenous whole blood transfusion relative to hemolysis and transfusion time.
    Keywords: Blood transfusion, hemolysis, hemorrhagic shock, intraosseous infusion, intraosseous transfusion.
    Version: 2014;82(3):198-202. Authors: James M. Burgert, CRNA, DNAP, CPT John Mozer, BSN, RN, ANC, USA, CPT Tina Williams, BSN, RN, ANC, USA, MAJ Jerry Gostnell, BSN, RN, ANC, USA, Brian T. Gegel, CRNA, DNAP, Sabine Johnson, MS, MAJ Michael Bentley, CRNA, PhD, ANC, USA, Arthur “Don” Johnson, RN, PhD, Col(ret), USAFR, NC
  • Perioperative Dorzolamide-Timolol Intervention for Rising Intraocular Pressure During Steep Trendelenburg Positioned Surgery Elevated intraocular pressure (IOP) and venous congestion may produce a low ocular perfusion state that can lead to postoperative visual loss. This study examined dorzolamide hydrochloride and timolol maleate eyedrops on reducing elevated IOP during laparoscopic surgery with the patient in steep Trendelenburg position.
    Keywords: Chemosis, intraocular pressure, ischemic optic neuropathy, ocular perfusion pressure, postoperative visual loss.
    Version: 2014;82(3):203-211. Authors: Bonnie Molloy, CRNA, PhD, APRN, Xiaomei Cong, PhD, RN
  • Community of Inquiry Model: Advancing Distance Learning in Nurse Anesthesia Education The number of distance education courses offered by nurse anesthesia programs has increased substantially. This article introduces the Community of Inquiry model for use in nurse anesthesia education.
    Keywords: Bloom’s revised taxonomy, collaborative learning, community of inquiry model, distance learning, higher order thinking.
    Version: 2014;82(3):212-218. Authors: Shannon L. Pecka, CRNA, PhD, Suhasini Kotcherlakota, PhD, Ann M. Berger, PhD, APRN-CNS, AOCNS, FAAN
  • Ultrasound-Guided Interscalene-Supraclavicular Block for an Intramedullary Nailing of a Pathologic Humeral Fracture: Practical Application of Ultrasound-Guided Regional Anesthesia Fractures of the proximal upper extremity present a challenge to the anesthesia provider when administering a regional anesthetic. This case study shows how ultrasound guidance permitted the performance of both an interscalene and supraclavicular nerve block for a single procedure without the increased volume of local anesthetic that would normally be required.
    Keywords: 2014;82(3):219-222.
    Version: Interscalene block, local anesthetic, supraclavicular block, ultrasound. Authors: Christian R. Falyar, CRNA, DNAP, Eric C. Grossman, MD
  • Sevoflurane as a Therapy for Acute Chlorine Gas Exposure in an Austere Healthcare Environment: A Case Report Because of the ubiquitous nature of chlorine in the world, chlorine-injured patients may be expected at all medical facilities. A patient with a history of severe chlorine inhalational injury sustained 2 chlorine gas exposures within 48 hours. Sevoflurane has a role in treating chlorine inhalation injury.
    Keywords: Airway injury, chlorine, military medicine, sevoflurane.
    Version: 2014;82(3):223-226. Authors: MAJ Sarah R. Bellenger, CRNA, MSN, COL James D. Frizzi, MD, FACS
  • High Fatigue Scores Among Older Dutch Nurse Anesthetists In the Netherlands, hospital care production pressure recently increased substantially, while the number of nurse anesthetists available did not. Dutch nurse anesthetists above the age of 50 years show a high fatigue score and therefore need special attention to prevent them from harmful effects and to sustain maximal patient safety.
    Keywords: Fatigue, nurse anesthetist, on-call shifts.
    Version: 2014;82(3):227-230. Authors: Vera Meeusen, CRNA, PhD, MA Jaap Hoekman, CRNA André van Zundert, MD, PhD, FRCA, EDA, FANZCA
  • Cardiopulmonary Collapse in the Wake of Robotic Surgery Since the Food and Drug Administration approved the da Vinci Surgical System in 2000, robotic surgery is becoming increasingly popular. This article illustrates a case study of a patient who underwent a da Vinci ureterectomy.
    Keywords: Cardiopulmonary arrest, CO2 insufflation, pneumoperitoneum, robotic surgery, steep Trendelenburg position.
    Version: 2014;82(3):231-234. Authors: Livia C. Lee, RN, BSN
  • AANA Journal Course: Update for Nurse Anesthetists—Part 2—Reexamining Traditional Intraoperative Fluid Administration: Evolving Views in the Age of Goal-Directed Therapy A thorough review of the literature explores the history of today’s widely accepted fluid administration equation and discusses possible explanations and consequences of iatrogenically induced hypervolemia.
    Keywords: Fluid management, fluid restriction, goaldirected volume administration, hypervolemia.
    Version: 2014;82(3):235-242. Authors: Kaitlin Gallagher, CRNA, Charles Vacchiano, CRNA, PhD