Recently, North Carolina Governor Bev Perdue (left) visited East Carolina University (ECU) College of Nursing Nurse Anesthesia Program, in Greenville. Maura McAuliffe, CRNA, PhD, FAAN, demonstrated the capabilities of a state-of-the-art simulated operating room and patient simulator. McAuliffe, who is professor and director of ECU’s Nurse Anesthesia Program, said Governor Perdue spent more than an hour visiting the program. (Photo taken by Susan Campbell, CRNA, MSN.)
Use of Lipid Emulsions for Treatment of Local Anesthetic Toxicity: A Case ReportIn this case report, the authors explain that intravenous administration of lipid emulsions may offer a viable adjunctive treatment of local anesthetic toxicity, and the growing list of case reports demonstrating successful resuscitation for patients with local anesthetic toxicity offers further support for the use of lipid emulsions. They conclude that continued research regarding the use of lipid emulsions and efficacy, optimal dosing regimens, and when to start lipid emulsion therapy merit further study.
Keywords: Lipids, local anesthetic overdose, local anesthetic toxicity.
Total Knee Arthroplasty in a Patient With Diastrophic DwarfismDiastrophic dwarfism is an autosomal recessive disease that predominantly occurs in the Finnish population but has been known to occur worldwide. The characteristic short trunk of these patients in addition to scoliosis, cervical kyphosis, and involvement of articular cartilages can create unique ventilation and airway challenges for anesthesia providers. This case report features a 50-year-old woman with known diastrophic dwarfism who presented for total knee arthroplasty.
Keywords: Anesthesia, diastrophic dwarfism, dysplasia, total knee arthroplasty.
Version: 2010;78(5):366-368.Authors: Robin L. Crowley, CRNA, MS
Richard E. Haas, CRNA, PhD
Postoperative Patient-Controlled Analgesia in the Pediatric Population: A Literature ReviewIn this review article, the author says the literature shows that patient-controlled analgesia (PCA) provides adequate pain control and high levels of satisfaction for the pediatric postsurgical population and their families. Safety issues, indications, contraindications, complications, and dosing regimens related to PCA are addressed. Recommendations for continuous pulse oximetry and sedation monitoring and individualized dosage requirements are presented to decrease the incidence of complications.
Case Report: Management of Elective Cesarean Delivery in the Presence of Placenta Previa and Placenta AccretaThe purpose of this case report is to discuss the obstetric disorder of placenta previa with the concurrent occurrence of placenta accreta. The author includes a review of the management and course of a patient undergoing elective cesarean delivery with the aforementioned disorders, followed by a discussion related to the management of an obstetric patient undergoing elective cesarean delivery with known placenta previa and placenta accreta.
Xenon as an Anesthetic AgentThe search for the ideal anesthetic agent has been ongoing since the inception of anesthesia. Currently, xenon is being used primarily throughout Europe, but the high price of manufacturing and scavenging the noble gas has discouraged more widespread use. As technology in anesthetic delivery improves, xenon is being investigated further as a possible replacement for nitrous oxide as an inhalational agent. This article reviews the anesthetic properties of xenon and current and potential research about the gas.
Keywords: General anesthesia, inhalational agent, nitrous oxide, noble gas, xenon.
Version: 2010;78(5):387-392.Authors: Bryan D. Jordan, CRNA, MNA
Elizabeth Laura Wright, CRNA, MNA
Implications of Pharmacogenomics for Anesthesia ProvidersPharmacogenomics has the potential to individualize drug therapy, help avoid adverse drug reactions and toxic effects, and improve therapeutic drug efficacy and outcomes by adjusting drug therapy to the patient’s genotype. This review article provides clinicians with basic knowledge related to pharmacogenomics and its implications in anesthesia. With an improved understanding of the clinical implications of pharmacogenomics, anesthesia providers may have an increased potential to individualize therapy.
Keywords: Anesthesia, drug variability, pharmacogenetics, pharmacogenomics, polymorphisms.
Version: 2010;78(5):393-399.Authors: Tori Ama, CRNA, MNA
Sou Bounmythavong, CRNA, MNA
Jodee Blaze, CRNA, MNA
Melissa Weismann, CRNA, MNA
Mary Shirk Marienau, CRNA, MS
Wayne T. Nicholson, MD, PharmD
Thoracotomy for Tracheal Disruption After Traumatic Intubation: A Case ReportPerforming tracheal intubation is associated with risks, including upper and lower airway trauma. In this case report, the author details the airway management strategies employed during an emergent thoracotomy for a patient who suffered tracheal perforation during endotracheal intubation. A discussion of airway anatomy, airway considerations, intubation complications, and one-lung ventilation techniques is provided.
Stress-Related Cardiomyopathy in a 31-Year-Old WomanStress-related cardiomyopathy, initially referred to as Tako-Tsubo cardiomyopathy and later as apical ballooning syndrome, has been largely observed in postmenopausal women and is characterized by acute left ventricular failure in the absence of obstructive coronary disease. It is frequently precipitated by a stressful event. This case report describes a 31-year-old woman who experienced stress-related cardiomyopathy immediately after a bilateral mastectomy.