AANA Journal Issue Details

On The Cover

Danielle Wilson, RN, BSN, practices airway management using a GlideScope video laryngoscope (Verathon Inc) with the Human Patient Simulator or HPS (Medical Education Technologies, Inc). Wilson is a student in the Department of Nurse Anesthesia, Ida V. Moffett School of Nursing, Samford University, Birmingham, Alabama. Experiential learning prior to starting clinical experience allows students to develop technical skills, direct laryngoscopy, and use of alternative methods of airway management. (Photo taken by Caroline Summers and submitted by Terri Cahoon, CRNA, DNP.)


  • Effects of Immobilization Stress and Hormonal Treatment on Nociception The purpose of this study was to evaluate the effects of stress and estradiol (E2) on pain tolerance. The authors state that with the exception of stressed rats treated with the ERβ agonist, there was no hormone effect on β-endorphin levels. These studies suggest that E2’s effect on pain thresholds may be mediated via the ERα, while the interaction between chronic stress and ERβ may also enhance pain threshold.
    Keywords: Estrogen receptor agonists, hot plate test, pain, restraint stress, stress.
    Version: 2011;79(5):375-380. Authors: LTC Danette F. Cruthirds, CRNA, MSN, ANC, USA Capt Amanda L. Siangco, CRNA, MSN, NC, USAF Capt Clinton J. Hartman, CRNA, MSN, MBA, NC, USAF Capt Danny C. Sandefur, CRNA, MSN, NC, USAF Capt James M. Spencer Jr, CRNA, MSN, NC, USAF Lt Col Christopher A. Dyer, CRNA, MSN, NC, USAF D. Omar Larco, BS T. John Wu, PhD
  • Recurrent Seizures in Pregnancy—Epilepsy or Eclampsia: A Diagnostic Dilemma? A Case Report Peripartum seizure is a serious disease with substantial morbidity and mortality for the mother and fetus. The authors of this case report point out that maximum vigilance is required for such patients, and therapy needs to be titrated according to the patient’s response, keeping in mind its impact on the fetus.
    Keywords: Eclampsia, epilepsy, pharmacotherapy, pregnancy, recurrent seizures.
    Version: 2011;79(5):388-390. Authors: Ravindra Pandey, MD Rakesh Garg, MD, DNB Vanlal Darlong, MD Jyotsna Punj, MD Puneet Khanna, MD
  • Renal Transplantation from an Unrelated Living Donor to a Malignant Hyperthermia–Susceptible Patient: A Case Report Transplantation is the optimal treatment for patients with end-stage renal disease; therefore, the incidence of living donor transplantation is increasing. This case report provides an example of kidney transplantation from an unrelated living donor to a malignant hyperthermia–susceptible recipient with Alport syndrome. The donor and the recipient had uneventful clinical courses and, to date, the renal transplantation has been successful.
    Keywords: Alport syndrome, malignant hyperthermia, nontriggering anesthetic technique, renal transplantation, total intravenous anesthetic.
    Version: 2011;79(5):397-400. Authors: Marli Kern, CRNA, MSNA
  • Intrapartum Seizure in a Patient Undergoing Cesarean Delivery: Differential Diagnosis and Causative Factors Seizures in the pregnant patient are assumed to be eclampsia unless other causes are known. This case describes the unusual occurrence of grand mal seizures in a 28-year-old patient undergoing a repeat cesarean delivery during spinal anesthesia. Included is a review of the current literature regarding seizures in the parturient and causative factors for this patient.
    Keywords: Cesarean delivery, closed head injury, seizures, traumatic brain injury.
    Version: 2011;79(5):403-407. Authors: Maria Hirsch, CRNA, DNAP
  • Anesthetic Considerations for Patients with Postpolio Syndrome: A Case Report Postpolio syndrome is a disorder related to the recurrence of neuromuscular symptoms in survivors of paralytic poliomyelitis. In this case report, the author discusses the anesthetic challenges and considerations in patients with postpolio syndrome, focusing on the importance of careful pharmacologic dosing of opioids and neuromuscular agents as well as perioperative and postoperative issues related to aspiration risks, cold intolerance, and positioning.
    Keywords: Anesthesia, neuromuscular disorder, postpolio syndrome.
    Version: 2011;79(5):408-410. Authors: Donna Wheeler, CRNA, MS
  • Advancing Recertification for Nurse Anesthetists in an Environment of Increased Accountability The purpose of this article is to present the essential concepts and current developments related to competence and continuing competence for nurse anesthetists. The National Board of Certification and Recertification for Nurse Anesthetists continues to seek input from nurse anesthetists and stakeholders in its deliberations on how to define the future requirements for continuing competence.
    Keywords: Continued competency, continued professional certification, credentialing, recertification.
    Version: 2011;79(5):413-418. Authors: Karen Plaus, CRNA, PhD, FAAN Timothy J. Muckle, PhD James P. Henderson, PhD
  • Use of Dexmedetomidine for Monitored Anesthesia Care for Diskography in Adolescents Procedural sedation in children and adolescents is becoming increasingly employed to facilitate successful diagnostic imaging studies. This case series describes the authors’ clinical experience in using dexmedetomidine as the sole sedative agent to facilitate diskography in 4 adolescent patients, ranging in age from 15 to 18 years, who presented with chief complaints of back pain and degenerative diskitis.
    Keywords: Dexmedetomidine, diskography, monitored anesthesia care.
    Version: 2011;79(5):421-425. Authors: James Furstein, CRNA, DNAP Manish Patel, DO Senthilkumar Sadhasivam, MD, MPH Mohamed Mahmoud, MD
  • Intrathecal Hydromorphone for Cesarean Delivery: In Search of Improved Postoperative Pain Management: A Case Report The purpose of this article is to encourage the development of more research regarding this use of intrathecal hydromorphone, which the author states may provide more consistent analgesia because its lipid solubility falls between that of morphine or fentanyl. This case report supports an emerging hypothesis that intrathecal hydromorphone is not only safe but possibly more effective than other intrathecal opioids for pain management after cesarean delivery.
    Keywords: Cesarean delivery, hydromorphone, intrathecal, pain management.
    Version: 2011;79(5):427-432. Authors: Erik Rauch, CRNA, MSN