On The Cover

Tom Bruns, MS, CRNA, is shown performing a preoperative interview with a pediatric patient at Redwood Area Hospital in Redwood Falls, Minnesota. (Photo by Alika Faythe Photography.)

Articles

  • Minimum Effective Dose (ED50 and ED95) of Intrathecal Hyperbaric Bupivacaine for Cesarean Delivery: A Systematic Review Determination of the mean effective dose of hyperbaric bupivacaine will aid clinicians in managing maternal hypotension. The systematic search of studies evaluating the mean effective dose of hyperbaric bupivacaine yielded 10 clinical trials reporting the minimum effective dose in 50% (ED50) and 95% (ED95) of patients.
    Keywords: Cesarean section, ED50, ED95, hyperbaric bupivacaine, low dose.
    Version: 2018;86(5):348-360. Authors: Tito D. Tubog, DNAP, CRNA; Virginia Londahl Ramsey, DNAP, CRNA, ARNP; Laura Filler, DNAP, CRNA; and Richard S. Bramble, RN, BSN.
  • Improved Anesthesia Handoff After Implementation of the Written Handoff Anesthesia Tool (WHAT) The Written Handoff Anesthesia Tool (WHAT), designed by the author, was implemented to improve the quality of anesthesia handoffs in the operating room and postanesthesia care unit (PACU). The author used the Anesthesia Handoff Communication survey to evaluate Certified Registered Nurse Anesthetist and PACU registered nurse satisfaction with anesthesia handoff.
    Keywords: Anesthesia, communication, handoff, handover, patient safety.
    Version: 2018;86(5):361-370. Authors: Laura H. Lambert, DNP, MSN, CRNA; Judith A. Adams, PhD, MSN, RN, FNP-BC.
  • Understanding Motivations and Barriers of CRNAs Involved in Global Health: A Qualitative Descriptive Study Surgical care provided through short-term medical missions (STMMs) is an important component of global healthcare. Certified Registered Nurse Anesthetists are equipped with valuable knowledge and skills to help those lacking access to healthcare. Understanding the motivations and barriers to the participation of CRNAs in STMMs is vital to increasing their participation in these trips, which positively influence global healthcare.
    Keywords: Certified Registered Nurse Anesthetist, humanitarianism, nurse anesthetist, short-term medical missions, volunteerism.
    Version: 2018;86(5):371-378. Authors: Katie Lamb, MSNA, CRNA; Chelsey Cobb, MSNA, CRNA; Courtney Brown, PhD, CRNA; Clifford Gonzales, PhD, CRNA.
  • Clinical Application of Point-of-Care Ultrasound Gastric Examination in the Management of an ASA Class 3E Patient: A Case Report During the preanesthetic examination, the patient revealed he had eaten a small amount of food before returning to the hospital, placing him at increased risk of pulmonary aspiration. a point-of-care ultrasound gastric study was performed at the bedside to assess for gastric contents.
    Keywords: Antrum, fasting times, gastric ultrasound, POCUS, pulmonary aspiration.
    Version: 2018;86(5):379-382. Authors: Christian Ross Falyar, DNAP, CRNA; Louis Kantzavelos, MD.
  • Effect of Norepinephrine on Intracellular Ca2+ Levels in Malignant Hyperthermia-Susceptible B Cells: Pilot Study in the Search for a New Diagnostic Test for Malignant Hyperthermia The purpose of this study was to determine whether MHS B lymphocytes would demonstrate an increased sensitivity to norepinephrine as indicated by an adrenergic augmentation of intracellular calcium ion (Ca2+) accumulation, to possibly develop a less invasive laboratory assay for determining MH susceptibility.
    Keywords: B cells, diagnostic assay, malignant hyperthermia, norepinephrine.
    Version: 2018;86(5):383-392. Authors: Susan M. Perry, PhD, CRNA, ARNP, FAAN, Col(ret), USAF, NC; Sheila Muldoon, MD; Luke P. Michaelson, PhD, RN; Rolf Bunger, MD, PhD; Christine E. Kasper, PhD, RN, FAAN.
  • Effects of Subanesthetic Intravenous Ketamine Infusion on Corticosterone and Brain-Derived Neurotrophic Factor in the Plasma of Male Sprague-Dawley Rats The authors used a clinically relevant method to administer a 2-hour subanesthetic IV ketamine infusion following a rodent fear-conditioning paradigm (paired tone plus foot shock) to evaluate the effects on corticosterone and brain-derived neurotrophic factor in the plasma of male Sprague-Dawley rats.
    Keywords: BDNF, coricosterone, fear conditioning, ketamine, rats.
    Version: 2018;86(5):393-400. Authors: CDR Kennett D. Radford, PhD, CRNA, NC, USN; Thomas Y. Park, BA; Lisa Osborne-Smith, PhD, CRNA, CAPT(ret), NC, USN; Kwang H. Choi, PhD.
  • Transfer of Care in Perioperative Settings: A Descriptive Qualitative Study The purpose of this study was to explore perioperative transfer-of-care events that contributed to professional malpractice claims to identify general themes, antecedents, and consequences to improve clinical practices and guide future research.
    Keywords: Anesthesia closed claims, malpractice, perioperative, transfer of care.
    Version: 2018;86(5):401-407. Authors: Bryan A. Wilbanks, PhD, DNP, CRNA; Marjorie Geisz-Everson, PhD, CRNA; Beth A. Clayton, MSN, CRNA; Rebecca R. Boust, MSNA, CRNA, APRN.
  • Anesthetic Management of a Unique Case of Double-Outlet Right Ventricle With Glenn Shunt for Cesarean Delivery: A Case Report The authors report the case of a patient at 36 weeks of gestation, with a partially palliated double-outlet right ventricle and a Glenn shunt, who presented with severe dyspnea and worsening cyanosis.
    Keywords: Obstetric anesthesia, congenital heart defect, epidural anesthesia, Glenn shunt.
    Version: 2018;86(5):408-411. Authors: Ajisha Aravindan, MD; Rajeshwari Subramaniam, MD; Praveen Talawar, MD; Sumit Bansal, MD; Riddhi Kundu, MD; Priyankar Kumar Datta, MD.
  • AANA Journal Course, Hypoglossal Nerve Stimulation: Effective Longterm Therapy for Obstructive Sleep Apnea Historically, obstructive sleep apnea (OSA) was believed to be primarily anatomical in origin due to excess tissue obstructing the airway. Uvulopalatopharyngoplasty, the most common surgical approach, failed to resolve OSA in 59% of patients. Contemporary research focuses on physiologic contributors to OSA, such as impaired airway dilator activity and failure of the neuromuscular feedback loop. Hypoglossal nerve stimulation is a new treatment option for eligible patients that addresses this neurofeedback-loop dysfunction.
    Keywords: Hypoglossal nerve stimulation, obstructive sleep apnea, upper airway stimulation.
    Version: 2018;86(5):412-416. Authors: Karen J. Maresch, MSN, CRNA