AANA journal
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Review Case Reports
Anesthetic considerations for the patient with hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu syndrome).
Hereditary hemorrhagic telangiectasia (HHT), Osler-Weber-Rendu Syndrome, is an uncommon disease but may be present in many people who remain undiagnosed. It is an autosomal dominant disorder characterized by multiple arteriovenous malformations (AVMs) and telangiectases that affect multiple organ systems. Hereditary hemorrhagic telangiectasia patients have a propensity for bleeding, especially from the oropharynx, nasopharynx and gastrointestinal tract, as well as from rupture of AVMs of other organ systems. Anesthetic care of patients with HHT involves very specific interventions with regard to control of bleeding, maintaining adequate oxygenation, and balancing hemodynamic values to optimize perfusion without compromising anesthetic depth.
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Review
Alpha2-adrenergic agonists and their role in the prevention of perioperative adverse cardiac events.
Alpha2-adrenergic agonists have been shown to reduce the incidence of perioperative myocardial morbidity and mortality. The purpose of this review article is to summarize the current data pertaining to alpha2-adrenergic agonists and their role in the prevention of perioperative adverse cardiac events. ⋯ The currently published randomized controlled trials indicate that alpha2-agonists reduce the incidence of myocardial ischemic episodes in patients with known or suspected coronary artery disease undergoing noncardiac surgery, and clonidine was shown to reduce mortality in noncardiac surgical patients. The authors of the studies concluded that while alpha2-agonists exert beneficial effects on hemodynamics and myocardial protection, large-scale, prospective, controlled trials are still needed.
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Biography Historical Article
Alice Magaw (Kessel): her life in and out of the operating room.
Alice Magaw (Kessel) was a pioneer in nursing research and the practice of nurse anesthesia through the publication of her clinical findings. This historical review will consolidate and preserve existing information and document new findings pertaining to this outstanding anesthetist. Primary historical sources, newspapers, legal documents, and other forms of information will be utilized, as well as correspondence with individuals who had some relative association with Magaw.
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Review Case Reports
Anesthetic management of a pregnant patient with an automatic implantable cardioverter-defibrillator: a case report.
There is little data currently available for the obstetric anesthetist to use as a reference for the anesthetic management of laboring women with automatic implantable cardioverter-defibrillators (AICDs). This case report involves a parturient with an AICD and a history of serious cardiac events. ⋯ The choice of anesthetics used to provide her with analgesia for labor is described, including the rationale for this anesthetic plan. A review of the literature that contains information on safe and effective anesthesia used for laboring women with AICDs is described.