AANA journal
-
Biography Historical Article
AANA's first annual meeting: the first-fruit of an adventure.
The75th Annuual Meeting of the American Association of Nurse Anesthetists will take place this year in Minneapolis, Minnesota. This column looks back at the Association's first Annual Meeting, held September 13-75, 1933, in Milwaukee, Wisconsin. Discussion includes Gertrude Fife's and Helen Lamb's work in organizing the meeting and the program, a day-by-day look at the meeting events and speakers, and the response to first Annual Meeting.
-
Randomized Controlled Trial Comparative Study
The influence of spinal needle orientation during administration of subarachnoid blocks on discharge criteria in same-day surgical patients.
Cost containment is a critical factor in today's healthcare industry, so finding ways to decrease length of stay is essential in anesthesia practice. We rely on rapid induction, recovery, and discharge to control cost in outpatient surgery. Subarachnoid block (SAB) is an acceptable anesthetic choice for many outpatient procedures. ⋯ Demographics (except weight) were not statistically different between the groups. Total hospital time did not differ between the groups. Regardless of needle orientation, patients in both study groups achieved discharge criteria in similar amounts of time.
-
Anesthesia providers may be called to treat injuries from chemical weapons or spills, for which prompt treatment is vital. It is therefore important to understand the mechanism of action of nerve agents and the resultant pathophysiology and to be able to quickly recognize the signs and symptoms of nerve agent exposure. This review article addresses the different types of nerve agents that are currently being manufactured as well as the symptomatic and definitive treatment of the patient who presents with acute nerve agent toxicity. This article also reviews the physiology of the neuromuscular junction and the autonomic nervous system receptors that nerve agent toxicity affects.
-
The use of antifibrinolytic therapy is commonplace in coronary artery revascularization procedures. Cardiac surgery accounts for more than 700,000 surgeries per year, with approximately 70% of these cases requiring antifibrinolytic therapy for coronary artery bypass graft (CABG) procedures. ⋯ However, new data have emerged regarding an increase in adverse outcomes associated with serine protease inhibitors. The purpose of this review article is to describe the clinical significance of antifibrinolytic therapy and the current implications associated with its use.
-
Randomized Controlled Trial
The effectiveness of 4% intracuff lidocaine in reducing coughing during emergence from general anesthesia in smokers undergoing procedures lasting less than 1.5 hours.
Coughing commonly occurs in patients emerging from general endotracheal anesthesia and is prominent in smokers due to underlying airway irritation. Clinical techniques used to mitigate emergence coughing include intravenous narcotics, intravenous or topical lidocaine, and deep extubation. Reduction of coughing by instilling lidocaine into the endotracheal tube cuff has been shown to be effective in long cases. ⋯ The control group received 5 mL of saline, and the experimental group received 5 mL of 4% lidocaine. On emergence, the anesthesia provider counted and recorded the number of coughs before awake extubation. This study did not show a correlation between use of intracuff lidocaine and a decrease in emergence coughing in procedures lasting less than 1.5 hours in patients who smoke.