AANA journal最新文献_第2页

A Word of Caution With Esophageal Replacement for Corrosive Esophageal Injury: A Case Report. 腐蚀性食管损伤行食管置换术的注意事项：1例报告。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001014

Kavitha Girish, Shreya Bharat Shah

引用次数: 0

Simulation Training for Epidural Placement: A Randomized Trial Comparing the Use of an Ex Vivo Porcine Spine Model With the M43B Lumbar Puncture Simulator IIA Model. 硬膜外放置的模拟训练：一项比较离体猪脊柱模型与M43B腰椎穿刺模拟器IIA模型的随机试验。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001017

Clare K Banigan, Loralee Sessanna, Brian Lowe, Tyler J Rolland

{"title":"Simulation Training for Epidural Placement: A Randomized Trial Comparing the Use of an Ex Vivo Porcine Spine Model With the M43B Lumbar Puncture Simulator IIA Model.","authors":"Clare K Banigan, Loralee Sessanna, Brian Lowe, Tyler J Rolland","doi":"10.70278/AANAJ/.0000001017","DOIUrl":"10.70278/AANAJ/.0000001017","url":null,"abstract":"Proficiency in epidural placement remains a challenging skill for anesthesia providers, requiring the ability to discern loss of resistance (LOR) when entering the epidural space. Current educational manikins lack the tactile feedback required for realistic epidural training. This descriptive pilot study aimed to compare an ex vivo porcine spine model with the M43B manikin model for simulation of clinical epidural placement. Expert anesthesia providers (n = 10) evaluated physical characteristics of each model using a survey comprised of a visual analog scale (0-100) and qualitative open-ended questions. Continuous data were analyzed using paired two-tailed Student's t tests, while qualitative open-ended narrative responses were reported by response frequency. Epidural simulation with the porcine spine demonstrated significantly higher clinical similarity scores (P < .001) for ligamentum flavum feel (85 ± 4.5 vs. 32 ± 8.1), LOR (93.5 ± 3.0 vs. 42.5 ± 10.7), catheter insertion (92.3 ± 3.9 vs. 48.8 ± 8.0), and novice training utility (92.5 ± 3.3 vs. 41.5 ± 7.7), while landmark identification (iliac crest/spinous processes) was comparable between models. Providers unanimously preferred the porcine model for epidural simulation. Simulation using an ex vivo porcine spine model enhances the realism of epidural training and underscores the importance of utilizing clinically relevant models for anesthesia procedural skill acquisition and maintenance.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"117-124"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prospective Observational Study of Pressure-Volume Curves and Respiratory Parameters in Oncology Patients Undergoing General Anesthesia. 肿瘤患者全麻压力-容积曲线和呼吸参数的前瞻性观察研究。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001013

Chrysoula Palazi, Theodoros Mariolis Sapsakos, Petros Galanis, Theodoros Katsoulas, Margarita Giannakopoulou, Evan Alexandrou, Georgios Skepastianos, Nikolaos Kopanakis, Maria E Bastaki, George Georgiopoulos, Evangelos A Konstantinou

{"title":"Prospective Observational Study of Pressure-Volume Curves and Respiratory Parameters in Oncology Patients Undergoing General Anesthesia.","authors":"Chrysoula Palazi, Theodoros Mariolis Sapsakos, Petros Galanis, Theodoros Katsoulas, Margarita Giannakopoulou, Evan Alexandrou, Georgios Skepastianos, Nikolaos Kopanakis, Maria E Bastaki, George Georgiopoulos, Evangelos A Konstantinou","doi":"10.70278/AANAJ/.0000001013","DOIUrl":"10.70278/AANAJ/.0000001013","url":null,"abstract":"The purpose of this study was the evaluation of the pressure-volume (PV) curve and all possible complications as it appears on an anesthesia monitor and the recording of parameters such as PO2 and SpO2 intraoperatively and before intubation. The study took place in the Surgery Department of a highly qualified Cancer Memorial Hospital, included 90 oncology patients diagnosed with abdominal cancer, and was divided into three groups. Patients in Group A had a normal history of pulmonary function and body mass index values; Group B included patients with a history of obstructive lung disease; and Group C comprised patients with a history of restrictive lung disease. Ppeak and Pplat measurements at baseline were significantly higher for Group C. PO2 for Group A was consistently higher. FiO2 was higher throughout Group C. It was found that rates of cough and shortness of breath differed significantly among the groups regarding respiratory complications. The PV curve for Group A was characterized by a sigmoid form; there was a concavity in the curve primarily in the final part for Group B; and there was a steep slope of the flow-volume curve and decreased forced vital capacity in Group C. Monitoring lung function during general anesthesia may provide useful information to anesthetists and allow the quantification of the severity of respiratory disease. The creation of PV curves and the evaluation of its data presents valuable information about lung mechanics and ventilator setup and can be an ideal postoperative tool as well as during general anesthesia.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"89-100"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anesthetic Considerations for the Convergent Plus Procedure: A Hybrid Approach to the Treatment of Nonparoxysmal Atrial Fibrillation. 收敛+手术的麻醉考虑：一种治疗非阵发性心房颤动的混合方法。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001009

Jenna E Jenkins, Margaret A Contrera

{"title":"Anesthetic Considerations for the Convergent Plus Procedure: A Hybrid Approach to the Treatment of Nonparoxysmal Atrial Fibrillation.","authors":"Jenna E Jenkins, Margaret A Contrera","doi":"10.70278/AANAJ/.0000001009","DOIUrl":"10.70278/AANAJ/.0000001009","url":null,"abstract":"One third of the population will develop atrial fibrillation in their lifetime and 12.1 million people in the United States are expected to be affected by 2030. A long-standing gap exists in traditional pharmacologic and nonpharmacologic treatments for persistent atrial fibrillation. An innovative, hybrid treatment, commonly referred to as the Convergent Procedure, combines surgical ablation of the posterior left atrium through a minimally invasive subxiphoid incision with traditional endocardial ablation techniques. When the procedure includes ligament of Marshall ligation and epicardial occlusion of the left atrial appendage using a video-assisted thoracoscopic approach, it is termed the Convergent 'Plus' Procedure. Evidence indicates that the procedure is twice as effective as endocardial ablation alone, reducing the need for atrial fibrillation medications by half. Consequently, demand for the procedure has surged, and anesthesia providers are now caring for patients in cardiac operating rooms and hybrid cardiology suites nationwide. Successful execution of the Convergent Plus Procedure demands close coordination among interdisciplinary teams, including surgery, cardiology, and anesthesiology. Anesthetic management is complex, requiring certified registered nurse anesthetists to understand procedural stages, ensure proper patient positioning, manage lung isolation, and be prepared for numerous complications such as hemodynamic instability, hemorrhage, and stroke.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"143-151"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Managing Simulated Anesthesia Emergencies with the Use of Clinical Decision Support Systems in a Rural Hospital Setting. 在农村医院使用临床决策支持系统管理模拟麻醉紧急情况。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001010

David Good, Sharon Schaaf

{"title":"Managing Simulated Anesthesia Emergencies with the Use of Clinical Decision Support Systems in a Rural Hospital Setting.","authors":"David Good, Sharon Schaaf","doi":"10.70278/AANAJ/.0000001010","DOIUrl":"10.70278/AANAJ/.0000001010","url":null,"abstract":"Certified registered nurse anesthetists (CRNAs) regularly encounter stressful emergency situations that demand critical thinking and quick intervention; these scenarios often result in task saturation and compromised mental acuity. An intervention utilizing a clinical decision support system (CDSS) with anesthesia emergency checklists built into the electronic health record (EHR) at a rural hospital in New Mexico was tested in a simulated environment. The simulation compared CRNA performance and adherence to evidence-based protocols with and without the checklists. The purpose of this study was to determine whether a CDSS built into the existing EHR could improve both CRNAs' adherence to evidence-based protocols and their documentation during an acute malignant hyperthermia (MH) emergency. Quantitative methods were used in the analysis of the data. Descriptive statistics and a paired t test were used to analyze MH evaluation tool data. Measures of central tendency were used to identify trends in the data. The study showed significant improvement (P < .05) in CRNA performance while using a CDSS during a simulated MH emergency and dramatic increases in documentation completeness.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"105-115"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers To Point-Of-Care Ultrasound Use In Nurse Anesthesiologists: A Preliminary Survey. 护士麻醉师在护理点使用超声的障碍：初步调查。

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001007

Morgan Morrow, Angela Burgess, Janet Vaughn, Charlotte Bolch

引用次数: 0

Postoperative Recovery Time After Knee Arthroscopic Surgery Using Low Dose Mepivacaine Spinal Anesthesia Versus General Anesthesia: A Retrospective Propensity Score Matched Cohort Study. 低剂量甲哌卡因脊柱麻醉与全身麻醉的膝关节镜手术术后恢复时间：回顾性倾向评分匹配队列研究

AANA journal Pub Date : 2025-04-01 DOI: 10.70278/AANAJ/.0000001011

Cheng Lin, Grace Xu, Rohan Dadak, Hesham Youssef, Kamal Kumar

{"title":"Postoperative Recovery Time After Knee Arthroscopic Surgery Using Low Dose Mepivacaine Spinal Anesthesia Versus General Anesthesia: A Retrospective Propensity Score Matched Cohort Study.","authors":"Cheng Lin, Grace Xu, Rohan Dadak, Hesham Youssef, Kamal Kumar","doi":"10.70278/AANAJ/.0000001011","DOIUrl":"10.70278/AANAJ/.0000001011","url":null,"abstract":"General anesthesia (GA) is the preferred technique in ambulatory surgery because GA is associated with a predictable recovery time. However, it carries higher risk of postoperative nausea and vomiting and drowsiness when compared with spinal anesthesia (SA). This study aimed to determine whether the recovery time in mepivacaine of 30 mg SA is noninferior when compared with GA. Our single-center retrospective study used a multivariable logistic regression to model anesthetic modality as a function of age, sex, body mass index, and American Society of Anesthesiologists physical status to generate a propensity score for each patient for matching. After screening 455 patients, 111 patients in each group were matched. SA was associated with 23.0 minutes (95% CI, -∞ to 31.0; P < .0001) longer recovery time, shorter operating room time (-8.0 minutes, 95% CI -13.0 to -3.0), more likely to bypass phase 1 recovery (OR, 2.77; 95% CI, 1.20 to 6.88) and less opioid use (-0.5 mg; 95% CI, -3.7 to -0.0001) but no difference in length of stay (LOS). Spinal anesthesia was correlated with inferior recovery time. The associated phase 1 bypass and similar LOS suggest SA as a viable alternative to GA.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 2","pages":"138-142"},"PeriodicalIF":0.0,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Prevention and Management of Hypoxemia During Anesthesia Induction In the Neonate and Small Infant. 新生儿和小婴儿麻醉诱导时低氧血症的预防和处理。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001006

Laura McDonald, Shelley Barenklau, Brittany Hollabaugh

引用次数: 0

Relationship Between Emotional Intelligence and Burnout Among Anesthesia Providers. 麻醉人员情绪智力与倦怠的关系

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001003

Julia Trainor, Kayla Nandlall, Nancy Crowell, Ladan Eshkevari, Avi Leibowitz, Mary Scott-Herring

{"title":"Relationship Between Emotional Intelligence and Burnout Among Anesthesia Providers.","authors":"Julia Trainor, Kayla Nandlall, Nancy Crowell, Ladan Eshkevari, Avi Leibowitz, Mary Scott-Herring","doi":"10.70278/AANAJ/.0000001003","DOIUrl":"10.70278/AANAJ/.0000001003","url":null,"abstract":"Previous studies have shown that higher emotional intelligence (EI) leads to lower incidence of burnout in clinical healthcare workers. However, there are currently no published studies that explore this relationship in anesthesia providers. This study aimed to investigate 1) whether anesthesia providers with higher EI were less likely to meet burnout criteria, and 2) whether demographic factors played a role in likelihood of burnout. In this study, 21 certified registered nurse anesthesiologists, 23 physician anesthesiologists, and six anesthesiologist assistants completed the 16-item Wong and Law Emotional Intelligence Score and the 16-item Oldenburg Burnout Inventory. T-test analysis was used for data interpretation to answer the emotional intelligence and burnout relationship proposed by the study. A statistically significant correlation was found between higher EI and lower incidence of burnout (P = .022). No statistically significant relationships were found between demographic variables and rates of burnout. Burnout is a tremendous issue among anesthesia providers, and further exploration into the influence of emotional intelligence on burnout may be instrumental to decreasing burnout incidence.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"55-60"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A Narrative, Qualitative Research Study of CRNA Perspectives of Practice Within the Anesthesia Care Team Model. 麻醉护理团队模式中CRNA实践视角的叙述性定性研究。

AANA journal Pub Date : 2025-02-01 DOI: 10.70278/AANAJ/.0000001027

Cindi Dabney, Michael Carter, Michael Herr, Todd Monroe, James Moore, Nina Sublette

{"title":"A Narrative, Qualitative Research Study of CRNA Perspectives of Practice Within the Anesthesia Care Team Model.","authors":"Cindi Dabney, Michael Carter, Michael Herr, Todd Monroe, James Moore, Nina Sublette","doi":"10.70278/AANAJ/.0000001027","DOIUrl":"10.70278/AANAJ/.0000001027","url":null,"abstract":"This research focused on the perspectives of certified registered nurse anesthetists on practice within the anesthesia care team (ACT) model. This narrative, qualitative study examined participants' perspectives on the strengths, challenges, conflict resolutions, and any other information they provided about working in the ACT model. The participants drew sharp distinctions between the supervision requirement of the ACT and that of collaboration with a team approach. The participants reported that they enjoyed and supported collaboration and found that the team approach led to efficient patient care while having extra hands to help and minds to problem-solve complicated patient scenarios. They did not believe physician supervision over their practice was necessary and proved burdensome. They further reported that they often relied on collaboration, accommodation, or compromise to resolve decision-making conflicts when they practiced within the ACT. However, several reported avoiding or leaving the ACT care model for independent practice. Participants who left ACTs reported that they were much happier with their profession and would never return to the ACT model. The recommendations from this study include discontinuing supervision of their practice while strengthening collaboration, a change in payment structure for anesthesia services, and reformed hospital credentialing. They believe that these recommendations would facilitate the full scope of practice and work independently to deliver the high-quality anesthesia care they trained for.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 1","pages":"45-52"},"PeriodicalIF":0.0,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143405129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0