AANA journal最新文献_第4页

Endotracheal Tube Replacement in the Prone Position With Intubating Laryngeal Mask Airway/Flexible Fiberoptic Scope Combination or Glidescope® Video Laryngoscope: A Manikin-Based Study. 俯卧位气管内插管与气管面罩气道/柔性纤维镜组合或滑梯镜®视频喉镜：一项基于人体模型的研究。

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001001

Abigail Villareal, Alejandro Ruiz de Somocurcio, Caleb Schauweker, Ron Fisher, Brian Cornelius

{"title":"Endotracheal Tube Replacement in the Prone Position With Intubating Laryngeal Mask Airway/Flexible Fiberoptic Scope Combination or Glidescope® Video Laryngoscope: A Manikin-Based Study.","authors":"Abigail Villareal, Alejandro Ruiz de Somocurcio, Caleb Schauweker, Ron Fisher, Brian Cornelius","doi":"10.70278/AANAJ/.0000001001","DOIUrl":"10.70278/AANAJ/.0000001001","url":null,"abstract":"Placing patients in the prone position is required for many surgical procedures. However, once in this position, the endotracheal tube (ETT) is often inaccessible to providers and accidental removal in an anesthetized, surgical patient can pose a life-threatening emergency. This experimental study aimed to examine the effectiveness of endotracheal reintubation in the prone position using a video laryngoscope (Glidescope®) compared with an intubating laryngeal mask airway (LMA) with ETT placement assisted by fiberoptic scope on a manikin. This study was conducted using 30 anesthesia providers with varying degrees of experience. The median times to intubation were lower using the Glidescope (73.5 s vs 130 s; P < .001). Moreover, the use of the Glidescope resulted in no esophageal intubations as well as fewer attempts than when using the LMA. Most anesthesia providers found that the Glidescope was the easiest technique to perform and learn. Despite these positive outcomes for the Glidescope, most of the participants reported the use of the LMA as a safer choice because of its capability to ventilate the manikin quickly (mean time to ventilation 12.13 s). The Glidescope method was found to be more likely to cause dental damage. The most important strategy is development of a plan prior to the emergent need.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 5","pages":"339-344"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243512","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

Methadone or Buprenorphine: Equal in Treating Opioid Dependent Parturients? 美沙酮或丁丙诺啡：治疗阿片类药物依赖的孕妇效果相同？

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001036

Cindi Dabney, Nicole Nelson, Michelle Canale, Sarah Jingying Zhang

{"title":"Methadone or Buprenorphine: Equal in Treating Opioid Dependent Parturients?","authors":"Cindi Dabney, Nicole Nelson, Michelle Canale, Sarah Jingying Zhang","doi":"10.70278/AANAJ/.0000001036","DOIUrl":"10.70278/AANAJ/.0000001036","url":null,"abstract":"Opioid use and misuse in parturients manifests in almost six out of every 1000 births, with close to 22,000 infants born annually to women using opiates. Additionally, the associated costs in managing these pregnant patients and their infants have increased to $1.5 billion annually. The American College of Obstetricians and Gynecologists currently recommends sublingual buprenorphine and oral methadone as the two opioid pharmacotherapy options for the treatment of opioid use disorder in pregnant patients. However, the pharmacology of buprenorphine and methadone differs greatly, making initiation and management of these two medications complex. Thus, it is crucial for anesthesia providers and obstetrical teams to have a thorough understanding of these two opioids and become familiarized with the current evidence-based practice for the management of parturients undergoing medication for opioid use disorder during pregnancy. In this journal course, the differences between the pharmacology of buprenorphine and methadone are described and benefits and limitations associated with the use of methadone and buprenorphine in parturients are discussed based on the current research data.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 5","pages":"379-390"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243457","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

PrEP-ared for Surgery? A Comprehensive Narrative Review of Perioperative Recommendations for Anesthesia Providers. 准备手术了吗？对麻醉提供者围手术期建议的综合述评。

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001034

Jennifer R Majumdar, Jake W Forrester, Kelly S Haviland, Christina D Massaro, John C Welch, Deirdre C Kelleher

{"title":"PrEP-ared for Surgery? A Comprehensive Narrative Review of Perioperative Recommendations for Anesthesia Providers.","authors":"Jennifer R Majumdar, Jake W Forrester, Kelly S Haviland, Christina D Massaro, John C Welch, Deirdre C Kelleher","doi":"10.70278/AANAJ/.0000001034","DOIUrl":"10.70278/AANAJ/.0000001034","url":null,"abstract":"The use of Pre-Exposure Prophylaxis (PrEP) for human immunodeficiency virus (HIV) prevention has increased significantly, with approximately 30% of eligible individuals in the U.S. receiving a prescription by 2021, up from 13% in 2017. As more patients on PrEP undergo surgical procedures, understanding the perioperative implications of these medications is crucial for anesthesia providers. This review aims to summarize current literature on the perioperative considerations for patients on PrEP and provide anesthesia providers with key recommendations to optimize patient safety and outcomes. It examines the pharmacology, side effects, and perioperative considerations of current PrEP formulations: Truvada, Descovy, and Apretude. We conducted a broad literature search focusing on publications from 2013 through 2024. The review identifies potential nephrotoxicity with tenofovir-based formulations, particularly when combined with nephrotoxic agents such as nonsteroidal anti-inflammatory drugs. Emtricitabine/tenofovir alafenamide use is associated with an increased risk of hypertension and hypercholesterolemia. No specific anesthetic agents are contraindicated, but dose adjustments for renally excreted drugs may be necessary. Current evidence supports continuing PrEP throughout the perioperative period, with strategies provided for managing different formulations during surgery. As PrEP use expands, anesthesia providers must balance safe, effective care with contributing to HIV prevention efforts. Future research should focus on long-term anesthetic implications of PrEP and optimal perioperative management strategies. By implementing informed practices, anesthesia providers can significantly enhance the care of patients on PrEP and support broader public health goals in HIV prevention.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 5","pages":"353-362"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12614839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Editor's Desk: The Critical Role of Peer Review: Ensuring Quality and Advancing Nurse Anesthesiology Scholarship. 编辑台：同行评议的关键作用：确保质量和推进护士麻醉学奖学金。

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001059

Edwin N Aroke

引用次数: 0

A National Survey Analysis of CRNAs' Perceived Ease of Use and Perceived Usefulness of Video Laryngoscopes for Difficult Airways. 一项全国调查分析crna对困难气道视频喉镜的感知易用性和感知有用性。

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001032

Uwe Klemm

{"title":"A National Survey Analysis of CRNAs' Perceived Ease of Use and Perceived Usefulness of Video Laryngoscopes for Difficult Airways.","authors":"Uwe Klemm","doi":"10.70278/AANAJ/.0000001032","DOIUrl":"10.70278/AANAJ/.0000001032","url":null,"abstract":"Video laryngoscopes (VLs) offer benefits by improving visualization and first-attempt success and decreasing failed intubations. This study examined the perceived usefulness and perceived ease of using VLs by certified registered nurse anesthetists (CRNAs) utilizing the Technology Acceptance Model published by Fred Davis in 1989. The study further investigated the influence of patient airway types, provider characteristics (age, years of practice, intubation frequency), and clinical factors (hospital size and technology availability) on subsequent selection and usage. The cross-sectional design included a one-time national survey using a purposive 3,000-CRNA sample. Data analysis included univariate, bivariate, and multivariate methodologies with multiple linear and binary logistic regression models. Approximately 71% of CRNAs were extremely likely to find VLs useful and easy to use and approximately 60% reported their selection and use when confronting difficult airways. Additionally, CRNAs selecting VLs for routine airways 50% to 100% of the time reported 4.49 times greater odds of always using VLs (100%) for difficult airways compared with CRNAs using this technology infrequently. This study provides current usage data by CRNAs and represents a first-ever assessment exploring CRNA perceptions of usefulness and ease in utilizing VLs in the operating room setting.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 5","pages":"345-352"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243491","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

Training Anesthesia Providers in Gastric Ultrasound Assessment: An Integrative Review. 培训麻醉提供者在胃超声评估：综合回顾。

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001037

Megan Rafferty, Aaron Turner, Eli Walch, Alexander Halstead

{"title":"Training Anesthesia Providers in Gastric Ultrasound Assessment: An Integrative Review.","authors":"Megan Rafferty, Aaron Turner, Eli Walch, Alexander Halstead","doi":"10.70278/AANAJ/.0000001037","DOIUrl":"10.70278/AANAJ/.0000001037","url":null,"abstract":"Point-of-care ultrasound (POCUS) is an inexpensive and often readily available tool for anesthesia providers to utilize to assess gastric content, both qualitatively and quantitatively, in the perioperative arena. Gastric POCUS requires the anesthesia provider to be trained and proficient in technique and interpretation of findings to accurately guide decision-making for patient care. The American Association of Nurse Anesthesiology, the American Society of Anesthesiologists, and the American Society of Regional Anesthesia have established guidelines supporting the use of gastric POCUS. This article aims to provide an integrative review of the literature surrounding current strategies in education and assessment of anesthesia provider competency in the perioperative utilization of gastric POCUS. Strict inclusion and exclusion criteria were used yielding eight articles in an effort to help determine feasible, efficient, reliable, and beneficial educational strategies to improve anesthesia provider competency. Findings suggest success with various educational strategies, including didactic, hands-on, electronic, and self-directed courses on gastric POCUS, supported by improved postintervention analyses of provider competency.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 5","pages":"363-370"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243505","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 Management of Elective Cesarean Delivery in a Pregnant Patient With Dilated Cardiomyopathy and Pulmonary Hypertension: A Multidisciplinary Approach. 扩张型心肌病合并肺动脉高压孕妇择期剖宫产的麻醉管理：多学科方法。

AANA journal Pub Date : 2025-10-01 DOI: 10.70278/AANAJ/.0000001039

Nikolas Zoé Ferreira Santos, Caio Cesar Levate Amaral, Maurício Vitor Machado Oliveira, Marina Ayres Delgado

{"title":"Anesthetic Management of Elective Cesarean Delivery in a Pregnant Patient With Dilated Cardiomyopathy and Pulmonary Hypertension: A Multidisciplinary Approach.","authors":"Nikolas Zoé Ferreira Santos, Caio Cesar Levate Amaral, Maurício Vitor Machado Oliveira, Marina Ayres Delgado","doi":"10.70278/AANAJ/.0000001039","DOIUrl":"10.70278/AANAJ/.0000001039","url":null,"abstract":"Peripartum cardiomyopathy (PPCM) complicated by pulmonary arterial hypertension (PAH) is an uncommon and high-risk condition that presents significant anesthetic and obstetric challenges. This case report contributes to the limited literature by describing the successful anesthetic management of a parturient with severe cardiac dysfunction and PAH, emphasizing the importance of a multidisciplinary approach. A 30-year-old pregnant woman with newly diagnosed dilated cardiomyopathy of unknown etiology and PAH was admitted for elective cesarean delivery. The diagnosis was established in the second trimester following symptoms of dyspnea at rest. Transthoracic echocardiography revealed severe left ventricular systolic dysfunction and elevated pulmonary artery pressures. A combined spinal-epidural technique was selected to allow for gradual onset of anesthesia and tight hemodynamic control. The patient was managed in a multidisciplinary setting involving anesthesiology, cardiology, obstetrics, and intensive care. Intraoperative and postoperative periods were uneventful, with no signs of pulmonary edema or right ventricular failure. The patient was discharged in stable condition on postoperative day 7. This case highlights the critical importance of individualized anesthetic planning and collaborative multidisciplinary care in the management of high-risk obstetric patients with PPCM and PAH. Early diagnosis, careful monitoring, and tailored interventions are key to optimizing maternal and neonatal outcomes in such complex scenarios.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 5","pages":"375-378"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145243488","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

The Editor's Desk: Evidenced-Based Practice and Quality Improvement Projects Can Improve Anesthesia Outcomes. 编者按：循证实践和质量改进项目可以改善麻醉结果。

AANA journal Pub Date : 2025-08-01

Charles A Griffis, Cormac O'Sullivan, Edwin N Aroke

引用次数: 0

GRIT as a Predictor of Nurse Anesthesiology Student Success. GRIT作为护士麻醉学学生成功的预测因子。

AANA journal Pub Date : 2025-08-01 DOI: 10.70278/AANAJ/.0000001022

Shawn Collins, Andy Tracy, Andy Benson, Sean Loughran, James Keaton, Salem Dehom

引用次数: 0

Practical Insights and Perspectives: Enhancing CRNA Practice Through Longitudinal Assessment. 实践洞察与展望：通过纵向评估加强CRNA实践。

AANA journal Pub Date : 2025-08-01 DOI: 10.70278/AANAJ/.0000001038

Christopher Gill, Kathryn Berry, Shahid A Choudhry, Matt Ferris, Timothy J Muckle, John C Preston

{"title":"Practical Insights and Perspectives: Enhancing CRNA Practice Through Longitudinal Assessment.","authors":"Christopher Gill, Kathryn Berry, Shahid A Choudhry, Matt Ferris, Timothy J Muckle, John C Preston","doi":"10.70278/AANAJ/.0000001038","DOIUrl":"10.70278/AANAJ/.0000001038","url":null,"abstract":"This narrative review examines the implications of longitudinal assessment (LA) for certified registered nurse anesthetists, proposing it as an innovative method to enhance continuous professional development and maintain certification. Grounded in theoretical frameworks such as Miller's Pyramid of Clinical Competence and Moore's Expanded Outcomes Framework, this review explores how LA fosters lifelong learning in healthcare and synthesizes current evidence, detailing the integration of frequent, low-stakes assessments and targeted feedback to support knowledge retention and application. The principles of LA--flexibility, rigor, and relevance--are discussed with its potential to address the evolving demands of clinical practice, ensuring patient safety and competence. Key findings highlight the role of LA in reducing stress associated with traditional high-stakes testing while promoting engagement and critical thinking. This review highlights that LA represents a paradigm shift in healthcare education, aligning assessment methods with modern clinical and educational needs. By fostering continuous learning and adaptability, LA enhances clinician growth and improves patient outcomes. Further research is recommended to optimize LA implementation across diverse healthcare specialties.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"93 4","pages":"259-266"},"PeriodicalIF":0.0,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144758913","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