AANA journal最新文献_第4页

The Editor's Desk: We Have Always Led Clinically--Now Let Us Lead Scientifically. 编者按：我们一直以临床为导向，现在让我们以科学为导向。

AANA journal Pub Date : 2026-08-01 DOI: 10.70278/AANAJ/.0000001101

Edwin N Aroke

引用次数: 0

A Competency-Based Evaluation Checklist for the Pericapsular Nerve Group (PENG) Block: A Delphi Study. 基于能力的囊包神经群（PENG）阻滞评估清单：德尔菲研究。

AANA journal Pub Date : 2026-08-01 DOI: 10.70278/AANAJ/.0000001067

Daniel Mulero-Marrero, Clinton Peterman, David Terrault, Christian Falyar, Sharon Harmon, Hallie Evans

{"title":"A Competency-Based Evaluation Checklist for the Pericapsular Nerve Group (PENG) Block: A Delphi Study.","authors":"Daniel Mulero-Marrero, Clinton Peterman, David Terrault, Christian Falyar, Sharon Harmon, Hallie Evans","doi":"10.70278/AANAJ/.0000001067","DOIUrl":"10.70278/AANAJ/.0000001067","url":null,"abstract":"The Pericapsular Nerve Group (PENG) block is a novel, ultrasound-guided regional anesthesia technique that provides analgesia for hip surgeries by targeting the articular branches of the femoral, obturator, and accessory obturator nerves, while preserving motor function. Unlike traditional blocks used for total hip arthroplasty and femoral neck fractures, the PENG is a motor sparing block, promoting early ambulation while reducing opioid use. Despite its advantages, variability in technique and lack of standardization result in inconsistent results. This study aimed to develop and validate a competency-based checklist for PENG block performance using the Modified Delphi Method. Twenty-five regional anesthesia experts were invited to participate; 16 responded to the first survey round. A consensus of over 75% was achieved on all checklist items, particularly those related to anatomic landmarks and post-block procedures. Variability in ultrasound image acquisition techniques highlighted the need for flexibility within a standardized framework. Expert feedback was integrated to refine the checklist, ensuring clinical relevance and educational value. Establishing a validated checklist will standardize PENG block administration, leading to enhanced provider competency, improved outcomes, and reduced incidence of complications.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 4","pages":"275-279"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576549","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 Qualitative Descriptive Study on the CRNA Transition to Academia. CRNA向学术界过渡的定性描述研究。

AANA journal Pub Date : 2026-08-01 DOI: 10.70278/AANAJ/.0000001083

Denise J Stuit, Travis L Chabo, David Hart, Kim Larson, Susan P McMullan

{"title":"A Qualitative Descriptive Study on the CRNA Transition to Academia.","authors":"Denise J Stuit, Travis L Chabo, David Hart, Kim Larson, Susan P McMullan","doi":"10.70278/AANAJ/.0000001083","DOIUrl":"10.70278/AANAJ/.0000001083","url":null,"abstract":"There is a paucity of research on the transition of Certified Registered Nurse Anesthetists (CRNAs) entering academia. Guided by Schlossberg's Transition Theory, the purpose of this qualitative descriptive study was to explore the experiences of CRNAs moving from clinical practice to academia. Seven focus groups were conducted with CRNA educators and program administrators across the United States. Transcripts were analyzed using inductive content analysis with iterative coding, key words in context, and thematic development validated through team consensus. Findings illuminate how CRNA faculty navigate academic entry, adjustment, and persistence. Three major themes were identified: \"Natural Progression,\" \"On My Own,\" and Staying Power. Themes reflected a gradual entry into academia through early teaching opportunities and professional connections, a general lack of formal mentorship and accessible resources during early transition, and a sustained commitment through legacy building, flexibility, and institutional benefits. Results underscore the need for effective mentorship and orientation, and faculty development pathways to enhance recruitment and retention of CRNA educators to safeguard the education pipeline.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 4","pages":"259-266"},"PeriodicalIF":0.0,"publicationDate":"2026-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148576594","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 Metamorphosis of NAR to CRNA: The Caterpillar to Butterfly Analogy. NAR到CRNA的蜕变：毛毛虫到蝴蝶的类比。

AANA journal Pub Date : 2026-08-01 DOI: 10.70278/AANAJ/.0000001081

Derrick C Glymph, Tamar Rodney, Daniel D King, Rishelle Y Zhou

引用次数: 0

Evaluating the Efficacy of Dexmedetomidine as an Adjunct to Local Anesthetics in Adductor Canal Blocks for Adult Patients Undergoing Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis. 评价右美托咪定作为局部麻醉药辅助内收管阻滞治疗成人初次全膝关节置换术的疗效：一项系统回顾和荟萃分析。

AANA journal Pub Date : 2026-06-01 DOI: 10.70278/AANAJ/.0000001071

William Belden, Maria Ciceron-Velazquez, Yo Lee, Hallie Evans, Tito D Tubog

{"title":"Evaluating the Efficacy of Dexmedetomidine as an Adjunct to Local Anesthetics in Adductor Canal Blocks for Adult Patients Undergoing Primary Total Knee Arthroplasty: A Systematic Review and Meta-Analysis.","authors":"William Belden, Maria Ciceron-Velazquez, Yo Lee, Hallie Evans, Tito D Tubog","doi":"10.70278/AANAJ/.0000001071","DOIUrl":"10.70278/AANAJ/.0000001071","url":null,"abstract":"Over 700,000 total knee arthroplasties (TKAs) are performed in the United States annually. Long-term functional recovery following TKA depends heavily on early ambulation and rehabilitation, which requires effective pain management. Adductor canal blocks (ACBs) offer targeted analgesia while preserving quadriceps strength. However, postoperative pain often outlasts single-shot peripheral nerve blocks. This analysis evaluated whether perineural dexmedetomidine added to local anesthetics increased the efficacy and duration of ACBs in patients undergoing TKA. This systematic review and meta-analysis examined adult patients undergoing primary TKA under general or spinal anesthesia and ACB. Five randomized controlled trials examining 445 patients met inclusion criteria. Patient ages ranged from 18 to 85 years and demonstrated similar comorbidities. Pooled analysis showed that patients receiving dexmedetomidine reported lower pain scores at rest (mean difference [MD] -0.35; P = .009) and during activity (MD -0.40; P < .0001). Opioid consumption decreased by an average of 8.91 mg (P = .05). Time to first rescue analgesia increased by 1.54 hours, and ambulation outcomes consistently showed improvement in the dexmedetomidine group. This analysis supports the use of dexmedetomidine as an adjunct for ACB in TKA. However, significant heterogeneity among studies limits applicability of this analysis's findings. Clinicians are advised to consider this when making practice decisions.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 3","pages":"179-191"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051846","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

Deep Sedation With a Natural Airway is a Viable Alternative to General Anesthesia With Endotracheal Tube for Isolated Transcatheter Pulmonary Valve Implantation. 在经导管肺动脉瓣置入术中，自然气道深度镇静是替代气管内插管全麻的可行方法。

AANA journal Pub Date : 2026-06-01 DOI: 10.70278/AANAJ/.0000001066

Keith Wemple, Lynsey Schmidt, Abigail Yaneff, Eric Kern, Matthew Koedam, Elena Swan, Elizabeth Vogel, Sean Loughran

{"title":"Deep Sedation With a Natural Airway is a Viable Alternative to General Anesthesia With Endotracheal Tube for Isolated Transcatheter Pulmonary Valve Implantation.","authors":"Keith Wemple, Lynsey Schmidt, Abigail Yaneff, Eric Kern, Matthew Koedam, Elena Swan, Elizabeth Vogel, Sean Loughran","doi":"10.70278/AANAJ/.0000001066","DOIUrl":"10.70278/AANAJ/.0000001066","url":null,"abstract":"There is growing interest in utilizing deep sedation with a natural airway rather than general endotracheal anesthesia (GETA) for cardiac catheterization procedures due to the presumed hemodynamic benefits and faster postprocedural recovery, although a paucity of data supports these assumptions. We hypothesized that the periprocedural complication rate would be lower in patients undergoing transcatheter pulmonary valve implantation (TPVI) under deep sedation with a natural airway versus those under GETA. We performed a retrospective chart review of 85 patients undergoing isolated TPVI at a large academic medical institution. A logistical regression adjusting for age was performed. The primary outcome was periprocedural complication rate, including access site rebleeding, hematoma, conversion to GETA, arrhythmia requiring intervention, cardiac arrest, blood transfusion, and postoperative nausea and vomiting. Significantly more patients in the GETA group experienced complications compared with the deep sedation group (41.2% vs 14.7%, P = .015). The secondary outcomes included vasopressor use, recovery location, and procedural, anesthesia, and recovery times. The median procedure time was shorter in the sedation group by 38 minutes (P = .010), and anesthesia time was shorter by 50 minutes (P = .001). Overall, we found that deep sedation is feasible for TPVI and in this retrospective study was associated with decreased periprocedural complications.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 3","pages":"173-178"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051825","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

Exploring the Relationship Between Job Satisfaction and Turnover Intentions Among CRNAs. crna工作满意度与离职意向的关系研究。

AANA journal Pub Date : 2026-06-01 DOI: 10.70278/AANAJ/.0000001072

Alaina Yamamoto, Sadeeka Al-Majid, Jennifer Thompson, Cyril Rakovski

{"title":"Exploring the Relationship Between Job Satisfaction and Turnover Intentions Among CRNAs.","authors":"Alaina Yamamoto, Sadeeka Al-Majid, Jennifer Thompson, Cyril Rakovski","doi":"10.70278/AANAJ/.0000001072","DOIUrl":"10.70278/AANAJ/.0000001072","url":null,"abstract":"This study explored job satisfaction and turnover intentions among certified registered nurse anesthetists (CRNAs) in a prominent Southern California health system. Job satisfaction and turnover intentions were measured using the Misener Nurse Practitioner Job Satisfaction Scale and Turnover Intention scales, respectively. Of the 60 CRNAs who completed the survey, 30% expressed turnover intentions, which was higher among new practitioners. Marital status emerged as a significant influence on both job satisfaction and turnover intentions. Overall job satisfaction was high, with male CRNAs scoring slightly higher. Principal components and regression analyses unveiled key factors regarding job satisfaction including satisfaction with supervisors, peer interactions, and flexibility in practice. The findings highlight the specific factors that influence CRNAs' career choices, stressing the importance of providing targeted support, particularly for those new to practice. The correlation between job satisfaction and specific factors is highlighted, offering healthcare organizations actionable insights. Addressing these dynamics can enhance job satisfaction, particularly among new CRNAs, and ultimately contribute to stable healthcare services. Findings from this study provide valuable insight that could guide development of strategies that mitigate turnover intentions and improve job satisfaction in the CRNA workforce.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 3","pages":"193-199"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051876","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

Unilateral Spinal Anesthesia in a Repeat Cesarean Delivery: A Case Report. 单侧脊髓麻醉在重复剖宫产中的应用：1例报告。

AANA journal Pub Date : 2026-06-01 DOI: 10.70278/AANAJ/.0000001069

Jillian M Moyer, Susan M Newell

引用次数: 0

The Editor's Desk: What's in a Label? The High Stakes of Choosing the Right Literature Review. 编辑台：标签里有什么？选择正确的文献综述的高风险。

AANA journal Pub Date : 2026-06-01 DOI: 10.70278/AANAJ/.0000001095

Edwin N Aroke

引用次数: 0

AANA Journal Course-GLP-1 Receptor Agonists: What CRNAs Need to Know About Their Expanding Role. AANA期刊课程- glp -1受体激动剂：crna需要了解它们的扩展作用。

AANA journal Pub Date : 2026-06-01 DOI: 10.70278/AANAJ/.0000001093

Adam Davies, Karla Maldonado, Mayte Diaz, Eleanor Rawson, Michelle Canale, Sarah Zhang, Cynthia Dabney

{"title":"AANA Journal Course-GLP-1 Receptor Agonists: What CRNAs Need to Know About Their Expanding Role.","authors":"Adam Davies, Karla Maldonado, Mayte Diaz, Eleanor Rawson, Michelle Canale, Sarah Zhang, Cynthia Dabney","doi":"10.70278/AANAJ/.0000001093","DOIUrl":"10.70278/AANAJ/.0000001093","url":null,"abstract":"Glucagon-like peptide-1 receptor agonists (GLP-1RAs) were developed to treat type 2 diabetes mellitus and later became widely used for the management of obesity. Recent evidence includes off-label uses for substance use disorders; nicotine and alcohol dependence; neurodegenerative diseases; and cardiovascular, kidney, and liver diseases. Certified registered nurse anesthetists (CRNAs) are likely to encounter patients using GLP-1RAs for both Food and Drug Administration-approved and nontraditional purposes. This review explores the pharmacology and mechanisms of action of GLP-1RAs, with a focus on their relevance in the perioperative period. It covers their effects on blood glucose control, gastric motility, and central nervous system pathways. Special attention is given to delayed gastric emptying, concerns about pulmonary aspiration, and the metabolic benefits of glucose-dependent insulin secretion and reduced blood glucose fluctuations. Current professional guidelines emphasize personalized, patient-centered perioperative care. The increasing use of GLP-1RAs, combined with more off-label prescribing and unregulated peptide use, emphasizes the need for thorough preoperative screening, clear medication reconciliation, and effective interdisciplinary communication. As more evidence emerges, CRNAs must remain vigilant while recognizing that the expanding role of GLP-1RAs is important for optimizing perioperative safety and achieving optimal patient outcomes in modern anesthesia practice.","PeriodicalId":7104,"journal":{"name":"AANA journal","volume":"94 3","pages":"225-233"},"PeriodicalIF":0.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148051902","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