LCDR Jason Patacsil, CRNA, MSN, NC, USN, secures an airway of a trauma patient in 1 of 12 operating rooms on the USNS Comfort. The hospital ship was deployed to Haiti after a magnitude 7.0 earthquake struck near Port-au-Prince on January 12. During the mission, 843 surgical cases were completed. Patacsil is a staff nurse anesthetist at Naval Hospital Pensacola, Florida. For more information on the USNS Comfort’s role in Operation United Response, see the Guest Editorial on page 264.
Use of Clevidipine for Intraoperative Hypertension Caused by an Undiagnosed Pheochromocytoma: A Case ReportThe severe intraoperative hypertension caused by an undiagnosed pheochromocytoma is a rare and challenging event for the anesthesia provider. If treatment is not prompt and successful, permanent and possibly lethal complications can ensue. This article reports what the author believes to be the first case study in which clevidipine (Cleviprex) was successfully used to treat a suspected, and later diagnosed, pheochromocytoma.
Version: 2010;78(4):301-309.Authors: CPT Kelly A. Chiffer McKay, CRNA, MSN, ANC, USA
CPT John E. Buen, CRNA, MSN, ANC, USA
Lt Col Kevin J. Bohan, CRNA, PhD, USAF, NC
CDR John P. Maye, CRNA, PhD, NC, USN
Pseudocholinesterase Deficiency: A Comprehensive Review of Genetic, Acquired, and Drug InfluencesPseudocholinesterase deficiency is an inherited or acquired condition in which the metabolism of succinylcholine, mivacurium, or ester local anesthetics is potentially impaired. The aim of this review article is to examine both the genetic aspects of pseudocholinesterase deficiency and the acquired aspects to help the reader stay abreast of established and current literature and theories. Nearly 250 articles were examined for importance, and 50 case reports, research studies, and review articles were cited.
Anesthetic Management for Lobectomy in a Patient With Coccidioidomycosis: A Case ReportCoccidioidomycosis is a fungal disease with a wide variety of manifestations. The rare coccidioidomycosis cases requiring surgical intervention present unique challenges to anesthesia providers. The author states that careful attention to perioperative fungal therapies, invasive monitoring, and electrolyte stabilization remain pivotal concerns offering the best outcomes for patients with coccidioidomycosis.
Acute Normovolemic Hemodilution in a Jehovah’s Witness Patient: A Case ReportPatients who are Jehovah’s Witnesses refuse blood transfusions and blood products as a matter of faith. For surgical procedures during which substantial blood loss is possible, their refusal presents a challenge. Anesthetists must generally respect the requests of adults not to receive blood and thus should have a clear understanding of how they will respond in the event of bleeding. In this case report, acute normovolemic hemodilution contributed to the successful outcome of an anemic Jehovah’s Witness who was undergoing major surgery.