Case Studies in Nurse Anesthesia

677 Pages·2009·30.69 MB·English

by  Sass Elisha

Case Studies in
NURSE
ANESTHESIA
Edited by
SASS ELISHA, EdD, CRNA
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Library of Congress Cataloging-in-Publication Data
Case studies in nurse anesthesia / [edited by] Sass Elisha.
p. ; cm.
Includes bibliographical references and index.
ISBN-13: 978-0-7637-6387-9 (alk. paper)
ISBN-10: 0-7637-6387-X (alk. paper)
1. Anesthesia—Case studies. 2. Nurse anesthetists—Case studies. I.
Elisha, Sass.
[DNLM: 1. Anesthesia—methods. 2. Anesthesia—nursing. 3.
Perioperative Nursing—methods. 4. Surgical Procedures, Operative—nursing. WY 151 C337 2010]
RD82.45C38 2010
617.9'6—dc22
2009033394
6048
Printed in the United States of America
13 12 11 10 09 10 9 8 7 6 5 4 3 2 1
Contents
Acknowledgments.............................................................vii
Foreword............................................................................ix
Contributors......................................................................xi
Unit.I. Otolaryngology...................................................................1
Chapter.1. Tonsillectomy......................................................................3
Sandra K. Bordi
Chapter.2. Radical.Neck.Dissection...................................................11
Yoo Eun Emily Hwang
Chapter.3. Laryngectomy...................................................................29
Mark Goelz
Chapter.4. Vocal.Cord.Polyp.Removal.with.Laser..............................41
Mark D. Welliver and Dawn C. Welliver
Chapter.5. Uvulopalatopharyngoplasty..............................................51
Dennis Spence
Unit.II. General.Surgery................................................................61
Chapter.6. Exploratory.Laparotomy.for.Bowel.Resection...................63
Timothy Palmer
Chapter.7. Laparoscopic.Gastric.Bypass............................................73
Michael Churchin and Paul Aguiar
Chapter.8. Open.and.Laparoscopic.Appendectomy ..........................85
Veronica Davis and Sandra E. Morris
Chapter.9. Cholecystectomy:.Open.and.Laparoscopic
. Approaches.......................................................................93.
. Garrett Peterson
Chapter.10. Liver.Failure.and.Nonalcoholic.Steatohepatitis..............105
Joseph F. Burkard
Chapter.11. Hepatic.Resection...........................................................115
Hamid Mahmood
iv Contents
Unit.III. Endocrine.Surgery............................................................................................123
Chapter.12. Anesthesia.Case.Management.for.Excision.of.a.Pheochromocytoma..............125
Becky Rubin and Michael Rubin
Chapter.13. Thyroidectomy.................................................................................................135
Joan Cornachio
Unit.IV. Trauma.Surgery...............................................................................................145
Chapter.14. Emergency.Airway.Management.for.the.Trauma.Patient.................................147
Matthew D’Angelo
Chapter.15. Craniotomy.for.Acute.Head.Injury..................................................................157
Greta Bray
Chapter.16. Penetrating.Traumatic.Injuries.........................................................................167
Jeremy S. Heiner
Chapter.17. Blunt.Thoracic.Injuries....................................................................................181
Matthew D’Angelo
Unit.V. Thoracic.Surgery..............................................................................................189
Chapter.18. Pneumonectomy.............................................................................................191
Mark Gabot
Chapter.19. Mediastinoscopy..............................................................................................211
Mary C. Karlet
Chapter.20. Video-Assisted.Thoracoscopic.Surgery.for.Mediastinal.Mass..........................221
Mark Gabot
Chapter.21. Anesthesia.Management.for.Thymectomy.......................................................235
Bernadette T. Higgins Roche
Unit.VI. Organ.Procurement.........................................................................................249
Chapter.22. Multiorgan.Procurement.................................................................................251
Bernadette T. Higgins Roche
Unit.VII. Vascular.Surgery..............................................................................................263
Chapter.23. Carotid.Endarterectomy..................................................................................265
Nancy A. Moriber
Chapter.24. Acute.Aortic.Dissection.and.Repair.................................................................279
Marjorie A. Geisz-Everson
Chapter.25. Thoracic.Aneurysm.Repair..............................................................................287
Cliff Roberson
Chapter.26. Abdominal.Aortic.Aneurysm.Repair................................................................301
Rachel Polazzi
Contents v
Unit.VIII. Cardiac.Surgery...............................................................................................311
Chapter.27. Minimally.Invasive.Coronary.Artery.Bypass.Graft...........................................313
Gayne Brenneman
Unit.IX. Neurosurgery...................................................................................................323
Chapter.28. Intracranial.Tumor.Debulking..........................................................................325
Mark D. Welliver
Chapter.29. Transsphenoidal.Hypophysectomy..................................................................339
John Cavitt
Chapter.30. Asleep-Awake.Craniotomy..............................................................................347
C. Wayne Hamm
Unit.X. Ophthalmic.Surgery........................................................................................357
Chapter.31. Retinal.Surgery................................................................................................359
Sarah E. Giron
Chapter.32. Ruptured.Globe...............................................................................................373
Charles Griffis and Erica J. McCall
Unit.XI. Gynecologic.Surgery.......................................................................................383
Chapter.33. Open.and.Laparoscopic.Approaches.for.Hysterectomy..................................385
Loretta Kitabjian
Chapter.34. Dilation.and.Curettage....................................................................................397
Donna Jasinski
Unit.XII. Obstetric.Surgery.............................................................................................405
Chapter.35. Cesarian.Section.............................................................................................407
Greg Nezat
Chapter.36. Cervical.Cerclage.............................................................................................417
Lynn L. Lebeck
Chapter.37. Intraoperative.Maternal.Hemorrhage.Caused.by.Uterine.Rupture.................423
Michael Rieker
Chapter.38. Labor.Epidural.................................................................................................433
Michael Rieker
Chapter.39. Laparoscopy.for.Adnexal.Mass.During.Pregnancy..........................................445
Edward Waters
Unit.XIII. Urologic.Surgery..............................................................................................455
Chapter.40. Radical.Prostatectomy.....................................................................................457
Jessica Bair
vi Contents
Chapter.41. Transurethral.Resection.of.the.Prostate...........................................................469
Sass Elisha
Chapter.42. Extracorporeal.Shock.Wave.Lithotripsy...........................................................481
Pamela Binns-Turner
Unit.XIV. Plastic.and.Reconstructive.Surgery..................................................................487
Chapter.43. Breast.Reconstructive.Surgery........................................................................489
Tatiana Bevans
Chapter.44. Liposuction......................................................................................................501
Vickie S. Jordan
Chapter.45. Mandibular.Osteotomy...................................................................................509
Joseph A. Joyce
Unit.XV. Orthopedic.Surgery........................................................................................519
Chapter.46. Anterior.Cervical.Discectomy/Fusion.............................................................521
Gary D. Clark and Nicholas C. Curdt
Chapter.47. Posterior.Spinal.Reconstructive.Surgery.........................................................531
Sass Elisha
Chapter.48. Anesthesia.for.Shoulder.Arthroscopy...............................................................543
Molly Wright
Chapter.49. Hip.Arthroplasty..............................................................................................551
Henry Talley
Chapter.50. Above-the-Knee.Amputation...........................................................................561
Lisa Osborne
Unit.XVI. Pediatric.Surgery.............................................................................................569
Chapter.51. Bowel.Resection.for.Necrotizing.Enterocolitis................................................571
Shaun Mendel
Chapter.52. Infantile.Hypertrophic.Pyloric.Stenosis..........................................................581
Deborah T. Bergstein
Chapter.53. Tracheoesophageal.Fistula.Repair...................................................................587
Travis Allen
Unit.XVII. Out.of.the.Operating.Suite.Procedures...........................................................595
Chapter.54. Electroconvulsive.Therapy...............................................................................597
Bernadette T. Higgins Roche
Chapter.55. Anesthesia.for.Office-Based.Pediatric.Dental.Surgery.....................................607
Allan Schwartz
. Figure.Credits...................................................................................................619
. Index................................................................................................................623
Acknowledgments
I would.like.to.thank.my.family;.all.of.the.authors;.John.Nagelhout,.CRNA,.PhD,.
FAAN;.Sandy.Bordi,.CRNA,.MSN;.Ed.Waters,.CRNA,.MN;.Retta.Smith;.Steve.Bebe;.
Karen.Plaus,.CRNA,.PhD;.and.Chuck.Biddle,.CRNA,.PhD,.for.their.support.of.this.
.academic.endeavor.

Foreword
Nurse anesthetists have contributed in myriad ways to the practice of anesthesia.
These include involvement in research, education, and the many technological
advances that are the cornerstone of modern surgery and anesthesia practice.
However, the most important contribution has come in the realm of patient care.
For many decades, nurse anesthetists have been an integral part of the evolution
of clinical practice. Our observations and innovative methods related to clinical
care have been essential to the remarkable safety record associated with current
anesthesia practice. The complexity and diversity of surgeries performed today
were unthinkable just a few years ago and their success in part is due to the
excellence of nurse anesthesia practice. The approach to patient care and criti-
cal assessment tools used by nurse anesthetists are a model that can be widely
applied in many patient care situations. These are the concepts that are the foun-
dation for this book.
This is the first book written by nurse anesthetists to use the case study format
for describing an array of procedures and disease states encountered in modern
anesthesia practice. In order to properly care for our patients, the perioperative
period must be viewed on a continuum within the total surgical experience. This
book presents clinical case studies in anesthesia which mirror the thought pro-
cesses required for successful clinical practice. Each case and patient scenario is
discussed from the preoperative, intraoperative, and postoperative perspective.
Pathophysiology, pharmacology, surgical intervention, anesthesia case manage-
ment, and postoperative considerations are thoroughly discussed and evaluated.
Key points, suggested readings, and review questions are presented, which further
enhance the effect of the educational material.
Dr. Elisha has gathered together a wide variety of national experts to share their
knowledge and suggestions on the most current clinical practices. The easily read-
able case based format will feel familiar to student registered nurse anesthetists and
anesthetists in clinical practice. This book is an invaluable resource for the practic-
ing clinician. I am confident that you will enjoy reading and rereading this textbook
and that it will become a permanent part of your medical library.
John J. Nagelhout, PhD, CRNA, FAAN