Anesthesiology Commons^™

Do Patients Who Receive Dexmedetomidine As An Adjunct To Spinal Anesthesia For Cesarean Delivery Achieve Longer Block Duration Compared To Those Who Receive Spinal Anesthesia With Local Anesthetic Alone?, Liana S. Garrison

Theses, Dissertations and Capstones

Problem Statement: Cesarean delivery is associated with significant postoperative pain, typically managed with spinal anesthesia using a local anesthetic. While opioids are often added as adjuncts, the addition of dexmedetomidine, an alpha-2 agonist, has emerged as a potential alternative that may enhance the efficacy of the spinal block in terms of pain management, potentially improving block duration and quality compared to local anesthetic alone.

Methodology: A literature review was conducted on the use of dexmedetomidine as an adjunct to spinal anesthesia for patients undergoing cesarean sections. Databases used for the search included PubMed, CINAHL Complete, and MEDLINE. The keywords used …

Is Long-Term Survival Higher In Patients Who Receive Propofol-Based Total Intravenous Anesthesia During Colorectal Cancer Surgery Compared To Volatile Anesthesia, Shad Anthony Mitchell

Theses, Dissertations and Capstones

The study reviewed several retrospective cohort studies that examined the impact of propofol-based total intravenous anesthesia (TIVA) versus volatile anesthesia (VA) on the long-term survival of colorectal cancer (CRC) surgery patients. Eight studies found no significant difference in mortality between the two anesthesia types, while three studies indicated a significant decrease in all-cause mortality favoring propofol TIVA. The studies had varying follow-up periods, with some extending to five years. Notably, two studies controlled the type of volatile anesthetic used, specifically sevoflurane and desflurane. The findings suggest a potential survival advantage for propofol TIVA, warranting further investigation.

Do Pediatric Patients That Receive Dexmedetomidine As Premedication Experience Less Emergence Delirium Than Pediatric Patients That Receive Midazolam As Premedication?, Shelby Mccloud

Theses, Dissertations and Capstones

Title: Do pediatric patients that receive dexmedetomidine as premedication experience less emergence delirium than pediatric patients that receive midazolam as premedication?

Problem Statement: Midazolam remains the current choice within the practice for premedication in the prevention of emergence delirium, however as research continues there could possibly be a gap between the research and current practice. Throughout the practice of pediatric anesthesia most providers choose to premedicate with midazolam while there may be a more beneficial option of dexmedetomidine.

Results: The study found a significant variance in the incidence of emergence delirium among pediatric patients, ranging from 18.1% to 89%, depending …

Effectiveness Of Tranexamic Acid Administration On Intraoperative Blood Loss In Elective Craniofacial Surgery, Kimberly Marie Vance

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to determine if intraoperative use of tranexamic acid (TXA) was associated with estimated blood loss in patients who underwent elective craniofacial surgery.

Introduction: Intraoperative blood loss has been shown to significantly contribute to postoperative morbidity and mortality in patients undergoing surgical procedures. It is the responsibility of the anesthesia clinician to accurately assess and actively replace ongoing blood loss, as well as employ strategies to curtail perioperative hemorrhage. While numerous methods exist to minimize surgical blood loss, such as mild hypothermia and controlled hypotensive techniques, these interventions can prove hazardous in pediatric patients …

Is Preoperative Administration Of Celecoxib And Pregabalin Associated With Decreased Intraoperative And Postoperative Opioid Consumption In Patients Undergoing Total Hip Or Knee Arthroplasty?, Cierra Treadway

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to determine if a preoperative dose of celecoxib and pregabalin in patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) was associated with less opioid consumption intraoperatively and postoperatively compared to those who did not receive this regimen.

Introduction: THA and TKA have been associated with a high incidence of postoperative pain. Historically, this pain has been managed with opioids; however, these drugs have negative side effects associated with their use. Consequently, anesthesia providers have begun utilizing multimodal non-opioid analgesics. Recently, a specific combination has been utilized, which includes a …

Does Prophylactic Administration Of Ondansetron Prior To Spinal Anesthesia Decrease Spinal-Anesthesia Induced Hypotension In Obstetric And Non-Obstetric Patients?: A Literature Review, Quinnton Rees

Theses, Dissertations and Capstones

Introduction: Neuraxial (spinal) anesthesia is a favored modality in the care of obstetric patients undergoing a cesarean-section (C-section). Spinal anesthesia is additionally popular as an alternative method for various surgical procedures in non-obstetric patients allowing practitioners to avoid potential risks associated with the use of general anesthesia. Spinal anesthesia-induced hypotension (SAIH) is a common side effect that presents status post-initiation of spinal anesthesia. The source of the hypotension produced after the initiation of spinal anesthesia is due to inhibition of the sympathetic nervous system (sympathectomy) and bradycardia caused by stimulation of the Bezold-Jarisch Reflex. A relatively new intervention that …

Intraoperative Administration Of Intravenous Acetaminophen At Induction Or End Of Surgery And Its Relationship With Opioid Consumption And Pain Scores, Spencer Davis Greenwood

Theses, Dissertations and Capstones

Obesity has become increasingly prevalent in the United States. Bariatric surgeries have increased as the prevalence of obesity has risen, providing an effective alternative to weight loss. Intravenous acetaminophen (IVA) is a safe and effective non-opioid medication that can be given without the risk of respiratory or cardiac complications. Research has shown that the use of IVA during surgery can improve postoperative pain scores, reduce opioid requirements, and improve patient satisfaction.

A retrospective cohort study of 200 patients (100 per group) undergoing laparoscopic bariatric surgery (LBS) was performed. Statistical analysis was used to determine the relationship between those who received …

What Is The Relationship Of Increased Intraocular Pressure And Body Mass Index In Patients Undergoing Robotic Prostatectomy In Sleep Trendelenburg Position?, Seth Parsons

Theses, Dissertations and Capstones

Introduction: Robotic Prostatectomy is a common procedure performed in surgery centers all over the world, but these procedures can be long and difficult to manage for Anesthesia providers. This study examined the relationship between increased intraocular pressure (IOP) and Body Mass Index (BMI) during Robotic Prostatectomies in Steep Trendelenburg (ST) position. Other variables studied were length of procedure, age, and ASA physical classification.

Methodology: The study was a retrospective cross-sectional design of 100 patients with a BMI over 30 and 100 patients with a BMI under 30 who have undergone Robotic Prostatectomies at Charleston Area Medical Center (CAMC) between …

Does Rotem-Guided Therapy Influence Postoperative Chest Tube Output In On-Pump Cabg?, Preston Franklin Woodburn-Camp

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to identify the association between ROTEM-guided therapy and chest tube output in patients who have undergone elective on-pump CABG.

Introduction: In open heart surgery, there are a variety of ways that coagulation disturbances occur, such as hemodilution of coagulation factors and platelets, a reduction in coagulation factors due to the use of cardiopulmonary bypass the administration of the anticoagulant heparin, and altered temperature. Severe bleeding is frequently associated with open-heart surgery, especially on-pump coronary artery bypass grafting (CABG). Thromboelastometry using rotational thromboelastometry (ROTEM) is a point-of-care testing that can show specific defects in …

Does Perioperative Angiotensin-Converting Enzyme Inhibitor Therapy Correlate With Increased Use Of Vasopressors During Posterior Lumbar Interbody Fusion Versus Those Not Receiving Angiotensin-Converting Enzyme Inhibitor Therapy: A Retrospective Study, Joshua Ross

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to evaluate if patients who took Angiotensin Converting Enzyme (ACE) inhibitors the morning of surgery for Posterior Lumbar Interbody Fusion (PLIF) required more treatment for intraoperative hypotension.

Introduction: PLIF is a surgical procedure used to correct spinal disorders that include compression, instability, pathological lesions, deformities, and pain. PLIF is completed utilizing the prone position for optimal access to the lumbar spine. Complications associated with prone position have included Post-Operative Vision Loss (POVL), compression of abdominal vessels, and head and neck venous compression resulting in neurologic injury. Currently, there are no set recommendations …

The Association Between Intraoperative Single-Dose Dexamethasone And Postoperative Pain In Patients Undergoing Laparoscopic Cholecystectomy, Sara Hatfield

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to examine the association between a single dose of intraoperative dexamethasone in patients undergoing outpatient laparoscopic cholecystectomy surgery and postoperative pain scores and the amount of postoperative opioid administration.

Introduction: Pain is one of the most common complaints in the postoperative period and the days following a patient’s procedure. While opioids are commonly used for treating intraoperative and postoperative pain, anesthesia providers can lessen their use by adopting multimodal analgesia techniques. This study attempts to fill the research gap related to the association of a single dose of intravenous dexamethasone intraoperatively …

The Influence On Morbidity And Mortality When Blood Products Are Transfused Using Conventional Coagulation Tests Versus Teg Or Rotem In Trauma Patients Perioperatively, Teresa Diana Kelley

Theses, Dissertations and Capstones

Abstract: Coagulopathy in trauma patients occurs due to tissue injury, hemodilution (dilution of hematocrit and clotting factors), infusion of hypo-coagulable blood products (e.g., packed red blood cells), acidosis, hypothermia, continued blood loss, and depletion of clotting factors. The onset of coagulopathy begins with the initial tissue injury and evolves rapidly. Many factors need consideration when determining resuscitative treatment for the trauma victim. These factors include the amount of time for extraction from the field, transport time to a trauma center, associated weather, and treatment provided in route. This study compared two clinical laboratory pathways (Conventional Coagulation test and Rotational Thromboelastometry …

Effects Of Ondansetron 4 Milligrams Compared With Ondansetron 8 Milligrams On The Incidence Of Post-Operative Nausea And Vomiting In Patients With Body Mass Index Greater Than 30kg/M2 Undergoing Mastectomy, Diego Alejandro Arroyo

Theses, Dissertations and Capstones

Introduction: Post-Operative Nausea and Vomiting (PONV) is a recurrent and frequent issue for the patient, the anesthesia team, and Post Anesthesia Care Unit (PACU) team. Both pharmacologic and non-pharmacologic recommended modalities have been utilized for both the prevention and treatment of PONV in the surgical-anesthesia setting. The 5-HT3-receptor antagonist ondansetron is one of the many known pharmacological modalities commonly utilized by anesthesia providers in preventing PONV.

Methodology: The design used for this research was a quantitative, retrospective case control study that evaluated existing data enclosed in the Electronic Medical Records (EMR) from Charleston Area Medical Center (CAMC), which is …

Inhalation Anesthesia Vs. Total Intravenous Anesthesia For Ambulatory Dental Surgery In Children, Kristin D. Neal

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to compare inhalation anesthesia with sevoflurane versus Total Intra Venous Anesthesia (TIVA) with propofol infusion as it relates to the quality of recovery including postoperative pain, Post Operative Nausea and Vomiting (PONV), and Post Anesthesia Care Unit (PACU) Length Of Stay (LOS) in pediatric patients undergoing ambulatory dental surgery. Introduction: Pediatric dental procedures are increasingly performed in an outpatient setting under general anesthesia due to inadequate cooperation, circumstantial anxiety, and other behavioral and health issues. Commonly used inhalation anesthetics, such as sevoflurane, can induce hyperalgesia in children. While sevoflurane increases the risk PONV, …

Secondhand Smoke Exposure As A Risk Factor For Perioperative Airway Complications In Pediatric Outpatient Procedures, Ashlee Denise Loudin

Theses, Dissertations and Capstones

Abstract: The purpose of this study is to assess the risk of perioperative airway complications, analyze extubation times, and PACU Length Of Stay (LOS), and their association with secondhand smoke exposure in pediatric populations receiving outpatient procedures that require general anesthesia.

Introduction: Tobacco Smoke Exposure (TSE), is well documented to cause physiologic changes in lung tissue that are associated with decreased lung function, increased risk of lower and upper respiratory tract illness, exacerbation of asthma or increased risk of asthma, increased prevalence of non-allergic bronchial hyperresponsiveness, sudden infant death syndrome, and a host of other respiratory complications in adult and …

Intraoperative Hyperglycemia In Adult Patients Undergoing An Emergency Craniotomy Following A Traumatic Brain Injury As A Predictor Of Postoperative Outcomes And Mortality, Sara Lynn Hoover

Theses, Dissertations and Capstones

Abstract: The purpose of this study was to determine if there was an association between intraoperative blood glucose ≥150 mg/dl in patients undergoing an emergency craniotomy and Intensive Care Unit (ICU) Length of Stay (LOS), hospital LOS and mortality.

Introduction: Traumatic Brain Injuries (TBI)’s are associated with increased morbidity and mortality. The stress response by the body may cause an increase in blood glucose levels which can cause secondary brain injury. When a patient undergoes an emergency craniotomy following a TBI the increased stress on the body can cause an even higher blood glucose. There is no consensus in …

Factors That Motivate Certified Registered Nurse Anesthetists To Practice Independently In The Appalachian Region, Michael Lee Frame Jr.

Theses, Dissertations and Capstones

Introduction: Independent Certified Registered Nurse Anesthetists (CRNAs) provide anesthesia services without the supervision or medical direction of anesthesiologists in healthcare facilities throughout the United States. The present literature is limited concerning the factors that motivate CRNAs to choose employment in rural independent practice.

Research Hypothesis: In a sample of CRNAs who practice independently in one of the 13 states of the Appalachian region there will be no differences between the CRNAs from Appalachian and Non-Appalachian counties in their responses to the motivation factors of achievement, recognition, responsibility, advancement, work itself, salary, working conditions, company and administrative policies, supervision, and …

Risk Factors For Ventilator-Associated Pneumonia In The Adult Trauma Patient: A Retrospective Case-Control Study From A Level I Trauma Center, Summer L. Chapman

Theses, Dissertations and Capstones

Introduction: Ventilator-Associated Pneumonia (VAP) continues to be a common complication among the adult trauma population. Little advancements have been made to decrease the incidence, suggesting further research is needed to establish modifiable risk factors. The purpose of this study was to test for an associated link between prehospital intubation and the development of VAP in the adult trauma patient.

Methodology: A retrospective, case-control study design was utilized. The sample included 494 adult trauma patients who required endotracheal intubation and mechanical ventilation for a minimum of 24 hours. All patients presented as a priority one or two trauma to the Charleston …

Predictors Of Postoperative Respiratory Failure In Patients Receiving Anesthesia, Marty Henley

Theses, Dissertations and Capstones

Introduction: Postoperative Respiratory failure has been identified as a prevention quality indicator by The Agency for Health Research and Quality (AHRQ). Postoperative Respiratory Failure is associated with increased length of stay, increased costs and increased morbidity and mortality. Unfortunately, current research is limited regarding scoring methods which are predictive for postoperative respiratory failure. This retrospective case control study was conducted to determine if the various tools of evaluation of risk currently available and to determine if any are predictive of the risk of developing postoperative respiratory failure.

Methodology: The design of this research was a retrospective case control study conducted …