University of Iowa

Cervical spine instability

Dr. Hindman and colleagues are studying the effect of the force of the laryngoscope blade on patients with cervical spine instability. The goal of this research is to develop new, c-spine injury-specific intubation protocols that minimize the risk of neurologic damage in patients with high risk forms of cervical instability.

Reference:

  1. Hindman BJ, Santoni BG, Puttlitz CM, From RP, Todd MM. Intubation biomechanics: laryngoscope force and cervical spine motion during intubation with Macintosh and Airtraq laryngoscopes. Anesthesiology 2014; 121(2):260-71

Chronic pain after thoracotomy

Chronic pain after thoracotomy continues to be a significant problem despite advancing perioperative care. This systematic review suggests that chronic pain rates after thoracotomy surgery are at approximately 50% and have been largely stable from the 1990s to the present. The severity of this pain is not consistently reported in most studies. Progress to reduce chronic pain after thoracotomy has been limited.

Reference:

  1. Bayman EO, Brennan TJ. Incidence and severity of chronic pain at 3 and 6 months after thoracotomy: meta-analysis. J Pain 2014; 15(9):887-97

Instruments for evaluating anesthesiologists’ performance in the operating room

Drs. Dexter, Hindman and colleagues are studying how anesthesia residents and nurse anesthetists evaluate faculty in order to better measure clinical performance and supervision of individual anesthesiologists.

References:

  1. Dexter F, Masursky D, Hindman BJ. Reliability and validity of the anesthesiologist supervision instrument when certified registered nurse anesthetists provide scores. Anesth Analg 2015; 120(1):214-9
  2. Dexter F, Hindman BJ. Quality of supervision as an independent contributor to an anesthesiologist’s individual clinical value. Anesth Analg 2015; 121:507-13

Prevention of intraoperative bacterial transmission to reduce the incidence of postoperative surgical infections

Drs. Loftus, Reddy and colleagues have identified patterns of transmission of bacteria in the operating room and have identified improved hand hygiene opportunities for anesthesiologists. This research will be used to guide clinical interventions that are expected to reduce intraoperative bacterial transmission and postoperative surgical infections.

References:

  1. Loftus RW, Koff MD, Brown JR, Patel HM, Jensen JT, Reddy S, Ruoff KL, Heard SO, Yeager MP, Dodds TM. The epidemiology of Staphylococcus aureus transmission in the anesthesia work area. Anesth Analg 2015; 120(4):807-18
  2. Loftus RW, Brown JR, Patel HM, Koff MD, Jensen JT, Reddy S, Ruoff Kl, Heard SO, Dodds TM, Beach ML, Yeager MP. Transmission dynamics of gram-negative bacterial pathogens in the anesthesia work area. Anesth Analg 2015; 120(4):819-26
  3. Loftus RW, Koff MD, Brown JR, Patel HM, Jensen JT, Reddy S, Ruoff KL, Heard SO, Yeager MP, Dodds TM. The dynamics of Enterococcus transmission from bacterial reservoirs commonly encountered by anesthesia providers. Anesth Analg 2015; 120(4):827-36
  4. Fernandez PG, Loftus RW, Dodds TM, Koff MD, Reddy S, Heard SO, Beach Ml, Yeager MP, Brown JR. Hand hygiene knowledge and perceptions among anesthesia providers. Anesth Analg 2015; 120(4):837-43

Ultrasound to improve success in radial artery cannulation

Although adult radial artery cannulation is a common invasive procedure in the operating room, intensive care unit and emergency department, successful radial artery cannulation can be technically challenging. The use of ultrasound by anesthetic trainees was more likely to succeed on the first attempt under ultrasound guidance compared with Doppler and palpation techniques, although there was no difference 5 min after the first attempt commenced.

Reference:

  1. Ueda K, Bayman EO, Johnson C, Odum NJ, Lee JJ. A randomised controlled trial of radial artery cannulation guided by Doppler vs palpation vs ultrasound. Anaesthesia 2015; 70(9):1039-44