Penn State Hershey Anesthesiology News
Chairman’s Corner
Spring/Summer
2014
Berend Mets, MB, ChB, PhD, FRCA, FFA(SA)
Eric A. Walker Professor and Chair of Anesthesiology
Penn State
Hershey Medical
Center
Inside this
Issue
Cardiothoracic
Division Update
2-3
Welcome &
General
Announcements
5
PARRC
6
Outreach Mission
with HVO
7
2013 Publications 8-10
Regional
Anesthesia
Workshop
11
we thank for many years of service in this
role. Dr. Kai Singbartl has been appointed as
the Anesthesia Co-Director for the Heart and
Vascular Institute. We are very pleased to announce that Mr. Brian Vells has been appointProfessor Berend Mets
ed as Assistant Chief Nurse Anesthetist in the
Eric A. Walker Professor and Chair
department recognizing the significant numThis issue of Penn State Anesthesiology News
bers of new CRNAs who have joined our dehighlights our Cardiothoracic Anesthesiology
partment.
Division, some of our International Outreach
involvement in the Dominican Republic and A number of initiatives have seen developEthiopia, our Publications for 2013, and atment over the last period. The Institutional
tendance at the 9th Pennsylvania Annual Resi- Opioid Use and Monitoring Task Force
dency Research Conference.
chaired by Drs. Gordin and Adhikary will
First and foremost, we must thank the outgoing Editor of Anesthesiology News, Dr.
Mary Beth McAlevy for her service in editing
this bulletin together with the very capable
associate editor, Kelly Shaak. Mary Beth has
served in this role for the last 4 years, and
we’ve seen significant improvement in its
content and quality over this period. We welcome Dr. Malina Varner as the new Editor
for the next edition in the Fall.
I would like to congratulate Drs. Hurwitz,
Menocci, and Read on their promotion to Assistant Professor of Anesthesiology and thank
Drs. Janicki and Bezinover for taking on new
roles in the department. Dr. Janicki will serve
as the Director for our Anesthesia Preoperative Evaluation Clinic (APEC), and Dr. Bezinover will serve as Director of Liver Transplantation taking over for Dr. Janicki whom
soon provide a report to the institution, while
the Clinical Alarms System Task Force,
chaired by Dr. JT Swick, will report on
rationalizing of these alarms for the department to optimize their utility.
This year an Ultrasound Committee was established, with Dr. Dmitri Guvakov as Chair,
to develop a Resident and Faculty educational
program in Periop Ultrasound and TEE. There
are plans to purchase a TEE simulator both for
education as well as for OSCE evaluation of
Resident expertise in this arena.
In order to enhance patient safety in Medication Administration, Dr. Kai Singbartl in his
role as Medicine Safety Physician Leader is
championing the use of prelabelled, prefilled
anesthetic and anesthetic adjuvant medication
administration in our ORs.
(continued on pg. 4)
Page 2
Spring/Summer 2014
Cardiothoracic Division Update
Srikantha Rao, MBBS, MS
Associate Professor of Anesthesiology
The Division of Cardiothoracic and Vascular Anesthesia at the Penn State Hershey Medical Center provides anesthesia
and perioperative care for approximately
1200 adult patients undergoing cardiothoracic and vascular
surgical procedures each year. As a tertiary care hospital
and referral center, we care for a large number of adult patients undergoing coronary revascularizations, valve repair
and replacement surgery, as well as pediatric patients for
repair of congenital heart disease. In addition we are involved in the perioperative management of heart failure
patients being implanted with left ventricular assist devices
(LVADs) or undergoing orthotopic heart transplants
(OHTs). About 40 LVADs and 16 OHTs are completed
each year.
of Anesthesiology; with some recertified by the ABA after
pursuing the MOCA program. All members of the cardiac
anesthesia division are competent in transesophageal echocardiography (TEE), and all are certified by the National
Board of Echocardiography. Three of the division’s faculty members are also board certified in intensive care medicine. These physicians (Drs. Kane High, Anita Malhotra
and Octavio Falcucci) rotate through both the SAICU and
HVICU (i.e. general surgical and cardiovascular intensive
care units). In the HVICU they attend to patients after surgical procedures as well as those with severe respiratory or
cardiac failure placed on extracorporeal membrane oxygenation (ECMO).
Clinical areas of focus of the cardiac anesthesia faculty
include postoperative pain management, TEE, major vascular, thoracic anesthesia, and pediatric anesthesia and critWe are happy to announce that this year the Division
worked alongside Penn State Heart and Vascular Institute ical care. Members of the cardiac anesthesia division are
actively involved in research in the operating room and
surgeons and cardiologists to start performing percutaneICU. There are a number of clinical studies in several areous aortic valve replacements.
as. Areas of pursuit in research include coagulation and
The Division works with thoracic surgeons to complete
blood management, hemodynamic monitoring, cardiopulmore than 200 general thoracic cases annually. Anesthesia
monary bypass management, mechanical circulation, and
services are also provided for interventional pulmonary and
health evaluation and data science. Our residents particielectrophysiology procedures and other OR and non-OR
pate in studies in the cardiac division, and scholarship is a
cardiothoracic and major vascular procedures including
required part of every fellowship year. Our fellows preabdominal and thoracic aortic stent graft repair.
sented their research at the SCA Annual Meetings in 2012,
Our anesthesiologists also manage the anesthetics for many 2013 and again this year.
critically ill patients undergoing a variety of perioperative
The anesthetizing sites include the operating rooms and
procedures whether it is for a colonoscopy in a patient with
hybrid OR suites within the Hershey Medical Center and
a non-pulsatile LVAD or a radical nephrectomy in a patient
Children’s Hospital. One of the faculty members, Dr. Dawith severe pulmonary hypertension.
vid Fehr, provides care for patients at the Children’s Hospital where pediatric cardiac and thoracic cases are perClinical
Anesthetic care for patients undergoing cardiac, thoracic or formed along with providing anesthesia for pediatric cardivascular surgery is provided by one of six members of the ac catheterizations.
faculty. Not only are all the faculty members fellowship
trained, they are all board certified by the American Board
Advanced monitors, including pulmonary artery catheters,
cerebral oximetry and TEE, are used to monitor patients in
Penn State Anesthesiology News
these operating rooms. TEE is performed for all the cardiac surgeries. We are elated as we make progress towards
acquiring a brand new 3D TEE machine for use in patients
undergoing complex cardiac surgery in the operating
room. The studies performed and interpreted by the anesthesiologists will be digitally archived in the upcoming
year.
Education & Research
The cardiac anesthesia division educates and trains residents in cardiac anesthesiology. Between their PGY1 year
and CA-2 year, all residents complete two one-month rotations in cardiac anesthesiology; and many choose to spend
a month in their senior year in cardiac anesthesia with an
additional month spent learning ultrasound-guided techniques including TEE. Three residents rotate through the
service monthly. Medical students may rotate in the cardiac operating rooms.
Our cardiac anesthesia fellowship program is accredited
by the ACGME. Our fellow’s educational curriculum is
designed to provide them dedicated academic time for self
-study and case conferences along with increasing responsibility in the care of patients, such that they finish their
training with skills and confidence as consultants in cardiac anesthesiology and meet requirements for board certification in advanced perioperative TEE. Linda
Sanger, BS is the Program Coordinator of the Adult Cardiothoracic Fellowship program and provides invaluable support during recruitment and efficient
administration of the program during the
year. Given all the changes in the requirements
mandated by the ACGME and RRC, her many
contributions and oversight help insure that the
program is compliant with the numerous regulatory requirements.
Administration
Members of the cardiac anesthesia division are
actively involved in several departmental and hospital committees in leadership roles.
Dr. David Fehr has been at the helm of the Anes-
Page 3
thesia Information Management System since its inception
and worked with hospital IT to customize the Cerner component that documents the Anesthesia Record as an integral part of the electronic medical record (EMR).
Drs. Octavio Falcucci and Kane High are members of the
University Faculty Senate.
Dr. Srikantha Rao was appointed as the Director of the
Cardiac Anesthesia Division last year and the Director of
the Cardiac Anesthesia Fellowship Program. He was the
physician lead in coordinating the department’s effort to
partner with the AQI to automate the AIMS data submission.
Several members of the cardiac anesthesia division actively participate in several Hospital Committees. Drs. High
and Rao represent the department in the Blood Utilization
Committee. Dr. High chairs the Hospital Sedation Committee where he has played a major role in ensuring safe
practices of sedation by non-anesthesiologists.
Dr. Dmitri Guvakov will coordinate the education of anesthesia faculty members interested in learning perioperative
TEE in patients undergoing non-cardiac surgery.
Dr. Anita Malhotra is the Associate Director of the Critical
Care Fellowship.
Page 4
Spring/Summer 2014
Outreach Mission to Puerto Plata, Dominican Republic
Bunty Shah, MD
Resident in Anesthesiology
As a senior resident, I recently had the opportunity to accompany Drs.
Grap and Vuong on a one-week medical mission trip to Puerto Plata, Dominican Republic, with an organization called Casa De Luz, based in Oakton, Virginia. We were able to provide general anesthesia for 38 strabismus repair
surgeries in patients ranging from 9 months to 42 years in age. The strabismus repairs will help to improve both visual acuity and quality of life issues
in terms of opportunities for education and job seeking in each patient's future. Additionally, our anesthesia team administered sedation for approximately 40 cataract removal cases. All of the surgeries and medical care were
provided free of cost through volunteers and both the Casa de Luz and Island
Pictured from Left: Drs. Bunty Shah, Julie
Vuong and Shannon Grap
Impact Organizations. Our United States based group consisted of 23 volunteers including 4 pediatric ophthalmologist
surgeons, 3 adult ophthalmologists, nursing staff, support staff, and our HMC anesthesiology team. We also had several
local Dominican volunteers assist us with patient clinic visits and translation.
Through the experience, I learned how to administer anesthesia in a new environment with unique challenges,
including fewer resources and equipment. We were able to bring the newly acquired departmental Glostavent portable
ventilator with us on the trip, and we used it to provide safe general anesthesia without the need for electricity. I also
had the opportunity to administer halothane anesthesia during the week in our second operating room setup. It was a
truly humbling and gratifying experience, and I am proud to have contributed with Drs. Grap and Vuong on behalf of
our department.
Chairman’s Corner (Continued from Page 1)
July 1 was the start date for an individual ASCOM phone system, with telephones issued to each Anesthesiologist, Resident and Nurse Anesthetist to ensure expeditious direct voice-to-voice communication during clinical practice in our
operating rooms.
Further, this coming year we are re-establishing the Joseph Priestley Resident Scholarship Program to encourage aspirant Resident Academic Anesthesiologists to develop research expertise during their residency training.
Additionally, in line with our significant International Anesthesia involvement as a department (Pgs. 4, 7), we are planning to formalize Education in International Anesthesia for our residents providing them the opportunity in their final
years to visit one of a number of Anesthesia Sites around the world (Ethiopia, China, Dominican Republic and Ecuador). Dr. Julie Vuong will be coordinating this program.
Finally, it remains for me to thank our Faculty, Residents, Nurse Anesthetists and Administrative, Clinical Improvement
and Research staff for all they do for the department and our patients.
Penn State Anesthesiology News
Page 5
Please Welcome Our New CRNAs and Staff
Justin
Howe, CRNA
Judy
Kimemia, CRNA
Delali
Mensah, CRNA
Roman
Picado, CRNA
Accomplishments & Recognition
Dr. Dalal was invited to join the NIG Pain Consortium project group as an expert consultant.
Dr. Eckert is 1 of 15 out of 75 Program Directors selected to serve on the ABA Basic Exam
Standard Setting Panel for 2014.
Dr. Singbartl was elected as a member of the Association of University Anesthesiologists.
Dr. Sinz was elected as a Fellow of the American College of Critical Care Medicine, and recognized at the 25th Annual Convocation of Fellows at the Society of Critical Care Medicine
Awards and Grants Presentation.
Brian Vells was recently promoted to Assistant Chief CRNA!
Page 6
Spring/Summer 2014
Congratulations PARRC & Resident Research Day Participants!
Pennsylvania Annual Resident Research Conference
Saturday, May 10, 2014
University of Pittsburgh Medical Center
Flower Austin: “A Novel Use of the Veress Surgical Insufflation Needle for TAP Block in Obese Patients”
Flower Austin: “Effects of Jazz on Post-operative Pain
and Stress in Patients Undergoing Elective Hysterectomy”
Matthew Bell: “During an Orthotropic Liver Transplant,
Cardiac Arrest due to Hypercoagulability in End Stage
Liver Disease”
Jason Conway: “Epidural Blood Patch for Postdural
Puncture Headache in a Pediatric Patient with Idiopathic
Intracranial Hypertension and a Ventriculoperitoneal
Shunt”
James Lamberg: “Takostsubo Cardiomyopathy Prior to
Induction of General Anesthesia”
Resident & Fellow Research Day
Friday, May 23, 2014
Penn State Hershey Medical Center
Flower Austin: “Effects of Jazz on Post-operative Pain
and Stress in Patients Undergoing Elective Hysterectomy”
Sally Baker: “MPI is a Reliable Screening Tool for Cardiac Evaluation of Liver Transplant Candidate”
Jason Conway: “Epidural Blood Patch for Post-Dural
Puncture Headache in a Pediatric Patient with Idiopathic
Intracranial Hypertension and a Ventriculoperitoneal
Shunt”
James Lamberg: “Serotonin Syndrome and Chronic Pain
Polypharmacy”
Brandon Rein: “The Prospective Observational Analysis
of Ambient Operating Room Noise during Induction and
Emergence - A Quality Improvement Study”
Manish Shah: “Fluoroscopically-Guided Epidural Blood
*1st Place Winner for Original Research Presentation* Patch for Spontaneous Intracranial Hypotension”
Saifeldin Mahmoud: “Effect of Acute Oxycodone Exposure on the Opioid-mediated Modulation of Ca2+ Channels Daniel Tapia: “Pharmacokinetic Simulation Software in
Anesthesia Residency Education”
and Signaling Pathways in ‘humanized’ Mouse Nociceptive Sensory Neurons Expressing the mu Opioid rReceptor
Polymorphism A118G”
*3rd Place Winner for Case Report Presentation*
Saifeldin Mahmoud: “Unexpected Increase in Arterial to
End-tidal CO2 Gradient in a Child Undergoing Embolization of MAPCAs”
Alexandria Nickless: “Preventing the Obturator Nerve
Reflex: A Comparison of Ultrasound Guided Nerve
Block and Classic Anatomic Technique”
Brandon Rein: “The Prospective Observational Analysis of Ambient Operating Room Noise during Induction and Emergence - A Quality Improvement Study”
Adam Schwarz: “Presumed Venous Air Embolism
During Cesarean Section”
*3rd Place Winner for Case Report Poster*
Manish Shah: “Fluoroscopically-Guided Epidural
Blood Patch for Spontaneous Intracranial Hypotension”
Bryan Tokarchic: “Unplanned Re-intubation in the
Operating Room and Post-anesthesia Care Unit”
Penn State Anesthesiology News
Page 7
Outreach Mission to Addis Abab, Ethiopia with Health Volunteers Overseas (HVO)
Alexandria Nickless, DO
Resident in Anesthesiology
I traveled to Addis Ababa, Ethiopia with Health Volunteers Overseas (HVO) in January, 2014. Prior to this experience, I had done some medical volunteering in Mexico
and the US but not for as long as I was scheduled to be
abroad this time. Thankfully, the HVO is well organized
and had a large amount of information regarding the responsibilities and previous volunteer experiences so I had
an idea of what to expect before arriving in Africa for the
first time.
the group and was
amazed to see how
interested they
were in learning
about their trade
and life in the US.
It wasn’t all work, though. I traveled to Debre Zeit which
is a lake town 40 km outside of the city. After an overwhelming first week, it was a treat to be surrounded by
My first day at Black Lion hospital was very overwhelm- this beautiful setting. I met many travelers and locals and
ing. I had never seen facilities as run down and dirty as
hiked Mount Zuqualla which has amazing views and a
those at this institution. It was only after I realized that
church at the top. I also hiked in the Entoto Mountains
this was the tertiary care facility for the whole country and where many of the famous Ethiopian runners have trained.
those surrounding it that I understood what my trip would I was also fortunate to be there for the celebration of
entail. I was responsible for teaching students in the mas- Temkat, or the Epiphany. The predominant religion in
ter’s anesthesia program. In Ethiopia, anesthetists go to
Ethiopia is Orthodox Catholic, so they take their religious
bachelor’s school for 2 years after high school and then
celebrations very seriously. There was a beautiful procespractice independently in the hospital which sponsored
sion with singing, dancing and incredible food. It was an
their education. Further training is obtained when that
amazing experience.
same student is sponsored by another hospital and many
Thank you to Drs. Mets, Eckert, Barbieri and Jennifer
students pursue this training for the financial benefits the
Swierczynski and Doug McDonald for allowing me to pardegree provides. It was a wonderful experience working
take in this trip. I am very grateful for the support of the
with these students in situations I could never have been in
department and for the master’s students who made my
as a resident in the US. Not only was I shifting gears in to time in Addis memorable.
the attending role, I was working with
unfamiliar medications and unreliable
equipment and all in a foreign language!
I cannot begin to describe how invaluable this experience was for my education. It taught me a lot about myself as a
physician and helped me to be a more
independent and thoughtful practitioner.
The students were so welcoming and
saw to it that I was taken care of and got
the full Ethiopian experience. I was responsible for giving weekly lectures to
Page 8
Spring/Summer 2014
Faculty Publication Highlight
“Vascular Access in Resuscitation - Is There a Role for the Intraosseous Route?”
Jonathan Anson, MD
Assistant Professor of Anesthesiology
Establishing vascular access is a critical component of resuscitation during a cardiac arrest. Intraosseous vascular (IO) access is a time-tested procedure which has been incorporated
into the 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation. Intravenous access is often difficult to achieve in shock patients, and central line placement can be
time consuming. Intraosseous vascular access, however, can be achieved quickly with minimal
disruption of chest compressions. Newer insertion devices are easy to use, making the IO route an
attractive alternative for venous access during a resuscitation event. A systematic review and meta-analysis was conducted to examine the safety and efficacy of IO access in the resuscitation of
critically ill patients. Based on the findings, it is critical that anesthesiologists, who are often at the forefront of patient
resuscitation, understand how to properly use this potentially life-saving procedure.
Penn State Hershey Anesthesiology Publications for 2013
Case Reports:
Lamberg JJ, Farbaniec M, Kuperman EF. Massive Paraesophageal Hernia Mimicking Pulmonary Embolus. Journal of General Internal Medicine. 2013 doi: 10.1007/s11606-013-2353-0. PMID 23404200.
Case Report.
Janicki PK, Vaida S, Al-Mondhiry HA. Targeted Next-Generation Resequencing of F5 Gene Identifies
Novel Multiple Variants pattern in Severe Hereditary Factor V Deficiency. Case Reports in Genetics,
Vol. 2013, Article ID 941684, pgs. 1-7.
Ramamoorthy S, Patel S, Bradburn E, Kadry Z, Uemura T, Janicki PK, Shah RA, Bezinover D. Use of
Methylene Blue for Treatment of Severe Sepsis in an Immunosuppressed Patient after Liver Transplantation. Case Report in Transplantation, Vol. 2013, Article ID 203791, 4 pages
Lamberg JJ, Answine JF. A Surgeon’s Assessment of Inadequate Neuromuscular Antagonism in a Case of Prolonged Neuromuscular Blockade. Case Report. Journal of Anaesthesiology Clinical Pharmacology, April-June 2013; 29(2):244-247.
Lamberg JJ, Malhotra AK, McAlevy ME. Intracardiac Epinephrine Injection during Open Thoracotomy and Circulatory Arrest.
J Anesth Clin Res, 2013, 4:7, Case Report http://dx.doi.org/10.4172/2155-6148.1000341.
Vaida S, Al-Mondhiry H, Bezinover D, Welsh L, Ural S, Janicki P. Peripartum Anesthetic Management of a Parturient with Inherited Factor V Deficiency. [Case Report] Anesthesia and Analgesia, December 15, 2013, Volume 1, No. 6, pp. 86-88.
Chapters:
Sathishkumar S, Uemura T. Postoperative Care of Living Donor for Liver Transplant. G. Wagener (ed.), Liver Anesthesiology
and Critical Care Medicine, DOI 10.1007/978-1-4614-5167-9.36, Springer Science+Business Media, New York, 2012
Janicki PK. Pharmacogenomics of Pain Management. T.R. Deer et al. (eds.), Comprehensive Treatment of Chronic Pain by Medical, Interventional, and Behavioral Approaches, DOI 10.1007/978-1-4614-1560-2_2, American Academy of Pain Medicine July
2013; pp. 23-33. Penn State Anesthesiology News
Page 9
Journal Articles:
Velayutham PK, Adhikary SD, Babu SK, Vedantam R, Korula G, Ramachandran A. Oxidative Stress-Associated Hypertension in
Surgically Induced Brain Injury Patients: Effects of β-Blocker and Angiotensin-Converting Enzyme Inhibitor. Journal of Surgical
Research, 179 (2013), 125-131.
Uhlenkott MC, Sathishkumar S, Murray WB, McQuillan PM, Adhikary SD. Real-time Multimodal Axillary Vein Imaging Enhances the Safety and Efficacy of Axillary Vein Catheterization in Neurosurgical Intensive Care Patients. J Neurosurg Anesthesiol,
January 2013, 25(1), 62-65.
Lamberg JJ, Cherian VT. Neuraxial Anesthesia in CADASIL Syndrome. Journal of Neurosurgical Anesthesiology 2013,
ANA200616.
Malhotra A. Con: Etomidate – The Ideal Induction Agent for a Cardiac Anesthetic? Journal of Cardiothoracic and Vascular Anesthesia, Pro and Con, Vol. 27, No. 1 (February), 2013; pp. 178-179.
Budde AO, Mets B. Pro: Etomidate is the Ideal Induction Agent for a Cardiac Anesthetic. Journal of Cardiothoracic and Vascular
Anesthesia, Pro and Con, Vol. 27, No. 1 (February), 2013; pp. 180-183.
Mets B. Management of Hypotension Associated with Angiotensin-Axis Blockade and General Anesthesia Administration. Journal
of Cardiothoracic and Vascular Anesthesia, Review Article, Vol. 27, No. 1 (February), 2013; pp. 156-167.
Chacko AG, Thomas SG, Babu KS, Daniel RT, Chacko G, Prahu K, Cherian V, Korula G. Awake craniotomy and electrophysiological mapping for eloquent area tumors. Clinical Neurology and Neurosurgery 2013; 115: 329-334.
Dalal PG, Doheny KK, Klick L, Britcher S, Rebstock S, Bezinover D, Palmer C, Berlin C, Postula M, Kong L, Janicki PK. Analysis of acute pain scores and skin conductance measurements in infants. Early Human Development 89 (2013), 153-158.
Bezinover D, Kadry Z, Uemura T, Sharghi M, Mastro AM, Sosnoski DM, Dalal P, Janicki PK. Association Between Plasma Cyclic Guanosine Monophosphate Levels and Hemodynamic Instability During Liver Transplantation. Liver Transplantation 19: 191198, 2013.
Gaitini LA, Yanovski B, Mustafa S, Hagberg CA, Charco Mora P, Vaida SJ. A Feasibility Study Using the VivaSight Single Lumen™ to Intubate the Trachea Through the Fastrach Laryngeal Mask Airway: A Preliminary Report of 50 Cases. Anesthesia &
Analgesia, March 2013, 116:3, pp. 604-608.
Murinson BB, Gordin V, Flynn S, Driver LC, Gallagher RM, Grabois M. Recommendations for a New Curriculum in Pain Medicine for Medical Students: Toward a Career Distinguished by Competence and Compassion. Pain Medicine 2013; 14: 345-350.
Laufenberg LJ, Weller GE, Lang CH, Ruiz-Velasco V. Nociceptin receptor signaling in sympathetic neurons from septic rats. J
Surg Res. 2013 Apr 11. doi:pii: S0022-4804(13)00294-1. 10.1016/j.jss.2013.03.076. [Epub ahead of print]
Yamauchi K, Kim JS, Stone AJ, Ruiz-Velasco V, Kaufman MP. Endoperoxide 4 receptors play a role in evoking the exercise pressor reflex in rats with simulated peripheral artery disease. J Physiol. 2013 Apr 8. [Epub ahead of print] PMID: 23568893
Stone AJ, Kim JS, Yamauchi K, Ruiz-Velasco V, Kaufman MP. Attenuation of autonomic reflexes by A803467 may not be solely
caused by blockade of NaV 1.8 channels. Neurosci Lett. 2013 Mar 21. doi:pii: S0304-3940(13)00220-6. 10.1016/
j.neulet.2013.03.015. [Epub ahead of print]
Janicki PK, Kadry Z. Research highlights from the latest articles in pharmacogenomics of tacrolimus and organ transplantation.
Pharmacogenomics, 2013 May;14(7):719-21. doi: 10.2217/PGS.13.67. PubMed PMID: 23651019.
Budde AO, Desciak M, Reddy V, Falcucci OA, Vaida SJ, Pott LM. The prediction of difficult intubation in obese patients using
mirror indirect laryngoscopy: A prospective pilot study. Journal of Anaesthesiology Clinical Pharmacology, April 2013; 29(2):183186.
Postula M, Janicki PK, Rosiak M, Kaplon-Cieslicka A, Trzepla E, Filipiak KJ, Kosior DA, Czlonkowski A, Opolski G. New single
nucleotide polymorphisms associated with differences in platelets reactivity in patients with type 2 diabetes treated with acetylsalicylic acid: genome-wide association approach and pooled DNA strategy. J Thromb Thrombolysis, 04 Oct 2012; [epub ahead of
print – not in pubmed when list was closed]
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Spring/Summer 2014
Penn State Hershey Anesthesiology Publications for 2013 (continued)
Postula M, Janicki PK, Rosiak M, Przybylkowski A, Kaplon-Cieslicka A, Grygorowicz T, Trzepla E, Filipiak KJ, Czlonkowski A,
Opolski G. Association of plasma concentrations of salicylic acid and high on ASA platelet reactivity in type 2 diabetes patients.
Cardiology Journal, 2013, 20(2): 170-177.
Postula M, Janicki PK, Rosiak M, Kaplon-Cieslicka A, Kondracka A, Trzepla E, Filipiak KJ, Kosior DA, Czlonkowski A, Opolski
G. Effect of common single-nucleotide polymorphisms in acetylsalicylic acid metabolic pathway genes on platelet reactivity in patients with diabetes. Med Sci Monit. 2013 May 27; 19:394-408. doi: 10.12659/MSM.883922
Muller MD, Mast JL, Cui J, Heffernan MJ, McQuillan PM, Sinoway, LI. Tactile stimulation of the oropharynx elicits sympathoexcitation in conscious humans. J Appl Physiol 115: 71-77, April 2013.
Rosiak M, Postula M, Kaplon-Cieslicka A, Kondracka A, Trzepla E, Zaremba M, Filipiak K, Kosior D, Czlonkowski A, Opolski G,
Janicki PK. Lack of effect of common single nucleotide polymorphisms in leukotriene pathway genes on platelet reactivity in patients with diabetes. Mol Med Rep. 2013 Jul 3. Doi: 10.3892/mmr.2013.1567 [epub ahead of print]
Jenkins DM, Murray WB, Kennett MJ, Hughes EL, Werner ER. The Effects of Continuous Application of the TASER X26 Waveform on Sus scrofa. J Forensic Sci, May 2013, Vol. 58, No. 3, pgs. 684-692, doi. 10.1111/1556y-4029.12070.
Weissman C, Murray WB. It’s Not Just Another Room… Anesthesia and Analgesia, August 2013, Volume 117, No. 2, pgs. 287289, doi. 10.1213/ANE.0b013e3182991c0e
Janicki PK, Bezinover D, Postula M, Thompson RS, Acharya J, Acharya V, McNew C, Bowman JD, Kurkowska-Jastrzebska I,
Mirowska-Guzel D. Increased Occurrence of Valproic Acid-Induced Hyperammonemia in Carriers of T1405 Polymorphism in Carbamoyl Phosphate Synthetase 1 Gene. ISRN Neurology, Vol. 2013 (2013), Article ID 261497, 4 pp.
Zhu Z, Hu Z, Jiang Y, Xu L, McQuillan PM. The use of a double-lumen central venous catheter for airway management in pediatric patients undergoing laryngeal papillomatosis surgery. Pediatric Anesthesia ISSN 1155-5645, doi: 10.1111/pan.12253, 2013.
Ramachandra R, Hassan B, McGraw SG, Dompor J, Farrag M, Ruiz-Velasco V, Elmslie KS. Identification of Cav channel types
expressed in muscle afferent neurons. J Neurophysiol 110: 1535-1545, July 2013.
Weissman C, Murray WB. It’s Not Just Another Room. [editorial] Anesthesia & Analgesia 2013; 117(2): 287-289, DOI: 10.1213/
ANE.0b013e3182991c0e
Dalal PG, Mets B. Dexmedetomidine and the Quality of Recovery: Yet Another Indication for its Use? [editorial] Minerva
Anestesiologica, 79(11), 1210-1211, November 2013.
Chin KJ, Alakkad H, Adhikary SD, Singh M. Infraclavicular brachial plexus block for regional anaesthesia of the lower arm.
Cochrane Database of Systematic Reviews 2013, Issue 8. Art. No. CD005487. DOI: 10.1002/14651858.CD005487.pub3.
An Update from Our Editor
Mary Beth McAlevy, MD
Assistant Professor of Anesthesiology
This issue of the Penn State Hershey Anesthesiology Newsletter will be my last edition. I would like to thank Dr. Mets and Dr. Vaida for the opportunity to be the
editor for the past 4 years. I would also like to thank Kelly Shaak for all of her hard
work to get the Newsletter to print and mailed out to all subscribers. I am passing
the reigns off to Dr. Malina Varner who is also an alumni of the Penn State Hershey
Anesthesia Residency Program. I wish her the best of luck and know she will bring
new fresh ideas for the publication. Thanks again to everyone for their support.
Dr. McAlevy
Dr. Varner
Penn State Anesthesiology News
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PSA and Penn State Co-Sponsor Innovative Regional Anesthesia Workshop
The Pennsylvania Society of Anesthesiologists (PSA) and Penn State University Department of Anesthesiology co-sponsored the
Fourth Annual Fundamentals of Ultrasound-Guided Regional Anesthesia Cadaver Course held at Penn State Hershey Medical
Center the weekend of May 17 and 18. The course was completely sold out almost 2 months prior to the date of the event, and was
attended by 50 participants coming from four mid-Atlantic states– Pennsylvania,
Maryland, Delaware, New Jersey, – and some from as far away as Florida and
Australia.
These participants were part of a course taught by 11 experts in regional anesthesia
from across the United States and Canada. The program began with didactic
presentations ranging from “Ultrasound and Related Physics” by Luminita M.
Tureanu, M.D., FRCPC, from Northwestern University, “Sonoanatomy of the Upper Limb” by Carlo D. Franko, M.D., of Rush University Medical Center in
Chicago, “Sonoanatomy of the Lower Limb” by J. Eric Greensmith, MD, Ph.D.,
from Lancaster Regional Medical Center, “Sonoanatomy Related to the Thoracic and Lumbar Spine” by Ki Jinn Chin, MBBS,
MMED, FANZCA, from the University of Toronto, “Sonoanatomy Related to the Abdominal and Thoracic Wall” by Paul G.
McHardy, M.D., FRCPC, from Sunnybrook Health Sciences Centre, and finally “Anticoagulation and Regional Anesthesia: Where
Do We Stand Today?” presented by Dr. Shalini Dhir from the Schulich School of Medicine at the University of Western Ontario.
Each of the faculty members also served as a mentor and coach as the participants each practiced ultrasound scanning on four human
volunteers and performed nerve blocks under ultrasound guidance on five cadavers. Throughout the course, faculty members challenged each other, and workshop participants, with controversial and stimulating questions, maintaining an active, interactive discussion capturing the interest of participants at all levels of experience.
The workshop was developed and directed by Sanjib Adhikary, M.D., Associate Professor, and Patrick A. McQuillan, M.D., Professor of Anesthesiology and Vice Chair for Clinical Affairs at Penn State. Richard O’Flynn, M.D., as PSA President, and Bhaskar
Deb, M.D., Chair of the PSA Continuing Education Committee, participated in the planning and the publicity for the event.
New features of the course this year included: real time interactive demonstrations of ultrasound scanning techniques presented via
video technology to all participants at one time. In addition, on the first day of the course, expert dissections showed the anatomy
associated with interscalene, supraclavicular, infraclavicular, axillary, femoral, adductor canal, and sciatic nerve blocks using one
side of several cadavers, while the other side of each was used to demonstrate the equivalent anatomy via ultrasound scanning. The
second day of the course featured ultrasound scanning of the trunk, including the spine and the abdominal and thoracic walls.
Each day, sessions concluded with a lively “How We Do It" discussion moderated by doctors Jaibin Liu, M.D., Ph.D. and Nabil
Elkassabany, M.D., from the University of Pennsylvania.
This course was hailed by the participants as one of the best ultrasound cadaver courses available anywhere in the country. Based on
this year’s very successful workshop, an expanded workshop, likely including complementary programs emphasizing basic and advanced ultrasound regional anesthesia techniques, is planned for the Spring of 2015. The dates and details of the workshop will be
announced in the next PSA Sentinel, well in advance so that those PSA members who did not get a chance to attend this year will be
able to reserve spots for next year's workshop.
Department of Anesthesiology - H187
PO Box 850
Hershey, PA 17033-0850
Do you have a submission or topic of
interest for the next edition?
Berend Mets, MB, ChB, PhD, FRCA, FFA(SA)
Eric A. Walker Professor and Chair
Editor:
Mary Beth McAlevy, MD
Assistant Professor of Anesthesiology
mmcalevy@hmc.psu.edu
Associate Editor:
Kelly Shaak
Projects Specialist
kshaak@hmc.psu.edu
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Save the Date!
Simulation-Based Education for Maintenance of
Certification in Anesthesiology (MOCA)
Advantages to attending a MOCA Course at the
Penn State Hershey Medical Center:
Skills Training
Teamwork
Crisis Intervention
State-of-the-Art Facility
Upcoming Sessions:
September 27, 2014
October 25, 2014
Penn State Hershey Clinical Simulation Center
If you would like an electronic version of this
newsletter, please email Kelly Shaak.
“Patient safety starts here. . .”
For more information please visit: www.pennstatehershey.org/anesthesia
or contact Gail Frohnert at 717-531-5173, gfrohnert@hmc.psu.edu