The Department of Anesthesiology and Perioperative Medicine was established in 1937 by Dr. Perry Volpitto, who also established the first residency program in the South for anesthesiology. The department's research laboratory currently boasts recruits from Boston University, Duke, and Harvard. Some areas of research include in vivo video microscopy, new drug development, and nanomedicine.


This community contains collections of the Department of Anesthesiology and Perioperative Medicine Lectures, Newsletters, Peer-Reviewed Publications, Posters, and Pre-Print Papers collections.

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Recent Submissions

  • Absolute cerebral oximeters for cardiovascular surgical cases

    Arthur, Mary E.; Department of Anesthesiology and Perioperative Medicine (Georgia Regents University, 2013-02)
    In the US, about 465,000 cardiopulmonary bypass grafting (CABG) procedures are performed every year. Decreases in oxygen levels occur in about 17-23% of CABG procedures which cause brain injury even in uncomplicated surgeries, and may lead to stroke, cognitive dysfunction, longer ventilation times; longer ICU and hospital stays, and higher health care costs. Because of the brain’s high metabolic rate with limited oxygen reserves, only about 10 seconds at normal body temperature makes the brain is susceptible to oxygen deprivation. A study on patients who underwent CABG surgery found that incidence of cognitive decline was 53% at discharge and 42% at 5 years (Newman, 2001). Furthermore, elderly patients are more likely to develop cerebral desaturation because of age-related reductions in physiologic reserve (Casati, 2005), and the number of surgeries involving older patients is on the rise.
  • Anterior Mediastinal Mass in a Patient Requiring Lung Isolation

    Janardhanam, Ram; Patel, Vijay; Arthur, Mary E.; Department of Anesthesiology and Perioperative Medicine; Department of Cardiothoracic Surgery (American Society of Anesthesiologists, 2010-10)
    A patient with an anterior mediastinal mass poses numerous challenges to an anesthesiologist, the major concerns being pulmonary or cardiac collapse on induction of anesthesia. Preoperative evaluation of the chest x-ray as well as the CT scan is valuable in assessing potential problems regarding management of this type of airway. An awake fiberoptic intubation is the preferred method of securing the airway.
  • Use of the Video RIFL (Rigid Flexible Laryngoscope) as an Adjunct to Direct Laryngoscopy

    Setty, Harsha; Gallen, Thomas; Dubin, Stevin; Department of Anesthesiology and Perioperative Medicine (Society for Airway Management, 2010-09)
    The ASA difficult airway algorithm incorporates different modalities in its progression. It is not uncommon for the user to fail at direct laryngoscopy, thus requiring an alternate method for securing an airway. Frequently, the alternate modalities include supraglottic airways, rigid videolaryngoscopes, or flexible fiberoptic bronchoscopes. We retrospectively reviewed charts from February 2009 to February 2010 on patients intubated in the operating room using the Video RIFL.
  • Granulomatous Conduit for Intrathecal Infusion of Morphine and Bupivacaine

    Webb, David M; Schneider, John R; Lober, Robert M.; Vender, John R.; Department of Anesthesiology and Perioperative Medicine; Department of Neurosurgery (American Society of Regional Anesthesia and Pain Medicine, 2010-11)
    Intrathecal Drug Delivery Systems (IT-DDS) have gained widespread acceptance as a therapeutic alternative to high dose parenteral opioids for unremitting chronic pain. Granuloma formation has been reported as a side effect in association with the greater use of IT-DDS. Etiological factors include infection, reaction to catheter material, and trauma at the site of implantation. The most widely accepted etiology is the use of intrathecal morphine, with granuloma formation dependent on morphine dosage. We present the case of a woman with unremitting GI pain and IT-DDS placement who developed a granuloma at the hub of the catheter which formed a sealed conduit that re-established drug flow between the pump and catheter.
  • Unanticipated Acute Adrenal Insufficiency During Emergency Thoracotomy Re-Exploration

    Rawlings, J Lee; Spivey, Jerry A; Castresana, Manuel R.; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2010-10)
    For the last 50 years there has been a debate over the management of corticosteroid supplementation in the context of surgical or critically ill patients. At a minimum, clinicians agree that chronic corticosteroids should be continued in the perioperative or ICU setting, however in patients without a history of steroid use, acute adrenal insufficiency as the cause of hemodynamic compromise can be an elusive diagnosis. We present a case report.
  • Thrombolytic Therapy in a Patient with an Epidural Catheter

    Janardhanam, Ram; Mellinger, John D.; Hammonds, William D; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2010-10)
    The ability to provide comfort and relieve pain during the postoperative period is a priority in the care of the surgical patient. Epidural anesthesia is widely used to manage postoperative pain. The epidural infusion of local anesthetics combined with opioids provides excellent pain relief. It also reduces intra- and postoperative narcotic requirements, leading to earlier mobilization and faster discharge. However, epidural analgesia carries risks for the patient. This presentation reports on the risk of treating a patient with thrombolytics while receiving epidural analgesia.
  • General Anesthesia in an Ex-Utero Intrapartum Treatment (EXIT) Procedure for a Neonate with NAGER Syndrome

    Grinage, Brandon C; O'Bannon, Robert Toney; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2010-10)
    In the ex-utero intrapartum treatment (EXIT) procedure, an incision is made similar to that for a cesarean section. Following uterine incision, the baby is partially delivered by the obstetrician but remains attached to the maternal-fetal unit, allowing the pediatric surgeon to establish or secure an airway while the baby maintains oxygen saturation on utero-placental support. Once the airway has been secured, the obstetric team resumes control of the procedure, the umbilical cord is cut and clamped, and the delivery of the baby is completed. We report on an EXIT procedure performed for fetal craniofacial abnormalities secondary to Nager Syndrome.
  • Challenge of a Difficult Airway and Anesthetic Management in a Patient with Still's Disease

    Donald, Ranita R.; Taylor, Emi; Gallen, Thomas; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2010-10)
    Adult-onset Still’s disease (AOSD) is a rare systemic inflammatory disorder of unknown etiology with articular and extra-articular (systemic) manifestations. The disorder owes its name to Sir George Frederick Still, who in 1897 described 22 children with symptoms consistent with what is currently known as systemic onset juvenile idiopathic arthritis. AOSD was established almost a century later in 1971, when Eric Bywaters encountered and described adult patients presenting with pediatric Still’s disease symptoms. Compared to rheumatoid arthritis in adults, AOSD runs a much more acute course, quite often affecting many parts of the body before settling in the various joints. Diagnosis of AOSD is difficult to establish due to the nonspecific clinical and laboratory findings. Tracheal intubation may become difficult due to impairment of cervical spine, temporomandibular joint and laryngeal involvement (crico-arytenoid arthritis). Patients with chronic articular disease have more disability and worse prognosis than patients with only systemic symptoms.
  • Strategies for a Successful Anesthesiology Clerkship and Rewarding Experience for Medical Students

    Donald, Ranita R.; Odo, Nadine; Dawkins, Susan; Mason, Nikova; Gilbertson, Laura; Department of Anesthesiology and Perioperative Medicine (American Society of Anesthesiologists, 2010-10)
    The anesthesiology clerkship is a senior year selective in our institution which fulfills the critical care rotation requirement. Our clerkship has been such a popular rotation that enrollment can be quite competitive. Thanks to the dedication of our faculty and residents, students consistently report positive experiences about this rotation. Many of the medical students are not aware of the anesthesiologist’s multi- faceted role as a perioperative physician until their clerkship rotation in anesthesiology. Choosing a specialty is a difficult and stressful process. Anesthesiology continues to be a highly desirable specialty among U.S. medical students.
  • Morbidly Obese Complex Obstetrical Patient with Undiagnosed Peripartum Cardiomyopathy and Development of Flash Pulmonary Edema in PACU

    Donald, Ranita R.; Crews, Lindsay K; Department of Anesthesiology and Perioperative Medicine (International Anesthesia Research Society, 2010-05)
    Peripartum cardiomyopathy (PPCM) is a rare disorder of uncertain etiology. Virchow and Porack first recognized the relationship between heart failure and pregnancy in the 1870s when they noted myocardial degeneration in patients who died in the postpartum period. PPCM was first described as a distinctive cardiomyopathy in 1937 by Gouley et al. Since then, much has been learned about this disease process, and better treatment options now exist. Incidence varies greatly worldwide. Reports suggest an incidence of 1 case per 299 live births in Haiti, 1 per 1000 in South Africa, and 1 per 3000-4000 in the United States. Reported mortality rates are between 18% and 56%. A latent form of PPCM has also been described. Here we describe a case of latent PPCM in a morbidly obese patient who developed dramatic flash pulmonary edema in the postanesthesia care unit.
  • Neurologic Deficit Following Ultrasound Guided Femoral Nerve Block

    Aryal, Anuj; Mayfield, James; Hammonds, William D; Department of Anesthesiology and Perioperative Medicine (Society for Ambulatory Anesthesia, 2010-05)
    Ultrasound provides real time visualization of peripheral nerves while performing a peripheral nerve block. We present a case of post operative neural dysfunction following ultrasound guided femoral nerve block on a patient undergoing left knee arthroscopy.
  • Intranasal Septal Perforation in a 4-Year-Old by an Impacted Button Battery: A Case Report and Review of the Literature

    Mattingly, Diana; Crews, Lindsay K; Florentino-Pineda, Ivan; Department of Anesthesiology and Perioperative Medicine (Society for Pediatric Anesthesia, 2010-03)
    While intranasal foreign bodies account for less than 1% of pediatric emergency room visits, proper diagnosis and management is critical to minimize significant morbidity and mortality. Intranasal button batteries in particular pose a significant threat to the pediatric population as nasal mucosal necrosis, septal perforation, facial cellulitis, and lateral nasal wall necrosis can occur within hours of insertion. The incidence of impacted button batteries has risen with the increased prevalence in common electronics like hearing aids, watches, and musical greeting cards. One study estimated that button batteries comprised 7% of intranasal foreign bodies removed from pediatric patients in a 6-month period. We report a case of intranasal button battery impaction in a 4-year-old male that resulted in significant tissue injury and required general anesthesia for extraction.
  • Prevention of Progressive Deterioration of Motor Evoked Potentials During General Anesthesia

    O'Bannon, Robert Toney; Dubin, Stevin; Department of Anesthesiology and Perioperative Medicine (Society for Neuroscience in Anesthesiology and Critical Care, 2010-10)
    The increasing frequency and complexity of spinal column corrective procedures have aided the advancement of evoked potential monitoring. The effectiveness of somatosensory evoked potentials (SSEPs) and motor evoked potentials (MEPs) to detect iatrogenic cord ischemia during surgical manipulation has been well established. Detection followed by corrective measures can limit and/or prevent iatrogenic injuries associated with instrumentation during these corrective surgical procedures.
  • The Influence of Ethnicity on Visual Analog Scale Pain Ratings: Pre- and Post-Radiofrequency Application for Pain of Zygapophyseal Joint Origin

    Rogg, Schuyler A; Martinez-Lu, Kianfa; Martin, Dan C; Williams, Gwendolyn O; Hammonds, William D; Department of Anesthesiology and Perioperative Medicine (American Society of Interventional Pain Physicians, 2010-02)
    Increased scrutiny of the allocation of health care dollars makes the identification of factors influencing treatment outcomes important. Few studies have examined the relationship between ethnicity and the efficacy of chronic pain management interventions (as opposed to acute pain syndromes). Radiofrequency application (RFA) is a common treatment modality for pain due to zygapophyseal joint (z joint) disease. This survey reviewed the efficacy of RFA in African American (AA) and non-Hispanic Caucasian patients. This study is a retrospective chart review of patients who underwent RFA to the L3, L4 medial branch nerves, dorsal ramus of L4, and the accessory nerve from the S1 dorsal ramus to the L5-S1 z joint.
  • Vigilance at GRU

    Department of Anesthesiology and Perioperative Medicine (2013-02)
    Table of Contents: 3 Faculty and Staff News; 4 Wu: Physician, Investigator, Resident, Graduation and Awards Banquet, "Small" News; 5 Recognition, FCCS Workshop to Offer Training for Noncritical Care Specialists; 6-9 A Celebration of 75 Years of Anesthetic Excellence, Saluting Our Veteran Anesthesiologists and Nurse Anesthetists; 10-11 Publications, Presentations and Research.
  • Vigilance at Georgia Health Sciences University

    Department of Anesthesiology and Perioperative Medicine (2012-03)
    Table of Contents: 3 Faculty and Staff News; 4 Chief Resident Anderson: A passion for medicine; 6 Angie Skinner: Blissit award finalist 'always several steps ahead,' Classroom gets an IT makeover; 7 Orthopedic surgeon 'walks a mile' in anesthesiologist's shoes, Publications, Presentations and Research.
  • Vigilance at Georgia Health Sciences University

    Department of Anesthesiology and Perioperative Medicine (2011-09)
    Table of Contents: 3 Respiratory Therapy Receives EPA Award of Excellence, Accomplished researched named Professor, other faculty and staff news; 4 Gale looking forward to retirement, Gregoretti bids department 'arrivederci,' GHSU holds rainly inaugural Earth Day; 5 Alumna of notes: DeCore reminisces about days as a resident; 6 Emergence delirium discussed at Latin American symposium, Thalidomide analog holds hope as sickle cell treatment, What's That? Masks; 7 Publications, Presentations, and Abstracts, and Research.
  • Vigilance at Georgia Health Sciences University

    Department of Anesthesiology and Perioperative Medicine (2011-03)
    Table of Contents: 3-4 Faculty and Staff News; 5 Our First Reception at ASA, In Memoriam: Dr. Jack K Pruett; 6 Zack Gramling: Creating a Legacy; 7 New Name, New Web site, New Email, 'Healthy Perspectives to Improve Cultural Competency at GHSU; 8 Nitric Oxide, Aptamers Could Treat Sickle Cell Disease; 9 Dr. Berger Plans to Combat Pain, Rapid Response Team Take Quick Action; 10 Publications, Presentations and Abstracts, and Research.
  • Vigilance at MCG

    Department of Anesthesiology and Perioperative Medicine (2010-09)
    Table of Contents: 3 Faculty and Staff news; 4 Who are the Aqualumni?, Rawlings believes in caring for people; 5 Medical students scope out anesthesiology, Antibiotic sponge ineffective on sternal wound infections, Critical care workshop slated for January, Study notes risks of desflurane during pediatric surgery; 6 Publications, Presentations and Abstracts, and Research.
  • Vigilance at MCG

    Department of Anesthesiology and Perioperative Medicine (2010-03)
    Table of Contents: 3 Faculty and Staff News; 4 Residency Coordinator gives 110 percent, A Glimpse of the Past: Founding chairman was like a father; 5 Guiding the use of spinal cord stimulators, Aptamers target sickle cell pain, Decive eases difficult intubations; 6 Publications, Presentations and Abstracts, and Research.

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