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A method for improving access to the paramedian epidural space in the lumbar region
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 19, 2017 Category: Anesthesiology Source Type: research

In reply: Analysis of perioperative antibiotic administration in electronic medical records: correlations among patients addressed by analyzing control chart data using the batch means method
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2017 Category: Anesthesiology Source Type: research

Analysis of perioperative antibiotic administration in electronic medical records: correlations among patients addressed by analyzing control chart data using the batch means method
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2017 Category: Anesthesiology Source Type: research

Point-of-care ultrasonography in Canadian anesthesiology residency programs: a national survey of program directors
ConclusionPoint-of-care ultrasonography training within Canadian anesthesiology residency programs is highly variable. Given the importance of POCUS abilities and their relevance to modern anesthesia practice, POCUS training and assessment within Canadian anesthesiology residency programs should be formalized. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Pre- or postoperative interscalene block and/or general anesthesia for arthroscopic shoulder surgery: a retrospective observational study
AbstractPurposeArthroscopic shoulder surgery can be performed with an interscalene brachial plexus block (ISBPB) alone, ISBPB combined with general anesthesia (GA), or GA alone. Postoperative pain is typically managed with opioids; however, both GA and opioids have adverse effects which can delay discharge. This retrospective study compares the efficacy of four methods of anesthesia management for arthroscopic shoulder surgery.MethodsCharts of all patients who underwent shoulder surgery by a single surgeon from 2012-2015 were categorized by analgesic regimen: GA only (n = 177), single-shot ISBPB only (n =&nb...
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

An observational study examining the effects of a surgically induced inflammatory response on the distribution of morphine and its metabolites into cerebrospinal fluid
AbstractPurpose Morphine is administered intravenously for pain management in the perioperative period. The effect of the inflammatory response to surgery on morphine distribution across the blood-brain barrier (BBB) in humans was investigated. We hypothesized that a graded surgically induced, systemic inflammatory response alters cerebrospinal fluid (CSF) levels of morphine, morphine-3-glucuronide (M3G), and morphine-6-glucuronide (M6G) through a temporary reduction in BBB drug efflux transporter function.MethodsWe conducted a prospective pharmacokinetic study of the plasma and CSF distribution of the P-glycoprotein (PG...
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Airway arteriovenous malformation in pregnancy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Strategies for prevention of spinal-associated hypotension during Cesarean delivery: Are we paying attention?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Morphine and the blood-brain barrier: diffusion, uptake, or efflux?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Front-of-neck airway meets front-of-neck simulation: improving cricothyroidotomy skills using a novel open-access three-dimensional model and the Airway App
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Coming soon: an expansion of the Journal ’s critical care offerings
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Clinical Fluid Therapy in the Perioperative Setting
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Interactive video game built for mask induction in pediatric patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

An up-down determination of the required seated duration after intrathecal injection of bupivacaine and fentanyl for the prevention of hypotension during Cesarean delivery
AbstractPurposeA prolonged seated time after intrathecal injection of hyperbaric bupivacaine and morphine is related to the incidence of hypotension during Cesarean delivery, but results in a high incidence of pain during peritoneal closure. We conducted this study to determine the effect of the addition of intrathecal fentanyl on the relationship between seated time and hypotension and intraoperative analgesia requirements.MethodsWomen undergoing Cesarean delivery were randomized to receive an intrathecal injection of either 11.25 or 15 mg of hyperbaric bupivacaine with morphine 150 µg and fentanyl 15 µg using...
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Patient retention and satisfaction with information exchange concerning peripheral nerve block risks
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Weaning from mechanical ventilation using tracheostomy cuff deflation and a one-way speaking valve: a historical-cohort series
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

Risk of look-a-like equipment in anesthesiology: it ’s not just medications
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2017 Category: Anesthesiology Source Type: research

In reply: Assessing flexible bronchoscopic intubation through the AuraGain ™ laryngeal mask versus a slit Guedel tube
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 8, 2017 Category: Anesthesiology Source Type: research

Assessment of flexible bronchoscopic intubation through the AuraGain ™ laryngeal mask versus a slit Guedel tube
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 8, 2017 Category: Anesthesiology Source Type: research

“Eyeball test” of thermographic patterns for predicting a successful lateral infraclavicular block
ConclusionWe conclude that visual evaluation by an eyeball test of specific thermographic patterns of the blocked hands may be useful as a valid and reliable diagnostic test for predicting a successful LIC block. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 7, 2017 Category: Anesthesiology Source Type: research

Guest Reviewers
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 5, 2017 Category: Anesthesiology Source Type: research

Assessment of cough strength in patients with a tracheostomy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 5, 2017 Category: Anesthesiology Source Type: research

In reply: Clinical supervision: what does it mean to be better?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 1, 2017 Category: Anesthesiology Source Type: research

Clinical supervision: what does it mean to be better?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 1, 2017 Category: Anesthesiology Source Type: research

Provider-controlled virtual reality experience may adjust for cognitive load during vascular access in pediatric patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 31, 2017 Category: Anesthesiology Source Type: research

Even low doses of dexmedetomidine produced obstructive apnea during spinal anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 31, 2017 Category: Anesthesiology Source Type: research

Coagulation after cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: a retrospective cohort analysis
AbstractPurposeCytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) benefit patients with peritoneal carcinomatosis. Nevertheless, this therapy is associated with considerable postoperative pain due to the extensive abdominal incision. While epidural analgesia offers efficacious pain control, CRS and HIPEC therapy is associated with perioperative coagulopathy that may impact its use. The purpose of this retrospective study is to characterize the postoperative coagulopathy in this patient subset and to develop a model that will help predict those at risk.MethodsOur database of patients treated w...
Source: Canadian Journal of Anesthesia - August 29, 2017 Category: Anesthesiology Source Type: research

Optimizing Crisis Resource Management to Improve Patient Safety and Team Performance - A handbook for acute care health professionals
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 29, 2017 Category: Anesthesiology Source Type: research

A safe and effective technique for application of a multi-level cervical epidural blood patch
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 28, 2017 Category: Anesthesiology Source Type: research

Agreement between venous and arterial blood gas analysis of acid-base status in critical care and ward patients: a retrospective cohort study
ConclusionsVenous gases are suitable for initial evaluation of acid-base status in critically ill patients. Based on clinical evaluation, an arterial sample may then be considered for confirmation, and thereafter, venous blood gases could be sufficient for monitoring response to treatment. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 23, 2017 Category: Anesthesiology Source Type: research

From visualizing nerves to visualizing blocks: a natural trend?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 22, 2017 Category: Anesthesiology Source Type: research

Radial artery spasm: Should we worry?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 18, 2017 Category: Anesthesiology Source Type: research

SOFT block ( S ciatic, O bturator and F emoral nerve block T echnique): a single-puncture, sole anesthetic for knee surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 18, 2017 Category: Anesthesiology Source Type: research

The tipping point: unanticipated dangers of operating room table position changes
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 18, 2017 Category: Anesthesiology Source Type: research

Post-ictal missing dentures
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 17, 2017 Category: Anesthesiology Source Type: research

Anesthesia in Yemen: Working with M édecins Sans Frontières
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 17, 2017 Category: Anesthesiology Source Type: research

Using a Mcintosh blade for retromolar intubation: a comment
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 16, 2017 Category: Anesthesiology Source Type: research

In reply: Using a Mcintosh blade for retromolar intubation: a comment
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 16, 2017 Category: Anesthesiology Source Type: research

Physiologie humaine appliqu ée, 2nde édition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2017 Category: Anesthesiology Source Type: research

Massive hemorrhage and transfusion in the operating room
ConclusionsMassive hemorrhage is a multidisciplinary challenge that requires immediate response and communication between clinicians, nurses, other healthcare providers, laboratory testing, and blood banks. Basic knowledge and utilization of available products and therapies are inconsistent. A massive transfusion protocol can be used effectively to reduce chaos and ensure that correct treatments and proper dosing occur in a timely manner. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

The effects of intranasal dexmedetomidine premedication in children: a systematic review and meta-analysis
ConclusionsIntranasal dexmedetomidine provided more satisfactory sedation at parent separation and reduced the need for rescue analgesics and the incidence of nasal irritation and postoperative nausea and vomiting when compared with other premedication treatments. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Predictive factors of maternal hypothermia during Cesarean delivery: a prospective cohort study
AbstractPurposeAlthough perioperative hypothermia may increase maternal morbidity, active warming is infrequently performed to maintain normothermia during Cesarean delivery (CD). The aim of this prospective observational study was to determine the factors associated with maternal hypothermia in this setting.MethodsWomen scheduled for elective or emergency CD were consecutively included in this study from November 2014 to October 2015. Maternal temperature was measured using an infrared tympanic thermometer on the patient ’s arrival in the operating room, at skin incision, and at the end of skin suture. Maternal hypo...
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Low-dose subcutaneous ketamine for postoperative pain management in Rwanda: a dose-finding study
ConclusionAdding subcutaneous ketamine to standard analgesic measures resulted in decreases in postoperative pain scores without serious side effects. These data can be used to inform a randomized controlled trial to compare subcutaneous ketamine plus standard care with placebo plus standard care for reducing postoperative pain. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Epidural blood patch treatment for headache caused by a ruptured Tarlov cyst
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Contribution of the nasal passage to face mask ventilation: a prospective blinded randomized crossover trial
AbstractBackgroundPrevious studies have shown that the nasal passage plays an important role in manual face mask ventilation, but this has yet to be quantitatively assessed. We conducted a prospective randomized crossover clinical trial to compare the change in pressure-controlled face mask tidal volume with and without nasal airway occlusion.MethodFemale patients undergoing elective surgery under general anesthesia served as study subjects. Patients were randomly assigned to face mask ventilation beginning either with or without nasal passage occlusion (achieved with a swimmer ’s nose clip), followed by removal or a...
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

We must ask relevant questions and answer with meaningful outcomes
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Ketamine: We need to continue to advocate against scheduling
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Precise mathematics yet hazy predictions: Can validated risk indices help improve patient selection for major elective surgery?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Serotonergic medications, herbal supplements, and perioperative serotonin syndrome
ConclusionEven small doses of fentanyl administered to patients taking multiple serotonergic medications and herbal supplements may trigger serotonin syndrome. Prompt reversal of serotonin toxicity in one patient by naloxone illustrates the likely opioid-mediated pathogenesis of serotonin syndrome in this case. It also highlights that taking serotonergic agents concomitantly can produce the compounding effect that causes serotonin syndrome. The delayed presentation of serotonin syndrome in the patient who received a large dose of midazolam suggests that outpatients taking multiple serotonergic drugs who receive benzodiazep...
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Brown ’s Regional Anesthesia Review - 1st Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research