Potential impact of changes in administrative database coding methodology on research and policy decisions: an example from the Ontario Health Insurance Plan
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 17, 2019 Category: Anesthesiology Source Type: research

A retrograde tunnelling technique for regional anesthesia catheters: how to avoid the skin bridge
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 15, 2019 Category: Anesthesiology Source Type: research

An underappreciated risk of an airway exchange catheter
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 11, 2019 Category: Anesthesiology Source Type: research

North-south syndrome in veno-arterial extra-corporeal membrane oxygenator: the other Harlequin syndrome
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 9, 2019 Category: Anesthesiology Source Type: research

Four early warning scores predict mortality in emergency surgical patients at University Teaching Hospital, Lusaka: a prospective observational study
AbstractPurposeThe value of early warning scoring systems has been established in high-income countries. There is little evidence for their use in low-resource settings. We aimed to compare existing early warning scores to predict 30-day mortality.MethodsUniversity Teaching Hospital is a tertiary center in Lusaka, Zambia. Adult surgical patients, excluding obstetrics, admitted for> 24 hr were included in this prospective observational study. On days 1 to 3 of admission, we collected data on patient demographics, heart rate, blood pressure, oxygen saturation, oxygen administration, temperature, consciousness level, and m...
Source: Canadian Journal of Anesthesia - October 9, 2019 Category: Anesthesiology Source Type: research

Practice advisory on the bleeding risks for peripheral nerve and interfascial plane blockade: evidence review and expert consensus
AbstractThe risk of bleeding complications during regional anesthesia procedures is a significant patient safety consideration. Nevertheless, existing literature provides limited guidance on the stratification of bleeding risk for peripheral nerve and newly described interfascial plane blocks. Our objective was to produce an evidence-based consensus advisory that classifies bleeding risks in patients undergoing regional peripheral nerve and interfascial plane block procedures. This advisory is intended to facilitate clinical decision-making in conjunction with national or local guidelines and to guide consideration for app...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Incidence and predictors of myocardial and kidney injury following endovascular aortic repair: a retrospective cohort study
AbstractPurposeWe performed a retrospective cohort study in patients who underwent endovascular aneurysm repair (EVAR) to determine the incidence and predictors of myocardial injury and acute kidney injury (AKI).MethodsWe included 267 consecutive patients who underwent EVAR at two tertiary centres in Canada and Poland. The primary outcome was myocardial injury during hospital stay after EVAR defined as a troponin elevation (ultra-sensitivity troponin I Vidas ≥ 19 ng·L−1, non-high-sensitivity troponin I Vidas ≥ 0.01 µg·L−1, high-sensitivity troponin T ≥ 20 ng·L−1, non-hi...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Peripheral electrical stimulation reduces postoperative hypoxemia in patients at risk for obstructive sleep apnea: a randomized-controlled trial
AbstractPurposeSeverity of hypoxemic events resulting from obstructive sleep apnea (OSA) is correlated with increased risk of complications and sudden death. We studied the use of a peripheral transcutaneous electrical stimulus (TES) on the magnitude and duration of sleep apnea associated hypoxemia in postoperative patients at high risk for OSA.MethodsIn this randomized, double-blind, controlled, single-centre trial, 106 adult patients undergoing elective surgery who were at medium to high risk for OSA (sleep apnea clinical scores of 18 –35) were randomized to either TES (active stimulus group,n = 53) or control (non...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Obstetric neuraxial anesthesia at low platelet counts in the context of immune thrombocytopenia: a systematic review and meta-analysis
AbstractPurposePrimary immune thrombocytopenia (ITP) is an autoimmune condition affecting women of childbearing age that is characterized by diminished platelet quantity with preserved function. Although pregnant women with ITP are often denied obstetric neuraxial anesthesia (OBNA) with low platelet counts for fear of neuraxial hematoma, the true magnitude of neuraxial hematoma for ITP parturients is unknown. The aim of this systematic review and meta-analysis was to examine OBNA outcomes in ITP parturients with platelet counts below 100 x 109·L-1.SourceArticles published in MEDLINE, Embase, Web of Science, Scopus, ...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

The future is now —it’s time to rethink the application of the Global Warming Potential to anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Deceased organ donation potential in Canada: a review of consecutive deaths in Alberta
AbstractBackgroundTransplantation is the most effective treatment for many patients with end-stage organ failure. There is a gap between the number of patients who would benefit from transplantation and availability of organs. We assessed maximum potential for deceased donation in Alberta and barriers to increasing the donation rate.MethodsAll deaths that occurred in Alberta in 2015 in areas where mechanical ventilation could be provided were retrospectively identified using administrative data. Medical records were reviewed by donation coordinators and critical care physicians with expertise in donation, using a standardi...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Post-traumatic stress in the postoperative period: current status and future directions
ConclusionResearch on postoperative traumatic stress, including PTSD, is in its infancy. Current evidence shows elevated incidence rates of postoperative traumatic stress, which can worsen overall physical and mental health outcomes. Future research on assessment, prevention, and treatment is warranted. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Practice advisory on the bleeding risks for peripheral nerve and interfascial blockade: going out on a limb
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Faculty perspectives on the transition to competency-based medical education in anesthesia
ConclusionTargeted interventions for faculty uptake should emphasize the trialability and observable results achieved over time. These efforts may have the greatest impact in the early/late majority group. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Pulse-ox paradox: potential versus pitfalls of pulse oximetry monitoring in surgical patients with obstructive sleep apnea
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Implementation of population-level screening for frailty among patients admitted to adult intensive care in Alberta, Canada
AbstractPurposeA substantial proportion of patients admitted to intensive care units (ICUs) are frail; however, the epidemiology of frailty has not been explored at a population-level. Following implementation of a validated frailty measure into a provincial ICU clinical information system, we describe the population-based prevalence and outcomes of frailty in patients admitted to ICUs.MethodsRetrospective cohort study of adult admissions to 17 ICUs. Data were captured using eCritical Alberta. A Clinical Frailty Scale (CFS) score assigned at ICU admission was used to define the exposure (CFS score ≥ 5). Primary outcome ...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

A cadaver pilot study to evaluate the impact of the needle bevel orientation on the ease of paravertebral catheter insertion
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Transesophageal echocardiographic imaging of an aortic intramural hematoma: characterizing the crescent
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Critical Care Medicine: Principle of Diagnosis and Management in the Adult
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Can electrical nerve stimulation guidance assist in cervical erector spinae plane block catheter placement for total shoulder arthroplasty?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Correction to: Intraoperative cerebral oximetry-based management for optimizing perioperative outcomes: a meta-analysis of randomized controlled trials
In the article entitled “Intraoperative cerebral oximetry-based management for optimizing perioperative outcomes: a meta-analysis of randomized controlled trials” Can J Anesth 2018; 65: 529-42, we wish to clarify the following items. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Correction to: Global surgery and the World Health Organization: indispensable partners to achieve triple billion goals
The legend of the Figure currently reads: “A formula for advancing surgical system strengthening and World Health Assembly resolution 68.15 through the World Health Organization’s thirteenth General Programme of Work (GPW-13). This graphic depicts the three strategic shifts outlined in GPW-13 and ties them to specific avenues for surgic al system strengthening to achieve overarching goals. GPW-13 = Thirteenth General Programme of Work; NSOAPs = National Surgical, Obstetric, and Anesthesia Plans; PHC = primary healthcare; SDG 3 = Sustainable Development Goal 3; UHC = universal health coverage; WHA 68.18 = World ...
Source: Canadian Journal of Anesthesia - October 5, 2019 Category: Anesthesiology Source Type: research

Epidural hematoma following epidural catheter removal after a single dose of clopidogrel
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 3, 2019 Category: Anesthesiology Source Type: research

Additional insights regarding aortic intramural hematoma
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 1, 2019 Category: Anesthesiology Source Type: research

In reply: Additional insights regarding aortic intramural hematoma
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 1, 2019 Category: Anesthesiology Source Type: research

Intraoperative continuous renal replacement therapy during liver transplantation: a pilot randomized-controlled trial (INCEPTION)
AbstractPurposeTo evaluate the feasibility of intraoperative continuous renal replacement therapy (IoCRRT) during liver transplantation (LT), in terms of recruitment, protocol adherence, and ascertainment of follow-up.MethodsIn this pilot randomized open-label controlled trial in adults receiving LT with a Model for End-Stage Liver Disease (MELD) score ≥ 25 and preoperative acute kidney injury (RIFLE - RISK or higher) and/or estimated glomerular filtration rate
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

I SURVIVE: inter-rater reliability of three physical functional outcome measures in intensive care unit survivors
ConclusionThese three measures show good inter-rater reliability when used by trained frontline clinicians to assess physical function in ICU survivors in the inpatient setting. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Randomized comparison of McGrath MAC videolaryngoscope, Pentax Airway Scope, and Macintosh direct laryngoscope for nasotracheal intubation in patients with manual in-line stabilization
The objective of this study was to determine the clinical usefulness of videolaryngoscopes (VLs) by comparing the time to intubation (TTI) and the ease of intubation of McGrath MAC VL (MVL), Pentax Airway Scope VL (PVL), and Macintosh direct laryngoscope (DL) during nasotracheal intubation using manual in-line stabilization to simulate difficult airways.MethodsOne hundred and twenty patients were randomly assigned to the MVL group (n = 40), the PVL group (n = 40), and the DL group (n = 40). Nasotracheal intubation was performed using MVL, PVL, or DL, according to group assignments. The primary outcome was TTI and secondary...
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Interprofessional communication in the operating room: a narrative review to advance research and practice
ConclusionThe perioperative community should be encouraged to implement existing effective solutions to improve communication and investigate creative solutions to identified barriers. Improved methods of data collection are needed to enhance evidence quality, increase understanding of communication barriers and facilitators, and identify the best strategy to advance practice. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Patient-centred perioperative mobile application in Cesarean delivery: needs assessment and development
ConclusionThe participant-driven changes in direction of the prototype showed the importance of involving key stakeholders early. This study provides guidance on further iterative development and implementation of an interdisciplinary mobile platform for patient-centred perioperative care and outcomes research. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Enhanced perioperative management of children with autism: a pilot study
ConclusionWe showed that a multidisciplinary perioperative care plan for children with severe ASD was feasible and 100% accepted at our institution. The individual nature of anxiolysis plans was considered a strength of the protocol. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

INCEPTION: is a larger trial to evaluate intraoperative renal replacement therapy in liver transplant patients more than just a dream?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Lidocaine lubricants for intubation-related complications: a systematic review and meta-analysis
ConclusionLidocaine lubricants applied on the tips of endotracheal tube are not effective against the morbidities of POST, PC, and PH.Trial registrationPROSPERO (CRD42017073259); registered 26 October, 2017. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Adaptation transculturelle et validation fran çaise du questionnaire de sensibilité à la douleur ( Pain Sensitivity Questionnaire )
ConclusionCette version valid ée peut être utilisée par les chercheurs et cliniciens francophones.Enregistrement de l ’étudewww.ClinicalTrials.gov (NCT03113903); le 14 avril 2017. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Exclusion criteria and adverse events in perioperative trials of tranexamic acid in cardiac surgery: a systematic review and meta-analysis
ConclusionWe found that systemic TXA is safe to use in cardiac surgery. Certain patient groups are frequently excluded from TXA cardiac surgery trials, and may consequently have limited efficacy and safety data on TXA. Further research in these patient groups may be needed; nevertheless, for many patient populations there are sufficient data to inform evidence-based guidelines for TXA use in cardiac surgery.Trial registrationPROSPERO (CRD42017060971); registered 4 April, 2017. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Pharmacology and Physiology for Anesthesia, Second Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Continuous fascia iliaca block for acute hip fractures: a randomized-controlled pilot study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Soins et handicap mental – relation soignante et prise en charge
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Serratus anterior plane blocks provide opioid-sparing analgesia in patients with isolated posterior rib fractures: a case series
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Ultrasound-guided pericapsular nerve group (PENG) hip joint phenol neurolysis for palliative pain
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Heart recovery after circulatory determination of death: time for public engagement
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 11, 2019 Category: Anesthesiology Source Type: research

Reassessment of a meta-analysis of intraoperative cerebral oximetry-based management studies
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 4, 2019 Category: Anesthesiology Source Type: research

In reply: “Returning to Frankenstein: the spark of being and the fire of life”
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 4, 2019 Category: Anesthesiology Source Type: research

Returning to Frankenstein: the spark of being and the fire of life
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 4, 2019 Category: Anesthesiology Source Type: research

Personalized perioperative medicine: a scoping review of personalized assessment and communication of risk before surgery
ConclusionsPersonalized preoperative risk assessment and communication may improve patient and system outcomes. This evidence is limited, however, by weaknesses in study design. Appropriately powered, low risk of bias evaluation of personalized risk communication before surgery is needed. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2019 Category: Anesthesiology Source Type: research

Postoperative sore throat: inevitable side effect or preventable nuisance?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2019 Category: Anesthesiology Source Type: research

Perioperative outcomes: easier to predict but harder to change
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2019 Category: Anesthesiology Source Type: research

Topical application of magnesium to prevent intubation-related sore throat in adult surgical patients: a systematic review and meta-analysis
ConclusionOur study suggests that preoperative topical magnesium can effectively prevent postoperative sore throat.Trial registrationPROSPERO (CRD42018110019); registered 26 September, 2018. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2019 Category: Anesthesiology Source Type: research

Oral medical assistance in dying (MAiD): informing practice to enhance utilization in Canada
AbstractThe legislation Bill C-14 legalized medical assistance in dying (MAiD) in Canada. After thorough assessments of eligibility by two clinicians, Bill C-14 allows for both intravenous-assisted death by a clinician (euthanasia) and prescription of oral medication for self-administration (assisted suicide). Nevertheless, since inception in June 2016, intravenous euthanasia is the main form of delivery of assisted death in Canada. The reasons why oral MAiD is underutilized in Canada are multifactorial. Currently, there is no consensus on either the medications or the protocols for oral administration, nor a comprehensive...
Source: Canadian Journal of Anesthesia - August 15, 2019 Category: Anesthesiology Source Type: research

A biased coin up-and-down sequential allocation trial to determine the optimum programmed intermittent epidural bolus time interval between 5 mL boluses of bupivacaine 0.125% with fentanyl 2 µg·mL −1
ConclusionThe EI90 between 5 mL boluses of bupivacaine 0.125% with fentanyl 2 µg·mL−1 during the first stage of labour is approximately 35 min.Trial registrationwww.clinicaltrials.gov (NCT #02758405); registered 2 May, 2016. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2019 Category: Anesthesiology Source Type: research