Using automated pump-delivery devices to reduce the incidence of excessive fluid administration during pediatric dental surgery: a randomized-controlled trial
AbstractPurposeThe harms caused by excessive perioperative intravenous (IV) fluid administration are both well recognized and avoidable. The purpose of this study was to compare the incidence of excess intraoperative fluid administration in pediatric dental surgery patients when either an automated pump-delivery device or a manual gravity-drip device is used.MethodsWe randomly assigned American Society of Anesthesiologists physical status I and II pediatric dental surgery patients to receive IV fluid via either a manual gravity-drip or automated pump-delivery device. Prior to each case, the attending anesthesiologist deter...
Source: Canadian Journal of Anesthesia - August 5, 2020 Category: Anesthesiology Source Type: research

Carbetocin compared with oxytocin in non-elective Cesarean delivery: a systematic review, meta-analysis, and trial sequential analysis of randomized-controlled trials
ConclusionsCarbetocin reduces the need for additional uterotonics in non-elective CD compared with oxytocin. TSA confirmed that this analysis was appropriately powered to detect the pooled estimated effect. Further trials utilizing consistent core outcomes are needed to determine an effect on PPH.Trial registrationPROSPERO CRD42019147256, registered 13 September 2019. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 3, 2020 Category: Anesthesiology Source Type: research

How the high acuity unit changes mortality in the intensive care unit: a retrospective before-and-after study
AbstractPurposeHigh acuity units (HAU) are hospital units that provide patients with more acute care and closer monitoring than a general hospital ward but are not as resource intensive as an intensive care unit (ICU). Nevertheless, the impact of opening a HAU on ICU patient outcomes remains poorly defined. We investigated how the creation of a HAU impacted patient outcomes in the ICU.MethodsThis historical cohort study compared ICU patient in-hospital mortality, ICU length of stay (LOS), and hospital LOS before and after the creation of a HAU in a tertiary-care hospital with a medical/surgical ICU between 1 January 2013 a...
Source: Canadian Journal of Anesthesia - August 3, 2020 Category: Anesthesiology Source Type: research

In reply: Potential risks associated with intensive care unit aerosol isolation hood use
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 3, 2020 Category: Anesthesiology Source Type: research

Potential risks associated with intensive care unit aerosol isolation hood use
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 3, 2020 Category: Anesthesiology Source Type: research

Spinal anesthesia for Cesarean delivery in women with COVID-19 infection: questions regarding the cause of hypotension
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

The lack of construct validity when assessing clinical clerks during their anesthesia rotations
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

Adult-onset presentation of a urea cycle disorder necessitating intensive care unit admission
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

In reply: Potential statistical issues in a study comparing postoperative hunger in patients anesthetized with propofol or sevoflurane
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

COVID-19 pandemic: the 3R ’s (reduce, refine, and replace) of personal protective equipment (PPE) sustainability
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

In reply: Spinal anesthesia for Cesarean delivery in women with COVID-19 infection: questions regarding the cause of hypotension
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

Potential statistical issues in a study comparing postoperative hunger in patients anesthetized with propofol or sevoflurane
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

Stress dose steroids —take another look at the literature
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

Safe(r) transesophageal echocardiography and COVID-19
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

Small-volume subdural injection with extensive cephalad spread
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2020 Category: Anesthesiology Source Type: research

A request for directed organ donation in medical assistance in dying (MAID)
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

The effect of intravenous dexamethasone on postoperative nausea and vomiting after Cesarean delivery with intrathecal morphine: a randomized-controlled trial
ConclusionsThis trial does not support the use of dexamethasone prior to intrathecal morphine for PONV prophylaxis in Cesarean delivery.Trial registrationwww.clinicaltrials.gov (NCT01734161); registered 27 November, 2012. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

The effect of morbid obesity or advanced maternal age on oxytocin-induced myometrial contractions: an in vitro study
AbstractPurposeThe purpose of this study was to investigate myometrial contractility induced by oxytocin in women with  advanced maternal age (AMA) and morbid obesity (MO). We hypothesized that both oxytocin-pretreated and oxytocin-naïve myometrial tissues from women of AMA and women who are MO would exhibit poor myometrial contractility compared with women that are younger and of normal body mass index (BMI).MethodsThis prospectivein vitro study was conducted using myometrial samples obtained from women undergoing elective Cesarean deliveries. Three groups of patient were studied: control ( ≤ 35 yr; BMI,...
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

Assessing the need for a chlorhexidine-containing central venous catheter: balancing the risk of anaphylaxis with infection
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

The impact of high-flow nasal cannula (HFNC) on coughing distance: implications on its use during the novel coronavirus disease outbreak
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

Potassium chloride for medical assistance in dying followed by organ donation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

In reply: Potential mechanism for bilateral sensory effects after a unilateral erector spinae plane block
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

Potential mechanism for bilateral sensory effects after a unilateral erector spinae plane block
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

In reply: Assessing the need for a chlorhexidine-containing central venous catheter: balancing the risk of anaphylaxis with infection
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 30, 2020 Category: Anesthesiology Source Type: research

Video Modeling and Video Feedback to Reduce Time to Perform Intravenous Cannulation in Medical Students: A Randomized-Controlled Mixed-Methods Study
ConclusionVideo modeling and feedback shortened time to IV skill completion, reduced complications, and improved satisfaction in novice medical students. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Patient factors associated with difficult flexible bronchoscopic intubation under general anesthesia: a prospective observational study
AbstractPurposePatient characteristics associated with difficult tracheal intubation using a flexible bronchoscope (FB) under general anesthesia have not been prospectively evaluated. This observational study aimed to identify demographic and morphologic factors associated with difficult FB intubation.MethodsWe recruited 420 adult elective surgery patients undergoing tracheal intubation during general anesthesia. Patients characteristics were recorded including age, sex, weight, height, body mass index, American Society of Anesthesiologists physical status, history of snoring, obstructive sleep apnea, Mallampati score, upp...
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Hungry for knowledge —the role of quality improvement projects in Canadian anesthesia departments
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Is ultrasound assessment of the inferior vena cava for fluid responsiveness unlikely to be helpful, or is it just too early to say?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

In reply: Regional anesthesia catheter tunnelling: a simpler approach
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Regional anesthesia catheter tunnelling: a simpler approach
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Oxford Textbook of Anesthesia e-book
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Advantages of a second ventilation circuit when using a double-lumen endotracheal tube
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

In reply: Is ultrasound assessment of the inferior vena cava for fluid responsiveness unlikely to be helpful, or is it just too early to say?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Lidocaine during intubation and extubation in patients with coronavirus disease (COVID-19)
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 11, 2020 Category: Anesthesiology Source Type: research

Variability in deceased donor care in Canada: a report of the Canada-DONATE cohort study
ConclusionThese study findings highlight areas for knowledge translation and further clinical research. Interprovincial discrepancies will likely pose unique challenges to national randomized trials.Trial registration: www.clinicaltrials.gov (NCT03114436); registered 10 April, 2017. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2020 Category: Anesthesiology Source Type: research

Impact of leg movement on skin-adductor canal distance: a potential cause for catheter tip displacement?
AbstractPurposeCatheter-based adductor canal blocks are an effective pain management strategy for total knee arthroplasty. Nevertheless, catheter-based techniques may fail if the tip migrates because of leg movement. This observational study used ultrasound to measure the distance from the skin to the adductor canal (SAC). We tested the hypothesis that leg movements mimicking those occurring during postoperative physiotherapy change the SAC distance.MethodsFollowing total knee arthroplasty under spinal anesthesia, the SAC distance was measured using ultrasound in 40 patients. The leg was passively moved into five standardi...
Source: Canadian Journal of Anesthesia - May 8, 2020 Category: Anesthesiology Source Type: research

An exploratory study of the McKay airway to assist bag-mask ventilation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2020 Category: Anesthesiology Source Type: research

Post-exposure prophylaxis or pre-emptive therapy for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2): study protocol for a pragmatic randomized-controlled trial
We describe the design of a clinical trial of hydroxychloroquine for post-exposure prophylaxis (PEP) and pre-emptive therapy (PET) for COVID-19.MethodsWe will conduct two nested multicentre international double-blind randomized placebo-controlled clinical trials of hydroxychloroquine for: 1) PEP of asymptomatic household contacts or healthcare workers exposed to COVID-19 within the past four days, and 2) PET for symptomatic outpatients with COVID-19 showing symptoms for less than four days. We will recruit 1,500 patients each for the PEP and PET trials. Participants will be randomized 1:1 to receive five days of hydroxychl...
Source: Canadian Journal of Anesthesia - May 7, 2020 Category: Anesthesiology Source Type: research

External validation of a prognostic model for intensive care unit mortality: a retrospective study using the Ontario Critical Care Information System
ConclusionsA risk prediction model primarily based on the MODS shows reproducibility and transportability after intercept recalibration. Risk adjusting models that use existing and feasible data collection can support performance measurement at the individual ICU level. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2020 Category: Anesthesiology Source Type: research

In reply: Does length of intubation explain the failure of intracuff local anesthetic to reduce postoperative sore throat
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2020 Category: Anesthesiology Source Type: research

Defining critical and non-critical moments in the operating room: a modified Delphi consensus study
ConclusionsBy defining the most critical moments of surgery, future research can determine the relative importance of behaviour and actions at each stage and target interventions to these stages. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 6, 2020 Category: Anesthesiology Source Type: research

Does length of intubation explain the failure of intracuff local anesthetic to reduce postoperative sore throat?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 6, 2020 Category: Anesthesiology Source Type: research

A report of probable paroxysmal sympathetic hyperactivity syndrome in a patient with necrotizing fasciitis
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 5, 2020 Category: Anesthesiology Source Type: research

Sedation during vitreoretinal surgery: practice patterns in Canada
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 4, 2020 Category: Anesthesiology Source Type: research

What to do when perioperative point-of-care ultrasound shows evidence of a full stomach despite fasting?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 1, 2020 Category: Anesthesiology Source Type: research

Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #2)
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 1, 2020 Category: Anesthesiology Source Type: research

Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letter #1)
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 1, 2020 Category: Anesthesiology Source Type: research

In reply: Regional anesthesia during the COVID-19 pandemic: a time to reconsider practices? (Letters #1 and #2)
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 1, 2020 Category: Anesthesiology Source Type: research

The effect of Tegaderm ™ versus EyeGard® on eyelid erythema during general anesthesia: a randomized-controlled trial
ConclusionWe found a small increase in postoperative eyelid erythema when using Tegaderm compared with EyeGard. While EyeGard could decrease the risk of eyelid erythema, this should be balanced against other potential benefits of Tegaderm such as protection from fluids leaking onto the cornea.Trial registrationwww.ClinicalTrials.gov (NCT03549429); registered 8 June, 2018. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 21, 2020 Category: Anesthesiology Source Type: research

Direct versus indirect laryngoscopy using a Macintosh video laryngoscope: a mannequin study comparing applied forces
ConclusionsIn this mannequin study, lower forces applied during indirectvs direct laryngoscopy may reflect an advantage of video laryngoscopy, but additional studies using patients are required to confirm the clinical implications of these findings. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 21, 2020 Category: Anesthesiology Source Type: research