In reply: Why goal-directed hemodynamic therapy is often ineffective and how can we try to improve the results
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2018 Category: Anesthesiology Source Type: research

The “stressed blood volume” revisited
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2018 Category: Anesthesiology Source Type: research

An analytical perspective on the venous return controversy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2018 Category: Anesthesiology Source Type: research

Stressed and unstressed volumes of the peripheral vasculature
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2018 Category: Anesthesiology Source Type: research

Comments on “Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy”
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 6, 2018 Category: Anesthesiology Source Type: research

In reply: Comments on “Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy”
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 6, 2018 Category: Anesthesiology Source Type: research

Effect of preoperative warming on intraoperative hypothermia: a randomized-controlled trial
AbstractPurposeThe purpose of this study was to evaluate the effects of preoperative forced-air warming on intraoperative hypothermia.MethodsIn this randomized-controlled trial, adult patients scheduled for elective, non-cardiac surgery under general anesthesia were stratified by scheduled surgical duration (
Source: Canadian Journal of Anesthesia - June 5, 2018 Category: Anesthesiology Source Type: research

Severe acute postoperative airway compromise secondary to submandibular sialadenitis
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 5, 2018 Category: Anesthesiology Source Type: research

A survey of medication preparation and administration practices among members of the Canadian Anesthesiologists ’ Society
ConclusionSharing medication vials between multiple patients is common practice in Canada, with new needles and syringes used for each patient. Unfortunately, a small minority of anesthesiologists continue to reuse needles and/or syringes between patients, and this may pose a significant risk of patient-to-patient infection transmission. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 4, 2018 Category: Anesthesiology Source Type: research

Cervical erector spinae plane block catheter using a thoracic approach: an alternative to brachial plexus blockade for forequarter amputation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 4, 2018 Category: Anesthesiology Source Type: research

Optimal dose of intrathecal isobaric bupivacaine in total knee arthroplasty
ConclusionIn this small study with tight control over operative duration, the median effective dosage of intrathecal isobaric bupivacaine for primary unilateral TKA was 3.5 mg and the ED95 was 5 mg. Reduction of conventional dosages of intrathecal bupivacaine is feasible at centres using fast-track arthroplasty protocols. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 1, 2018 Category: Anesthesiology Source Type: research

Ketamine-based anesthesia improves electroconvulsive therapy outcomes: a randomized-controlled study
ConclusionsIn this early-terminated small-sized study, ketamine-based anesthesia compared with propofol-based anesthesia provided response and remission after fewer ECT sessions.Trial registrationwww.clinicaltrials.gov (NCT01935115). Registered 4 September 2013. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

Dexmedetomidine versus propofol-opioid for sedation in transcatheter aortic valve implantation patients: a retrospective analysis of periprocedural gas exchange and hemodynamic support
AbstractPurposeDifferent sedation regimens have been described for use during transfemoral transcatheter aortic valve implantation (tf-TAVI) for treatment in patients with severe aortic stenosis. The purpose of this study was to compare dexmedetomidine (DEX) with a combination of propofol-opioid (PO) with respect to periprocedural gas exchange and hemodynamic support.MethodsData from a cohort of patients sedated with either DEX or PO for tf-TAVI were retrospectively analyzed from a prospectively maintained TAVI registry. Operative risk was determined from comorbidities and risk scores. Periprocedural partial pressure of ca...
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

Can we prevent significant brain desaturation during defibrillator testing by increasing the brain saturation reserve?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

The Pediatric Cardiac Anesthesia Handbook
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

The impact of reducing intensive care unit length of stay on hospital costs: evidence from a tertiary care hospital in Canada
ConclusionReducing ICU LOS has limited cost-saving potential given that ICU costs are greatest early in the course of admission, and this study does not support the notion of reducing ICU LOS as a sole cost-saving strategy. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

Avoidable tracheal injury using a double-lumen endotracheal tube: a case report
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

Le bless é par attentat terroriste
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

The use of ultrasound imaging for brachial plexus injury assessment following operative clavicle repair
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

The use of point-of-care ultrasound to diagnose patent foramen ovale in elective hip and knee arthroplasty patients and its association with postoperative delirium
ConclusionGiven the very low incidence of PFO and postoperative delirium in this study, we could not form any conclusions regarding the impact of a PFO on important outcomes including delirium or other major adverse events. No recommendation can be made regarding screening for PFO in patients scheduled for lower extremity arthroplasty surgery.Trial registrationClinicalTrials.gov (NCT02400892). Registered 27 March 2015. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2018 Category: Anesthesiology Source Type: research

Ethical dilemmas in global anesthesia and surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 14, 2018 Category: Anesthesiology Source Type: research

Learning beyond the operating room: a call for feedback on postoperative care
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 9, 2018 Category: Anesthesiology Source Type: research

World Health Organization-World Federation of Societies of Anaesthesiologists (WHO-WFSA) International Standards for a Safe Practice of Anesthesia
AbstractThe International Standards for a Safe Practice of Anesthesia were developed on behalf of the World Federation of Societies of Anaesthesiologists (WFSA), a non-profit organization representing anesthesiologists in 150 countries, and the World Health Organization (WHO). The recommendations have been approved by WHO and the membership of WFSA. These Standards are applicable to all anesthesia providers throughout the world. They are intended to provide guidance and assistance to anesthesia providers, their professional organizations, hospital and facility administrators, and governments for maintaining and improving t...
Source: Canadian Journal of Anesthesia - May 7, 2018 Category: Anesthesiology Source Type: research

When and how should we cluster and cross over: methodological and ethical issues
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 4, 2018 Category: Anesthesiology Source Type: research

The impact of hyperoxia on outcomes after cardiac surgery: a systematic review and narrative synthesis
ConclusionsHyperoxia had minimal impact on organ dysfunction, length of stay, and mortality in adult cardiac surgery. The current evidence base is small, heterogeneous, and at risk of bias.Trial registrationInternational Prospective Register of Systematic Reviews (PROSPERO) (CRD42017074712). Registered 17 August 2017. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 2, 2018 Category: Anesthesiology Source Type: research

Primary central sleep apnea and anesthesia: a retrospective case series
AbstractPurposePrimary (idiopathic) central sleep apnea (PCSA) is a rare central sleep-related breathing disorder characterized by increased chemoreceptor sensitivity to partial pressure of carbon dioxide, which manifests as hyperventilation followed by apnea during non-rapid eye movement sleep. The purpose of this retrospective study was to describe the postoperative course of patients who had PCSA and underwent procedures requiring anesthetic management.MethodsPatients who received a diagnosis of PCSA at our institution and required procedural anesthesia between 1 January 2010 and 1 June 2016 underwent a comprehensive re...
Source: Canadian Journal of Anesthesia - May 1, 2018 Category: Anesthesiology Source Type: research

Intraoperative cerebral oximetry-based management for optimizing perioperative outcomes: a meta-analysis of randomized controlled trials
ConclusionsIntraoperative cerebral oximetry appears to be associated with a reduction in POCD, although this result should be interpreted with caution given the significant heterogeneity in the studies examined. Further large (ideally multicentre) RCTs are needed to clarify whether POCD can be favourably impacted by the use of cerebral oximetry-guided management. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

Intraoperative Valsalva maneuver: a narrative review
AbstractThe Valsalva maneuver (VM) involves expiratory effort against a closed mouth and/or glottis in the sitting or supine position with the increased intraoral and intrathoracic  pressure raised to 40 mmHg for 15-20 sec after which the pressure is suddenly released and the breathing restored to normal. Complex cardiovascular and other physiologic changes occur during the VM. The VM has been used for diagnostic and therapeutic reasons as well as intraoperatively during spec ific surgical procedures. Although the VM is usually safe, rare complications have been reported. This review examines the published literature ...
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

Self-pressurized air-Q ® intubating laryngeal airway versus the LMA ® Classic™: a randomized clinical trial
AbstractPurposeThe self-pressurized air-Q ® (air-Q SP) intubating laryngeal airway is a relatively new supraglottic airway (SGA) device. The intracuff pressure of air-Q dynamically equilibrates with the airway pressure and adjusts to the patient’s pharyngeal and periglottic anatomy, potentially providing improved airway fit and seal. The aim of this prospective randomized study was to compare the clinical performance of air-Q to the LMA® Classic™ SGA.MethodsAdult patients requiring general anesthesia for elective surgery were prospectively enrolled and randomly assigned to either air-Q SP or the LMA Cla...
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

Effect of position and positive pressure ventilation on functional residual capacity in morbidly obese patients: a randomized trial
AbstractPurposeIn morbidly obese patients, the position and ventilation strategy used during pre-oxygenation influence the safe non-hypoxic apnea time and the functional residual capacity (FRC). In awake morbidly obese volunteers, we hypothesized that the FRC would be higher after a five-minute period of positive pressure ventilation compared with spontaneous ventilation at zero inspiratory pressure.MethodsUsing a prospective crossover randomized trial design, obese subjects underwent, in a randomized order, a combination of one of three positions, supine (S), beach chair (BC), and reverse Trendelenburg (RT), and one of tw...
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

Monitoring the brain strikes a discordant note for anesthesiologists
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

In reply: Postoperative pain and study design: the type of surgical procedure matters
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

Radial artery spasm treatment by radial, median, or musculocutaneous nerve block? A potential therapeutic dilemma
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 6, 2018 Category: Anesthesiology Source Type: research

Anesthesia for interventional pulmonology procedures: a review of advanced diagnostic and therapeutic bronchoscopy
ConclusionsIt is fundamental for the anesthesia provider to be updated on interventional pulmonology procedures in this rapidly growing area of medicine. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 5, 2018 Category: Anesthesiology Source Type: research

Monitoring the Nervous System for Anesthesiologists and Other Health Care Professionals, Second Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 2, 2018 Category: Anesthesiology Source Type: research

Benefits of recording images during video laryngoscopy for early detection of oropharyngeal and laryngeal lesions: implications for “inattentional blindness”
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 2, 2018 Category: Anesthesiology Source Type: research

Updated guide for the management of malignant hyperthermia
ConclusionsThe risk of dying from MH has increased over the past few years. A knowledgeable anesthesiologist who is diligent and attentive can recognize signs of an impending MH reaction and treat promptly to avoid complications of this deadly condition. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 29, 2018 Category: Anesthesiology Source Type: research

Pectoral nerves I block is associated with a significant motor blockade with no dermatomal sensory changes: a prospective volunteer randomized-controlled double-blind study
ConclusionsThis study shows that a PECS I block produces motor blockade as shown by reduced upper limb adductor strength without any overlying dermatomal sensory loss.Trial registrationwww.clinicaltrials.gov (NCT03040167) 2 February 2017. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 29, 2018 Category: Anesthesiology Source Type: research

In reply: Not which forceps, but whether forceps?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 27, 2018 Category: Anesthesiology Source Type: research

Not which forceps, but whether forceps?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 27, 2018 Category: Anesthesiology Source Type: research

Comparison of oropharyngeal leak pressure between the Ambu ® AuraGain™ and the LMA® Supreme™ supraglottic airways: a randomized-controlled trial
AbstractPurposeStudies comparing the recently introduced Ambu ® AuraGain™ (Auragain) with the LMA® Supreme™ (Supreme) supraglottic airway (SGA) have reported conflicting results regarding differences in oropharyngeal leak pressure (OLP). This randomized-controlled trial investigated the OLP of the Auragain compared with the Supreme in patients undergoing ambulatory surgery.MethodsAdult patients with a body mass index ≤ 40 kg·m−2 presenting for ambulatory surgery and requiring an SGA were randomized to receive either the Auragain or the Supreme. Anesthesia was induced with lidocaine (1 mg...
Source: Canadian Journal of Anesthesia - March 26, 2018 Category: Anesthesiology Source Type: research

Complications of Regional Anesthesia: Principles of Safe Practice in Local and Regional Anesthesia – Third Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 26, 2018 Category: Anesthesiology Source Type: research

A 25-year retrospective analysis of the American Society of Anesthesiologists physical status classification: did we “up-code” young obese patients when obesity was not yet considered a disease?
AbstractPurposeThe influence of obesity on anesthetic risk remains controversial, and obesity has only recently been specifically identified as a criterion by which a patient can be given a higher American Society of Anesthesiologists-physical status (ASA-PS) score. Nevertheless, we hypothesized that clinicians had assigned obese patients a greater ASA-PS score before obesity became an “official” criterion in 2015.MethodsBasic demographic and physical details were collected on patients receiving anesthetics in the Virginia Commonwealth University Health System between 1986 and 2010. The risk ratio (RR) of &ldqu...
Source: Canadian Journal of Anesthesia - March 23, 2018 Category: Anesthesiology Source Type: research

Sample size calculations for randomized clinical trials published in anesthesiology journals: a comparison of 2010 versus 2016
ConclusionWhile the reporting of sample size calculations improved from 2010 to 2016, the expected values in these sample size calculations often assumed effect sizes larger than those actually observed in the study. Since overly optimistic assumptions may systematically lead to underpowered RCTs, improvements in how to calculate and report sample sizes in anesthesiology research are needed. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 22, 2018 Category: Anesthesiology Source Type: research

A simple and widely available alternative method for endotracheal tube cuff pressure monitoring
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 22, 2018 Category: Anesthesiology Source Type: research

Miller ’s Anesthesia Review: Third Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 19, 2018 Category: Anesthesiology Source Type: research

Relative importance of strategies for improving the sample size selection and reporting of small randomized clinical trials in anesthesiology
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 19, 2018 Category: Anesthesiology Source Type: research

Reappraisal of the Canadian Critical Care Society ’s position on withholding and withdrawing life-sustaining treatment
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 16, 2018 Category: Anesthesiology Source Type: research

In reply: Reappraisal of the Canadian Critical Care Society ’s position on withholding and withdrawing life-sustaining treatment
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 16, 2018 Category: Anesthesiology Source Type: research

Pediatric Anesthesiology Review, 2nd Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 15, 2018 Category: Anesthesiology Source Type: research