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Characteristics and outcomes of patients who underwent bedside surgical tracheostomy performed in the intensive care unit: a retrospective study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

The Young Investigator Retreat of the Canadian Critical Care Trials Group: mentorship and self-discovery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

Erector spinae plane block for the management of chronic shoulder pain: a case report
ConclusionsThe ESP block may be a promising alternative to other interventional procedures in the management of chronic shoulder pain and deserves further study. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

Survey of medical students ’ knowledge and perceptions of anesthesiology at one Canadian university: pre-clerkship and during clinical clerkship, a cohort study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

Comparing the socioeconomic status of critical care doctors and patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

A technique for securing the Aintree Intubation Catheter ™ to a flexible bronchoscope
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

Venous circulation and the invisible hand
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

In reply: Eye taping and chlorhexidine exposure: caution when interpreting scarce evidence
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2018 Category: Anesthesiology Source Type: research

Body mass index predicts insulin sensitivity during cardiac surgery: a prospective observational study
AbstractPurposeTaking into account the previously described link between body weight and diabetes mellitus (DM) in non-surgical patients, and the understanding that the degree of intraoperative insulin resistance is a predictor of adverse clinical outcomes, we investigated the relationship between body mass index (BMI) and insulin sensitivity during cardiac surgery.MethodsWe prospectively enrolled 400 patients scheduled for elective cardiac surgery and divided them into groups based on the presence or absence of type-2 DM. They were further categorized into four subgroups based on their BMI: group 1- normal weight, BMI 18....
Source: Canadian Journal of Anesthesia - February 12, 2018 Category: Anesthesiology Source Type: research

The curious tale of perioperative precision medicine: a story of hydroxocobalamin and cardiac surgery-associated vasoplegia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 8, 2018 Category: Anesthesiology Source Type: research

The sound of air: point-of-care lung ultrasound in perioperative medicine
ConclusionsBecause of the unique physical properties of the lungs, only a careful and systematic analysis of both artifacts and anatomical images allows accurate interpretation of sonographic findings. Future studies exploring the use of software for automatic interpretation, quantitative methods for the assessment of interstitial syndrome, and continuous monitoring devices may further simplify and expand the use of this technique at the bedside in acute medicine and the perioperative setting. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 6, 2018 Category: Anesthesiology Source Type: research

The agreement between venous and arterial blood gases in critical care and ward patients: is there a need to stratify for shock?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 5, 2018 Category: Anesthesiology Source Type: research

In reply: the agreement between venous and arterial blood gas in critical care and ward patients: is there a need to stratify for shock?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 5, 2018 Category: Anesthesiology Source Type: research

A review of diagnostic accuracy and clinical impact from the focused use of perioperative ultrasound
ConclusionPerioperative point-of-care ultrasound is a useful method for the diagnosis of many important perioperative conditions. The impact of this diagnostic approach on patient outcomes however remains to be determined. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 2, 2018 Category: Anesthesiology Source Type: research

Postdural puncture headache at Sylvanus Olympio University Hospital of Lom é in Togo: incidence and risk factors
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 2, 2018 Category: Anesthesiology Source Type: research

Ultrasound-guided lateral-medial transmuscular quadratus lumborum block for analgesia following anterior iliac crest bone graft harvesting: a clinical and anatomical study
ConclusionUltrasound-guided TQL injections consistently cover the thoraco-lumbar innervation relevant to the AIC graft donor site. The injectate spread seen in anatomical dissections correlated with the dermatomal anesthesia clinically. The TQL has the potential to provide reliable analgesia for patients undergoing AIC bone graft harvesting. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Equivalent analgesic effectiveness between perineural and intravenous dexamethasone as adjuvants for peripheral nerve blockade: a systematic review and meta-analysis
ConclusionsThe results of our meta-analysis suggest that PN and IV dexamethasone provide equivalent analgesic benefits and have similar safety profiles, when used as adjuvants, for peripheral nerve blockade. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Anesthesiologists ’ perception of perioperative stroke risk during non-neurologic and non-cardiac surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Nitrous oxide added at the end of isoflurane anesthesia hastens early recovery without increasing the risk for postoperative nausea and vomiting: a randomized clinical trial
ConclusionsAdding N2O during the last 30 min of an isoflurane-based inhalational anesthetic reduced the time to extubation, eye opening, and orientation. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Greenhouse gases: the choice of volatile anesthetic does matter
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

A modified lightwand-guided approach for placement of a King Laryngeal Tube ™
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Sodium-glucose cotransporter-2 inhibitors (SGLT-2i) in the perioperative setting
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Subcutaneous ketamine for postoperative pain relief in Rwanda: a randomized clinical trial
AbstractPurposePostoperative pain control is often inadequate in low-income countries such as Rwanda, prompting the search for an inexpensive improvement. A randomized controlled trial was conducted to study the use of subcutaneous ketamine for the management of postoperative pain in patients undergoing major surgery in Kigali, Rwanda.MethodsFifty-nine patients undergoing major abdominal, head and neck, plastic, or gynecological surgeries were studied. In addition to standard care, patients received five subcutaneous injections of ketamine 1 mg ·kg−1 (ketamine group,n = 30) or normal saline (placebo group,n = ...
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Perioperative implications of sodium-glucose cotransporter-2 inhibitors: a case series of euglycemic diabetic ketoacidosis in three patients after cardiac surgery
We present three cases of euDKA that occurred following elective coronary artery bypass grafting surgery. The role of the anesthesiologist in the prevention, diagnosis, and management of this complication is also discussed.Clinical featuresThree patients receiving chronic SGLT2i therapy for DM-II (discontinued one to two days preoperatively) underwent cardiac surgery. On the first postoperative day, each exhibited nausea, vomiting, and tachypnea. Although these nonspecific postoperative findings are common, our patients also exhibited anion gap metabolic acidosis (pH 12 mmol ·L−1) with lower than anticipated s...
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

The gas has the last laugh
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 13, 2018 Category: Anesthesiology Source Type: research

Acquiring and maintaining point-of-care ultrasound (POCUS) competence for anesthesiologists
ConclusionsPresently, our specialty requires consensus by expert stakeholders to address issues of competence, certification, development of standards and terminology, and the management of unexpected diagnoses. To promote POCUS competency in our discipline, we support its incorporation into anesthesiology curricula and training programs and the continuing professional development of POCUS-related activities at a national level. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 11, 2018 Category: Anesthesiology Source Type: research

Management strategies for unintentional dural puncture: a Canadian experience survey in an academic setting
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 11, 2018 Category: Anesthesiology Source Type: research

Impact of ENIGMA trials on nitrous oxide: a survey of Canadian anesthesiologists and residents
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 11, 2018 Category: Anesthesiology Source Type: research

Mobile ascending aortic mass presenting as acute myocardial infarction
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 11, 2018 Category: Anesthesiology Source Type: research

Postoperative pain and study design: the type of surgical procedure matters
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2018 Category: Anesthesiology Source Type: research

Under pressure: an audit of airway device pressures
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 10, 2018 Category: Anesthesiology Source Type: research

In reply: 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 - January 10, 2018 Category: Anesthesiology Source Type: research

Efficacy of ultrasound-guided modified thoracolumbar interfascial plane block for postoperative analgesia after spinal surgery: a randomized-controlled trial
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - January 9, 2018 Category: Anesthesiology Source Type: research

Effect of dexamethasone dose and route on the duration of interscalene brachial plexus block for outpatient arthroscopic shoulder surgery: a randomized controlled trial
ConclusionCompared with the intravenous route, perineural dexamethasone prolongs the mean interscalene block duration by a small amount that may or may not be clinically significant, regardless of dose. However, the difference in mean block durations between 8 mg and 4 mg of dexamethasone is highly unlikely to be clinically important, regardless of the administration route.Trial registrationwww.clinicaltrials.gov (NCT02426736). Registered 14 April 2015. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

Withholding and withdrawing life-sustaining treatment: The Canadian Critical Care Society position paper
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

Incidence of non-physiologically complex surgical procedures performed in children: an Ontario population-based study of health administrative data
AbstractPurposeQuantification of surgical procedures undertaken by hospitals is necessary for informing resource allocation and modelling healthcare services. Our objective was to quantify the incidence, similarity, and diversity of non-physiologically complex surgical procedures performed at pediatric specialist hospitals and other hospitals performing pediatric surgery.MethodsWe conducted a population-based cohort study of children aged 28 days to 18 yr who underwent surgery in the province of Ontario from 2007 to 2015 using healthcare administrative databases. We estimated the incidence of non-physiologically complex pr...
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

Withholding and withdrawing life support: difficult decisions around care at the end of life
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

Correction to: A primer on nerve agents: what the emergency responder, anesthesiologist, and intensivist needs to know
AbstractIn the article entitled: “A primer on nerve agents: what the emergency responder, anesthesiologist, and intensivist needs to know” published in the October 2017 issue of theJournal, Can J Anesth 2017; 64: 1059-1070, two doses in Table  3 contained errors and have now been corrected (and highlighted in bold) in the revised table herein. In the table on page 1064, next to “Pralidoxime/Obidoxime/HI-6”, the second column should read: “Pralidoxime- Mild cases:1-2 giv over 5-10 min orim”. Also in the same row, the third column should read: “Individual doses should not exceed...
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

T éléconsultation d’anesthésie au domicile : une enquête d’acceptabilité
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 20, 2017 Category: Anesthesiology Source Type: research

The Leech airway: precursor to the modern supraglottic airway
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 20, 2017 Category: Anesthesiology Source Type: research

Review of the enhanced recovery pathway for children: perioperative anesthetic considerations
ConclusionAlthough adult ERAS pathways have been successful at reducing patient morbidity, the translation, creation, and utility of instituting pediatric ERAS pathways have yet to be realized. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 19, 2017 Category: Anesthesiology Source Type: research

A randomized comparison between interscalene and combined infraclavicular-suprascapular blocks for arthroscopic shoulder surgery
AbstractBackgroundThis randomized trial aimed to evaluate combined infraclavicular-suprascapular blocks (ICB-SSBs) as a diaphragm-sparing alternative to interscalene blocks (ISBs) for arthroscopic shoulder surgery. We hypothesized that ICB-SSB would provide equivalent postoperative analgesia to ISB 30 min after surgery without the risk of hemidiaphragmatic paralysis.MethodsFollowing research ethics board approval and written informed consent, participants in the ISB group received an ultrasound-guided ISB with 20  mL of levobupivacaine 0.25% and epinephrine 5 µg·mL−1. In the ICB-SSB group, ultr...
Source: Canadian Journal of Anesthesia - December 19, 2017 Category: Anesthesiology Source Type: research

The physiologic basis for goal-directed hemodynamic and fluid therapy: the pivotal role of the venous circulation
ConclusionsThe physiologic basis of goal-directed hemodynamic therapy is complex and not necessarily reflected in the information received from hemodynamic monitors. Understanding the physiologic basis of such therapy is a logical step towards its optimal use. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

Benzodiazepine administration during adult cardiac surgery: a survey of current practice among Canadian anesthesiologists working in academic centres
ConclusionsBenzodiazepine use is common among academic cardiac anesthesiologists in Canada. Nonetheless, heterogeneity exists between individual practices, suggesting clinical equipoise between restrictive and liberal administration of benzodiazepines for cardiac anesthesia. L ’administration de benzodiazépines pendant la chirurgie cardiaque chez l’adulte: évaluation de la pratique actuelle des anesthésiologistes canadiens exerçant en milieu universitaire (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

Case Studies in Adult Intensive Care Medicine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

The utility and safety of flexible bronchoscopy in critically ill acute leukemia patients: a retrospective cohort study
ConclusionsFlexible bronchoscopy with BAL is relatively safe and helps to guide medical management among patients with AL admitted to the ICU. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

Correction to: Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review
AbstractThe following row on page 691 of Table  3, as highlighted in bold under Incidence of Retention (%) should read “0” instead of “N/A”. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

St. Ren é Goupil: the patron saint of anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 15, 2017 Category: Anesthesiology Source Type: research

Guidelines to the Practice of Anesthesia – Revised Edition 2018
OverviewThe Guidelines to the Practice of Anesthesia Revised Edition 2018 (the Guidelines) were prepared by the Canadian Anesthesiologists ’ Society (CAS), which reserves the right to determine their publication and distribution. The Guidelines are subject to revision and updated versions are published annually. The Guidelines to the Practice of Anesthesia Revised Edition 2018 supersedes all previously published versions of this docu ment. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the CAS cannot guarantee any specific patient outco...
Source: Canadian Journal of Anesthesia - December 14, 2017 Category: Anesthesiology Source Type: research

Interventions to improve the mechanical ventilation fidelity of the Laerdal SimMan ® 3G simulation mannequin
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 14, 2017 Category: Anesthesiology Source Type: research