Parental presence at induction of anesthesia is feasible with minimal preparation and resources
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 3, 2016 Category: Anesthesiology Source Type: research

A randomized-controlled trial of high- or low-volume intravenous Plasma-Lyte ® to prevent hypotension during sedation for colonoscopy
Abstract Purpose The purpose of this study was to compare the incidence of hypotension during sedation in adults presenting for elective colonoscopy and randomized to intravenous Plasma-Lyte 148® at either 2 mL·kg−1 (low volume) or 20 mL·kg−1 (high volume). Methods Patients aged ≥ 18 yr presenting for elective colonoscopy, with or without gastroscopy, after oral bowel preparation were randomized to receive the intervention immediately before the start of the procedure. Hypotension was defined as a ≥ 25% decrease...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

“Must do CPR??”: strategies to cope with the new College of Physicians and Surgeons of Ontario policy on end-of-life care
Abstract The College of Physicians and Surgeons of Ontario recently released a new policy, Planning for and Providing Quality End-of-Life Care. The revised policy is more accurate in its consideration of the legal framework in which physicians practice and more reflective of ethical issues that arise in end-of-life (EOL) care. It also recognizes valid instances for not offering cardiopulmonary resuscitation (CPR). Nevertheless, the policy poses a significant ethical and legal dilemma—i.e., if disputes over EOL care arise, then physicians must provide CPR even when resuscitation would fall outside this medic...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

The alignment approach to nasotracheal intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Physical Diagnosis of Pain: an Atlas of Signs and Symptoms - 3rd Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Utility of transesophageal echocardiography in identifying spinal canal structures and epidural catheter position: a prospective observational study of intraoperative hemodynamics and postoperative analgesia
Abstract Purpose The aims of this study were to determine the utility of transesophageal echocardiography (TEE) for identifying spinal canal structures and epidural catheter position and to assess the effect of catheter position on intraoperative hemodynamics and quality of postoperative analgesia. Methods Twenty-six adult patients undergoing thoracic surgery were included in this prospective, observational study. An epidural catheter was inserted 7.5 cm or more into the thoracic epidural space using a midline approach and a loss-of-resistance tec...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Prolonged transesophageal echocardiography during percutaneous closure of the left atrial appendage without general anesthesia: the utility of the Janus mask
Conclusion Deep sedation with noninvasive ventilation may be a reasonable and safe alternative to general endotracheal anesthesia in patients requiring prolonged TEE for noninvasive cardiac procedures, including LAA closure. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Rationale for a modified endotracheal tube for intubation using video laryngoscopy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Objective Structured Clinical Examination in Intensive Care Medicine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

The future of regional anesthesia education: lessons learned from the surgical specialty
Conclusion In this narrative review, we describe the theory behind the evolution of surgical skills training. We also outline how we can apply these learning theories and simulation models to a competency-based curriculum for training in ultrasound-guided regional anesthesia. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Latex sensitization in patients with myelomeningocele undergoing urological procedures: prevalence and associated factors
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Low oxygen content in medical air outlets mounted on movable ceiling pendants
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Anesthetic management for Cesarean delivery in parturients with a diagnosis of dwarfism
Abstract Purpose The literature on the anesthetic management of parturients with dwarfism is sparse and limited to isolated case reports. Pregnancy complications associated with dwarfism include an increased risk of respiratory compromise, an increased risk of Cesarean delivery, and an unpredictable degree of anesthesia with neuraxial techniques. Therefore, we conducted this retrospective review to evaluate the anesthetic management of parturients with a diagnosis of dwarfism. Methods We used a query of billing data to identify short statured wome...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Emergency airway management: What are the roles for surgical cricothyroidotomy and the Ventrain ® device?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Echocardiographic guidance for MitraClip implantation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Rationale for a modified endotracheal tube for intubation using video laryngoscopy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

A technique for advancing an endotracheal tube over a stylet during intubation when an assistant is not available
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Spinal prilocaine for same-day surgery: the importance of equipotent doses
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Curriculum reform for residency training: competence, change, and opportunities for leadership
Conclusion Canadian anesthesia residency programs will soon transition to CBME in order to promote better transparency, accountability, fairness, fiscal responsibility, and patient safety. Competency-based medical education offers significant potential advantages for healthcare stakeholders. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Dosing and efficacy of intranasal dexmedetomidine sedation for pediatric transthoracic echocardiography: a retrospective study
Conclusion We found that aerosolized intranasal dexmedetomidine offers satisfactory conditions for TTE in children three months to three years of age with an optimal dose of 2.5-3.0 µg·kg−1administered under the supervision of a pediatric cardiac anesthesiologist. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

A qualitative study exploring mentorship in anesthesiology: perspectives from both sides of the relationship
Conclusion We identified three key factors that facilitate or hinder mentorship relationships and proposed solutions for designing effective mentorship programs for postgraduate training programs. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Safety and comparative costs of preoperative assessments for cataract surgery: traditional mandatory assessment versus a novel graded assessment system
Conclusion The graded system resulted in no major complications and a low rate of minor complications. The information obtained from the mandatory assessment is unlikely to prevent complications. Additionally, the cost effectiveness of the mandatory system was poor. This novel graded preoperative assessment system for cataract surgery patients can save time and resources by eliminating unnecessary patient visits. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Intracuff 160 mg alkalinized lidocaine reduces cough upon emergence from N 2 O-free general anesthesia: a randomized controlled trial
This study evaluates the benefits of endotracheal tube (ETT) intracuff alkalinized lidocaine during N2O-free general anesthesia by 1) assessing the in vitro effect of alkalinization on lidocaine diffusion kinetics across the cuff’s membrane and 2) evaluating, in a randomized controlled clinical trial, the impact of 160 mg of intracuff alkalinized lidocaine on cough upon emergence from anesthesia for surgery lasting> 120 min. Methods In the in vitro study, diffusion kinetics of various intracuff alkalinized lidocaine amounts (40, 80, and 160 mg) were compared to their non...
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Competency-based medical education: Its time has arrived
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Embolie amniotique compliquant une interruption médicale de la grossesse
Conclusion L’embolie amniotique est un diagnostique rare et difficile surtout lors de situations inhabituelles mais qui peut être facilité par la recherche sérique de marqueurs amniotiques et de la tryptase. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Performing post-tetanic count during rocuronium blockade has limited impact on subsequent twitch height or train-of-four responses
Conclusion A small but clinically insignificant increase in T1 is seen for at least ten minutes after PTC without any detectable change in T4/T1 values. The TOF responses are reliable as early as one minute after PTC. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Lung Ultrasound in the Critically Ill – The BLUE Protocol
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Methylene blue-induced serotonin syndrome presenting with ocular clonus and failure of emergence from general anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

The C-MAC ® D-BLADE™: use of the guide rail as a guiding channel for a gum elastic bougie
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Strategies for lung isolation: to block or not to block?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Lack of data on standardized metrics for surgical care in a developing country with middle total expenditure on health
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Novel maneuvers to increase the internal jugular vein diameter during ultrasound-guided cannulation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

In Reply: Fellowships and subspecialization in anesthesia: Are they good, bad, or both?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

The “William Tell” sign: difficult airway resulting from cranial transfixion by an arrow
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

In reply: Neuromuscular monitoring should be required when neuromuscular blocking drugs are used: Is it time to change the Canadian guidelines?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Fellowships and subspecialization in anesthesia: Are they good, bad, or both?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Neuromuscular monitoring should be required when neuromuscular blocking drugs are used: Is it time to change the Canadian guidelines?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Postoperative awake paralysis in the intensive care unit after cardiac surgery due to residual neuromuscular blockade: a case report and prospective observational study
Conclusion Postoperative residual paralysis after fast-track cardiac surgery was common in our institution and likely contributed to the reported case of postoperative awake paralysis. We suggest that an NMB not be administered after intubation in fast-track patients. If given, however, it must be well communicated to the ICU team upon ICU admission. We further recommend routine assessment of neuromuscular function before sedation is weaned prior to extubation. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Managing critically ill patients with severe traumatic brain injury: How should we season the recipe?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

A randomized clinical trial of prone position extubation to reduce the severity of coughing in patients undergoing dorsolumbar spine surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

The relationship between study findings and publication outcome in anesthesia research: a retrospective observational study examining publication bias
Abstract Purpose Many areas of medicine have shown bias towards the publication of studies with positive results. To estimate publication bias in the anesthesia literature, we reviewed all abstracts presented at the American Society of Anesthesiologists (ASA) annual meetings over a four-year period and compared study results (positive vs negative) with publication outcomes. Methods This review included all abstracts from the 2001-2004 ASA annual meetings performed as randomized-controlled trials in humans. We scored their outcome results as positi...
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Stress ulcer prophylaxis in critical illness: a Canadian survey
Conclusions Stress ulcer prophylaxis is reportedly used primarily for the duration of mechanical ventilation. The CCCTG physicians believe that a placebo-controlled RCT is needed to evaluate the effectiveness and safety of contemporary SUP with PPIs. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Pre-procedural ultrasonography and marking for neuraxial anesthesia: an observational study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Thinking globally, training locally
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Intraperitoneal ketorolac for post-cholecystectomy pain: a double-blind randomized-controlled trial
Conclusion This study did not demonstrate any advantage for the off-label topical intraperitoneal administration of ketorolac in this surgical population. Intraperitoneal and IV ketorolac showed comparable analgesic efficacy following laparoscopic cholecystectomy. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Monitoring recovery from rocuronium-induced neuromuscular block using acceleromyography at the trapezius versus the adductor pollicis muscle: an observational trial
Conclusions We conclude that recording evoked acceleromyographic responses at the trapezius muscle is an acceptable alternative when monitoring from the adductor pollicis muscle is compromised. Nevertheless, we caution that recording a 90% TOF response at the trapezius muscle may overestimate functional recovery from the neuromuscular blockade. This trial was registered at ClinicalTrials.gov identifier, NCT01849198. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Publication bias in the anesthesiology literature: shifting the focus from the “positive” to the “truth”
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Anesthetic management of the first pediatric bilateral hand transplant
Conclusion This report describes the anesthetic management of the first pediatric bilateral hand transplant. This procedure required considerable preoperative planning and communication between various teams to ensure all resources needed to deliver the care for this complex and novel transplant surgery were readily available. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Reply to book review of Neonatal Anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Erratum to: Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research