Log in to search using one of your social media accounts:

 

Efficacy of a simple scavenging system for long-term critical care sedation using volatile agent-based anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 15, 2015 Category: Anesthesiology Source Type: research

A new analgesic paradigm for pediatric tonsillectomy: Are we dragging our heels?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 15, 2015 Category: Anesthesiology Source Type: research

The challenges in producing high-quality clinical evidence
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 15, 2015 Category: Anesthesiology Source Type: research

Calibration of the neuromuscular monitor: Is it necessary?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 14, 2015 Category: Anesthesiology Source Type: research

In reply: Calibration of the neuromuscular monitor: Is it necessary?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 14, 2015 Category: Anesthesiology Source Type: research

David Lussier and Pierre Beaulieu (eds): Adjuvant analgesics
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 11, 2015 Category: Anesthesiology Source Type: research

Ketamine added to morphine or hydromorphone patient-controlled analgesia for acute postoperative pain in adults: a systematic review and meta-analysis of randomized trials
Conclusions Adding ketamine to morphine/hydromorphone PCA provides a small improvement in postoperative analgesia while reducing opioid requirements. Adjunctive ketamine also reduces postoperative nausea and vomiting without a detected increase in other adverse effects; however, adverse events were probably underreported. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 10, 2015 Category: Anesthesiology Source Type: research

A comparison of motor stimulation threshold in ultrasound-guided interscalene brachial plexus block for arthroscopic shoulder surgery: a randomized trial
This study included 94 patients undergoing arthroscopic shoulder surgery with ultrasound-guided interscalene brachial plexus block (ISBPB) plus nerve stimulation. Patients were randomized into two groups for the ISBPB procedure, i.e., when an evoked motor response was obtained at a current intensity of either 0.2 mA (Group 0.2) or 0.5 mA (Group 0.5). Block onset time, location of the needle tip, and distribution of local anesthetic were assessed. Results A response was elicited at the appropriate motor stimulation threshold in 88 patients (Group 0.2 = 43; Group 0.5 = 45). Block failu...
Source: Canadian Journal of Anesthesia - December 10, 2015 Category: Anesthesiology Source Type: research

The need for consensus, consistency, and core outcome sets in perioperative research
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 10, 2015 Category: Anesthesiology Source Type: research

Left atrial involvement of a right lung tumour
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 10, 2015 Category: Anesthesiology Source Type: research

Substance use disorder in Canadian university departments of anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 8, 2015 Category: Anesthesiology Source Type: research

In reply: Substance use disorder in Canadian university departments of anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 8, 2015 Category: Anesthesiology Source Type: research

Preoperative optimization in pheochromocytoma: phenoxybenzamine may be redundant but not alpha blockade
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 7, 2015 Category: Anesthesiology Source Type: research

A novel approach for monitoring volatile anesthetic concentration during cardiopulmonary bypass
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 3, 2015 Category: Anesthesiology Source Type: research

Chasing myocardial outcomes: perioperative myocardial infarction and cardiac troponin
Abstract Perioperative myocardial infarction represents the most common cardiovascular complication following non-cardiac surgery, but frequently presents without the usual clinical signs and symptoms consistent with acute coronary syndrome. Given the silent nature of this event, a clinician’s reliance on risk stratification tools and cardiac specific biomarkers to assist in the identification of at-risk individuals is heightened in the perioperative setting. Although cardiac troponin elevations following non-cardiac surgery have been consistently linked to increased mortality, uncertainty remains over how t...
Source: Canadian Journal of Anesthesia - December 3, 2015 Category: Anesthesiology Source Type: research

Interscapular pain associated with neuraxial labour analgesia: a case series
Conclusions While little is understood about the etiology of this unique anesthetic complication, it may have important clinical consequences, including inadequate analgesia, inability to provide timely epidural anesthesia, and an increased risk of Cesarean delivery. Future work should characterize at-risk patients, delineate effective treatment strategies, and identify any associated long-term consequences. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 3, 2015 Category: Anesthesiology Source Type: research

Is 60 mg a suitable dosage for same-day spinal prilocaine?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 2, 2015 Category: Anesthesiology Source Type: research

In reply: Is 60 mg a suitable dosage for same-day spinal prilocaine?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 2, 2015 Category: Anesthesiology Source Type: research

Novel use of the Nexfin TM HD monitor for real-time physiological assessment of blood flow during creation of an upper extremity arteriovenous fistula
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 18, 2015 Category: Anesthesiology Source Type: research

Failure of metyrosine therapy for preoperative management of pheochromocytoma: a case report
Conclusion In the case of this patient’s PHEO, the use of metyrosine was unsatisfactory in achieving sufficient inhibition of catecholamine synthesis as evidenced by significant intraoperative hypertension. Metyrosine could have a role in preoperative management of these patients, but it may not be optimal as monotherapy for some patients with actively secreting tumours. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Anesthetic management of a parturient with hypermobility phenotype but possible vascular genotype Ehlers-Danlos syndrome
Conclusion The risk of severe morbidity and mortality in parturients with vascular EDS has warranted recommendations for modified management of labour, particularly regarding mode and timing of delivery. Nevertheless, a multidisciplinary approach and consideration of phenotype rather than genotype alone were instrumental in the successful management of this patient. Genetic testing of patients who display features of EDS and/or who have a positive family history of the disease is important in the preparation for labour and delivery. In the absence of convincing signs of vascular EDS and a negative family history...
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Concepts of safety reporting
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Improving perioperative outcomes in low-resource countries: It can’t be fixed without data
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

A closed-circuit anesthesia ventilator facilitates significant reduction in sevoflurane consumption in clinical practice
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Acknowledgement
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

The impact of changes in drug availability for hemodynamic management in pheochromocytoma: prêt-à-porter or tailor-made?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Anesthetic substance abuse: international perspectives and parallels
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Erratum to: A prospective observational study comparing a physiological scoring system with time-based discharge criteria in pediatric ambulatory surgical patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Erratum to: Managing the challenging pediatric airway: Continuing Professional Development
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 14, 2015 Category: Anesthesiology Source Type: research

Special announcement: Guidelines to the Practice of Anesthesia - Revised Edition 2016
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 3, 2015 Category: Anesthesiology Source Type: research

Definitive airway management of patients presenting with a pre-hospital inserted King LT(S)-D™ laryngeal tube airway: a historical cohort study
Conclusion In this study of patients presenting to a hospital with a King LT, the majority of airway exchanges required an advanced airway management technique beyond direct laryngoscopy. Upper airway edema was the most common adverse observation associated with King LT use. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 30, 2015 Category: Anesthesiology Source Type: research

In reply: Ultrasound-guided internal jugular vein cannulation: a novel technique for confirming that the guidewire is directed towards the right atrium
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 28, 2015 Category: Anesthesiology Source Type: research

Ultrasound-guided internal jugular vein cannulation: a novel technique for confirming that the guidewire is directed towards the right atrium
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 27, 2015 Category: Anesthesiology Source Type: research

Outcomes in neuroanesthesia: What matters most?
Conclusions Future endeavours in neuroanesthesia research should advocate prospective randomized trials that focus on long-term neurologic outcomes. These initiatives will require coordination of multiple centres through a clinical trials network. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 23, 2015 Category: Anesthesiology Source Type: research

Outcome measures and quality markers for perioperative blood loss and transfusion in cardiac surgery
Conclusion Perioperative bleeding itself is a complex syndrome that can be classified as an outcome measure. Red blood cell transfusion has limitations when considered as an outcome variable and can be biased by many confounders. Its relationship with clinical outcome remains uncertain. In addition to being potential outcome measures, transfusion rates and the number of allogeneic blood products transfused may also be considered as quality-of-care markers. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 22, 2015 Category: Anesthesiology Source Type: research

Effects of changing from sevoflurane to desflurane on the recovery profile after sevoflurane induction: a randomized controlled study
Abstract Purpose Desflurane has the lowest solubility of currently available volatile anesthetics and may allow for more rapid emergence and recovery compared with sevoflurane. Nevertheless, after volatile induction with sevoflurane, it has not been determined whether the use of desflurane provides faster emergence and recovery. The present study aimed to elucidate the effects of changing from sevoflurane to desflurane during the early part of anesthesia. Methods Fifty-two patients who were scheduled for vitreous surgery with general anesthesia were enro...
Source: Canadian Journal of Anesthesia - October 20, 2015 Category: Anesthesiology Source Type: research

Mismanagement of obstructive sleep apnea may result in finding these patients dead in bed
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 19, 2015 Category: Anesthesiology Source Type: research

The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications
Abstract Quality of recovery is a complex construct whose definition is influenced heavily by the opinions and biases of the individual patient, clinician, or institution. As a result, recovery assessment tools differ in their fundamental definitions of recovery, breadth, and assessment time frame. Accurate assessment of recovery is essential as suboptimal recovery has both economic and prognostic implications. Quality of care is often substituted as a surrogate at the institutional level for quality of recovery, but it is ideologically distinct from patients’ perceived quality of care, recovery, and satisfa...
Source: Canadian Journal of Anesthesia - October 16, 2015 Category: Anesthesiology Source Type: research

Complementary and alternative medicine therapies for the anesthesiologist and pain practitioner: a narrative review
Conclusions Complementary and alternative medicine therapies in general may provide a useful adjunct in the management of chronic pain. Nevertheless, many patients are not aware of the risks and benefits of individual therapies. In the perioperative setting, the most concerning CAM therapy is the use of herbs and other supplements that may produce physiologic and metabolic derangements and may interact with prescription medications. Resources exist to aid pain specialists, anesthesiologists, and patients in the evidence-based utilization of CAM therapies. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 14, 2015 Category: Anesthesiology Source Type: research

Uterine exteriorization compared with in situ repair for Cesarean delivery: a systematic review and meta-analysis
Conclusion Uterine repair by exteriorization may reduce blood loss and the associated decrease in hemoglobin, but the difference may not be clinically relevant. There was no statistically significant difference between the two repair techniques for intraoperative nausea, vomiting, or pain. In situ repair may be associated with a faster return of bowel function. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 7, 2015 Category: Anesthesiology Source Type: research

Ultrasound guidance versus direct palpation for radial artery catheterization by expert operators: a randomized trial among Canadian cardiac anesthesiologists
Conclusions Among experienced cardiac anesthesiologists, the use of US to facilitate radial arterial catheterization did not affect insertion times, the number of re-directs, or the number of attempts when compared with DP. Ultrasound use had no significant effects on the rates of success on first attempt, failure, or hematoma formation. This trial was registered at www.clinicaltrials.gov: NCT02118441. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 7, 2015 Category: Anesthesiology Source Type: research

Tranexamic acid: When is enough (data) enough?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 7, 2015 Category: Anesthesiology Source Type: research

Perioperative Kidney Injury: Principles of Risk Assessment, Diagnosis and Treatment
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 7, 2015 Category: Anesthesiology Source Type: research

Erratum to: Real-time ultrasound-guided epidural catheter insertion in obese parturients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 7, 2015 Category: Anesthesiology Source Type: research

A randomized trial comparing axillary block versus targeted intracluster injection supraclavicular block for upper limb surgery
Abstract Purpose This randomized trial aimed to validate a new method for brachial plexus blockade, i.e., targeted intracluster injection supraclavicular block (TII SCB), by comparing it with ultrasound-guided axillary block (AXB). We hypothesized that TII SCB would result in a shorter total anesthesia-related time. Methods Forty patients undergoing upper limb surgery were randomized to ultrasound-guided TII SCB (n = 20) or AXB (n = 20). In the TII SCB group, we deposited 16 mL of lidocaine 1.5% with epinephrine 5 µg·mL−1 into the...
Source: Canadian Journal of Anesthesia - October 2, 2015 Category: Anesthesiology Source Type: research

Antithrombin activity and heparin response in neonates and infants undergoing congenital cardiac surgery: a retrospective cohort study
Abstract Purpose The immature coagulation system during infancy has age-related physiological differences in proteins that contribute to significant variation in heparin responsiveness through alterations in heparin-enhanced thrombin inhibition. The primary aim of this study was to evaluate the relationship between preoperative antithrombin (AT) activity and heparin responsiveness in neonates and infants undergoing congenital cardiac surgery. Methods In this retrospective cohort study, neonates (aged 0-28 days) and infants (aged 29-365 days) undergoing c...
Source: Canadian Journal of Anesthesia - October 2, 2015 Category: Anesthesiology Source Type: research

Preoperative pulse and thermal radiofrequency facilitates prehabilitation and subsequent rehabilitation of a patient scheduled for total knee arthroplasty
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 2, 2015 Category: Anesthesiology Source Type: research

Opioid information pamphlet increases postoperative opioid disposal rates: a before versus after quality improvement study
Conclusion The introduction of an education pamphlet significantly improved self-reported proper opioid disposal rates in postoperative patients. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 2, 2015 Category: Anesthesiology Source Type: research

Crisis Management in Anesthesiology, 2nd Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

Comparison of train-of-four count by anesthesia providers versus TOF-Watch ® SX: a prospective cohort study
Conclusion Anesthesia providers report higher values of TOF count compared with the TOF-Watch SX, especially at intermediate levels of neuromuscular blockade. Since the dosing guidelines for the timing and dose of reversal agents are based on the TOF count derived from the TOF-Watch SX, a manually assessed TOF count may lead to inadequate dosing and/or premature administration of reversal agents. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research