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Effect of absent bilateral radial arteries on the accuracy of continuous real-time noninvasive blood pressure monitoring with the Nexfin™ system
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

Guide d’échographie pratique en anesthésie-réanimation: anesthésie locorégionale
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

Using lung ultrasound in an infant to detect bronchial intubation not previously identified by auscultation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

Comparison of the endotracheal tube cuff pressure between a tapered- versus a cylindrical-shaped cuff after changing from the supine to the lateral flank position
Abstract Purpose Positional change can displace an endotracheal tube (ETT) and change the ETT cuff pressure in a tracheally intubated patient. Endotracheal tubes with different cuff shapes may lead to different cuff pressures after positional change. We hypothesized that the intracuff pressure in the TaperGuard™ ETT with a tapered-shaped cuff would be higher than that in the conventional ETT with a cylindrical-shaped cuff after a change from the supine to the lateral flank position. Methods Fifty-eight patients scheduled for open urological...
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

In reply: A view from the middle of the totem pole
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

A view from the middle of the totem pole
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 6, 2015 Category: Anesthesiology Source Type: research

A randomized controlled trial of light versus deep propofol sedation for elective outpatient colonoscopy: recall, procedural conditions, and recovery
This study aimed to determine if the incidence of recall was equivalent between light and deep sedation for colonoscopy. Secondary analysis included complications, patient clinical recovery, and post-procedure cognitive impairment. Methods Two hundred patients undergoing elective outpatient colonoscopy were randomized to light (bispectral index [BIS] 70-80) or deep (BIS
Source: Canadian Journal of Anesthesia - September 3, 2015 Category: Anesthesiology Source Type: research

Universal tranexamic acid therapy to minimize transfusion for major joint arthroplasty: a retrospective analysis of protocol implementation
Abstract Purpose Tranexamic acid (TXA) therapy can reduce red blood cell (RBC) transfusion; however, this therapy remains underutilized in many surgical patient populations. We assessed whether implementation of a protocol to facilitate universal administration of TXA in patients undergoing total hip or knee arthroplasty would reduce the incidence of RBC transfusion without increasing adverse clinical outcomes. Methods We implemented a quality of care policy to provide universal administration of intravenous TXA at a dose of 20 mg·kg−1 ...
Source: Canadian Journal of Anesthesia - September 3, 2015 Category: Anesthesiology Source Type: research

Noninvasive pulse pressure variation and stroke volume variation to predict fluid responsiveness at multiple thresholds: a prospective observational study
Conclusion Noninvasive PPV and SVV measurements allow an acceptable FR prediction, although the reliability of both variables is dependent on the intended increase in SVI, which improves substantially with concomitant smaller grey zones at higher ↑SVI thresholds. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 3, 2015 Category: Anesthesiology Source Type: research

Histological confirmation of needle tip position during ultrasound-guided interscalene block: a randomized comparison between the intraplexus and the periplexus approach
Conclusion Although our study was somewhat underpowered due to a lower than previously reported rate of subepineurial needle tip positioning, our results suggest that there may be an increased likelihood of subepineurial needle tip position with the intraplexus approach. The periplexus technique resulted in no subepineurial spread of ink, suggesting that this approach may be less likely to result in mechanical trauma to nerves from direct needle injury. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 3, 2015 Category: Anesthesiology Source Type: research

Safe and effective positioning of a left-sided double-lumen tube
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 1, 2015 Category: Anesthesiology Source Type: research

A novel airway management technique for nasal surgery following transoral robotic surgery for patients with obstructive sleep apnea
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 29, 2015 Category: Anesthesiology Source Type: research

Optimizing depth of sedation for colonoscopy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 26, 2015 Category: Anesthesiology Source Type: research

Ultrasound-guided internal jugular vein cannulation: techniques to confirm guidewire location
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 26, 2015 Category: Anesthesiology Source Type: research

In reply: Ultrasound-guided internal jugular vein cannulation: techniques to confirm guidewire location
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 26, 2015 Category: Anesthesiology Source Type: research

Efficacy of palonosetron for preventing postoperative nausea and vomiting: a systematic review and meta-analysis
Conclusion Palonosetron provides more effective prophylaxis of early PON, late PON, and late POV compared with ondansetron. Future studies are required to investigate the role of palonosetron during 24-72 hr following surgery. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 22, 2015 Category: Anesthesiology Source Type: research

One-year outcome of the sevoflurane in acute myocardial infarction randomized trial
Abstract Background Sevoflurane is an inhalation anesthetic that has cardioprotective effects. There is limited information regarding its use outside of the operating room and its potential protective effect for patients presenting with myocardial infarction. Methods In the Sevoflurane In Acute Myocardial Infarction trial, patients with a first acute ST-elevation myocardial infarction (STEMI) who were treated by primary percutaneous coronary intervention were randomized to inhalation of sevoflurane or oxygen (control). From the time of the patient’...
Source: Canadian Journal of Anesthesia - August 22, 2015 Category: Anesthesiology Source Type: research

The “grey zone” or how to avoid the binary constraint of decision-making
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 22, 2015 Category: Anesthesiology Source Type: research

Advances in photoplethysmography: beyond arterial oxygen saturation
Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 19, 2015 Category: Anesthesiology Source Type: research

Perioperative outcomes: Are we asking the right questions?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 19, 2015 Category: Anesthesiology Source Type: research

A foreign body in the nasopharynx: missing tooth mystery solved
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 18, 2015 Category: Anesthesiology Source Type: research

Ethical concerns for anesthesiologists during an Ebola threat
Conclusions Government, public health authorities, and anesthesia departments need to be prepared to respond to an outbreak of Ebola. Anesthesiologists have a skill that is suited to treat the complications of Ebola virus disease, and in case they are called for duty, anesthesiologists should be aware of the ethical concerns of treating a highly contagious communicable disease. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Substance abuse: a national survey of Canadian residency program directors and site chiefs at university-affiliated anesthesia departments
Conclusion The prevalence of substance abuse among Canadian anesthesiologists and the substances abused appear comparable with data from the United States, with residents being the group most often affected. Early recognition and treatment of chemically dependent anesthesiologists remain imperfect. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Perspectives of anesthesia residents training in Canada on fellowship training, research, and future practice location
Conclusion The majority of anesthesia residents training in Canada choose to pursue fellowship training and work at an academic hospital. Approximately one-third of residents have an interest in incorporating research into their future careers. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Mentoring during anesthesia residency training: challenges and opportunities
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

So…why do you want to become an anesthesiologist?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Chestnut’s Obstetric Anesthesia Principles and Practice, Fifth Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Replacing a double-lumen tube with a single-lumen tube or a laryngeal mask airway device to reduce coughing at emergence after thoracic surgery: a randomized controlled single-blind trial
In this study, the DLT was replaced with either a single-lumen endotracheal tube (ETT) or a laryngeal mask airway (LMA) device or left in place, and the incidence of coughing at emergence was compared between the three groups. Methods Fifty-eight adults scheduled for thoracic surgery with a DLT were included. Exclusion criteria were an anticipated difficult airway, obesity, and contraindication to the use of an LMA ProSeal™ (LMA-P). After surgery but before emergence, patients were randomized to having the DLT (1) removed and replaced by an LMA-P (LMA-P Group), (2) removed ...
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

The impact of two different inspiratory to expiratory ratios (1:1 and 1:2) on respiratory mechanics and oxygenation during volume-controlled ventilation in robot-assisted laparoscopic radical prostatectomy: a randomized controlled trial
Abstract Background Volume-controlled ventilation with a prolonged inspiratory to expiratory ratio (I:E ratio) has been used to optimize gas exchange and respiratory mechanics in various surgical settings. We hypothesized that, when compared with an I:E ratio of 1:2, a prolonged I:E ratio of 1:1 would improve respiratory mechanics without reducing cardiac output (CO) during pneumoperitoneum and steep Trendelenburg positioning, both of which can impair respiratory function in robot-assisted laparoscopic radical prostatectomy. Furthermore, we evaluated its effect on oxygenation during robot-a...
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

A survey of mentorship among Canadian anesthesiology residents
Conclusions Formal mentorship programs were present in half of anesthesiology training programs. Although 74% of the residents identified a mentor, 42% did not interact regularly with their mentor. The presence of a formal mentorship program was positively associated with mentorship. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Analysis of the number of publications by Canadian anesthesiology departments from 2000-2013
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Anesthesiology: Is it a career, a job, or both?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Oh’s Intensive Care Manual, 7 th Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Airway neurofibroma
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

The complications of awake tracheal intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

The real cost of care: focus on value for money, rather than price-tags
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2015 Category: Anesthesiology Source Type: research

Intrathecal hyperbaric 2% prilocaine versus 0.4% plain ropivacaine for same-day arthroscopic knee surgery: a prospective randomized double-blind controlled study
Abstract Background Short-duration spinal anesthesia is a good option for ambulatory knee surgery. Hyperbaric 2% prilocaine has short onset and rapid recovery times and, therefore, may be well suited in this setting. The aim of this study was to compare the times to reach motor block, motor block resolution, and discharge from the postanesthesia care unit (PACU) between hyperbaric 2% prilocaine and 0.4% plain ropivacaine. Methods In this prospective randomized double-blind study, 140 patients (ages 18-80 yr and American Society of Anesthesiologists physi...
Source: Canadian Journal of Anesthesia - August 14, 2015 Category: Anesthesiology Source Type: research

Prophylactic intravenous ephedrine to minimize fetal bradycardia after combined spinal-epidural labour analgesia: a randomized controlled study
Conclusions We conclude that prophylactic intravenous ephedrine administration at the time of CSE during labour was ineffective at reducing the risk for EPFB associated with CSE. Nevertheless, a lower than expected rate of EPFB resulted in the trial being underpowered. This trial was registered at ClinicalTrials.gov, identifier: NCT02062801. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 14, 2015 Category: Anesthesiology Source Type: research

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

iTIVA Anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 13, 2015 Category: Anesthesiology Source Type: research

Unsuspected difficulty using a laryngeal mask airway and a video laryngoscope due to unanticipated congenital pharyngeal bands
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 7, 2015 Category: Anesthesiology Source Type: research

Managing the challenging pediatric airway: Continuing Professional Development
Conclusion Although direct laryngoscopy can still be used to manage the care of the majority of children with a known or suspected challenging airway, there is now a noticeable trend towards the use of a supraglottic airway and apneic intubation using fibreoptic and video laryngoscopic equipment. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2015 Category: Anesthesiology Source Type: research

Limiting the accessibility of cost-prohibitive drugs reduces overall anesthetic drug costs: a retrospective before and after analysis
Abstract Purpose Cost effectiveness is becoming increasingly important in today’s healthcare environment. Remifentanil, dexmedetomidine, and desflurane are costly agents that often have suitable alternatives to their use. We sought to identify changes in cost and outcomes following interventions that limited the availability of these drugs. Methods We calculated anesthetic drug costs for all operating room procedures performed before and after the accessibility interventions. We retrospectively compared drug costs per case and the frequency of agen...
Source: Canadian Journal of Anesthesia - August 4, 2015 Category: Anesthesiology Source Type: research

Inferior vena cava filter migration during the prone position for spinal surgery: a case report
Conclusions The prone position during surgery can induce anatomic and hemodynamic changes in the IVC. This may contribute to the migration of IVC filters—especially flexible retrievable filters. Careful handling and positioning of patients with IVC filters is recommended to avoid a sudden increase in IVC pressure that may predispose to IVC filter migration. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 4, 2015 Category: Anesthesiology Source Type: research

Point-of-care ultrasound defines gastric content and changes the anesthetic management of elective surgical patients who have not followed fasting instructions: a prospective case series
Conclusions This prospective case series suggests that a standardized point-of care gastric ultrasound examination informs anesthesiologists’ perceived level of aspiration risk and leads to changes in anesthetic management in a significant proportion of elective patients who did not follow fasting instructions. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 4, 2015 Category: Anesthesiology Source Type: research

Reviving older drugs to deal with anesthesia drug shortages
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 4, 2015 Category: Anesthesiology Source Type: research

Guidelines for Reporting Health Research: A User’s Manual
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 4, 2015 Category: Anesthesiology Source Type: research

Curtailing the cost of anesthetic drugs: prudent economics or an infringement of clinical autonomy?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 4, 2015 Category: Anesthesiology Source Type: research

Real-time ultrasound-guided epidural catheter insertion in obese parturients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 1, 2015 Category: Anesthesiology Source Type: research