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Computerized training system for ultrasound-guided lumbar puncture on abnormal spine models: a randomized controlled trial
Conclusion Residents trained with augmented reality 3D visualization had better performance metrics on ultrasound-guided LP in pathological spine models. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2015 Category: Anesthesiology Source Type: research

The impact of pneumoperitoneum and Trendelenburg positioning on respiratory system mechanics during laparoscopic pelvic surgery in children: a prospective observational study
Abstract Purpose The aim of this study was to describe the changes in respiratory system compliance and other measures of respiratory mechanics associated with peritoneal insufflation (12 mmHg pressure) with carbon dioxide (PNP12) and 20° Trendelenburg positioning (TDG20) in pediatric patients undergoing laparoscopic surgery for abdominal cryptorchidism. Methods Twelve subjects with abdominal cryptorchidism undergoing orchiopexy were enrolled in the study. General anesthesia was conducted with sevoflurane/O2/air, fentanyl, and rocuronium....
Source: Canadian Journal of Anesthesia - June 7, 2015 Category: Anesthesiology Source Type: research

Estimated glomerular filtration rate better predicts 30-day mortality after non-cardiac surgery than serum creatinine: a retrospective analysis of 92,888 patients
Abstract Background Serum creatinine is the most commonly used indicator of renal function, but its derivative, estimated glomerular filtration rate (eGFR), has been shown to be superior in non-surgical settings. It remains unknown if eGFR better predicts postoperative mortality in non-cardiac surgical patients. We thus tested the hypothesis that eGFR predicts 30-day mortality after non-cardiac surgery better than serum creatinine. Methods We evaluated patients who had inpatient non-cardiac surgery of at least one hour duration during January 2006...
Source: Canadian Journal of Anesthesia - June 7, 2015 Category: Anesthesiology Source Type: research

Extracorporeal membrane oxygenation for blastomycosis-related acute respiratory distress syndrome: a case series
Conclusion This report describes the successful application of ECMO as rescue therapy in aid of four patients with refractory blastomycosis-associated ARDS. In addition to early appropriate antimicrobial therapy, transfer to an institution experienced with ECMO should be considered when caring for patients from endemic areas with rapidly progressive respiratory failure. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2015 Category: Anesthesiology Source Type: research

The incidence, success rate, and complications of awake tracheal intubation in 1,554 patients over 12 years: an historical cohort study
Abstract Purpose Awake tracheal intubation is one recommended option to address select situations in the management of a patient with an anticipated difficult airway. A scarcity of data exists on how often awake intubation is performed or whether its use is changing over time, particularly with the increasingly widespread availability of video laryngoscopy. This retrospective database review was undertaken to determine the incidence, success, and complications of awake intubation and the incidence of other tracheal intubation techniques in the operating room over a 12-yr period (2002-2013) ...
Source: Canadian Journal of Anesthesia - June 7, 2015 Category: Anesthesiology Source Type: research

Novel use of photoplethysmographic technology (Nexfin™) for real-time assessment of cardiac output during endovascular stenting in a patient with chronic inferior vena cava occlusion
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 5, 2015 Category: Anesthesiology Source Type: research

Fast wake-up time in obese patients: Which anesthetic is best?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 4, 2015 Category: Anesthesiology Source Type: research

Use of a nerve stimulator to assist cricothyroid membrane puncture during difficult airway topicalization
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 3, 2015 Category: Anesthesiology Source Type: research

Apolipoprotein epsilon 4 genotype is associated with less improvement in cognitive function five years after cardiac surgery: a retrospective cohort study
Abstract Purpose Cognitive performance after cardiac surgery can be impaired, and genetic risk factors have previously been suggested. When compared with other isoforms of the gene, the apolipoprotein epsilon 4 (APOE4) allele is associated with worse outcomes in many neurologic disorders. We hypothesized that the APOE4 allele is associated with less favourable cognitive function five years after surgery. Methods Caucasian patients enrolled in previously reported prospective cognitive trials in both cardiac and non-cardiac surgery participated in t...
Source: Canadian Journal of Anesthesia - May 8, 2015 Category: Anesthesiology Source Type: research

Why I blog and tweet
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2015 Category: Anesthesiology Source Type: research

Just who is “Skeptical Scalpel”?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2015 Category: Anesthesiology Source Type: research

A simple method for positive pressure ventilation during fibreoptic intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2015 Category: Anesthesiology Source Type: research

Entrapment of a pulmonary artery catheter inside a knotted percutaneous sheath introducer
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2015 Category: Anesthesiology Source Type: research

Erratum to: Preoperative brain magnetic resonance imaging and postoperative delirium after off-pump coronary artery bypass grafting: a prospective cohort study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 8, 2015 Category: Anesthesiology Source Type: research

Randomized controlled trial of gabapentin as an adjunct to perioperative analgesia in total hip arthroplasty patients
Conclusions This trial indicated that gabapentin treatment had no clinically important reduction in postoperative morphine consumption at 72 hr in patients undergoing THA. Multimodal analgesia may account for the similar primary and secondary outcomes found in the groups. This trial was registered at ClinicalTrials.gov, number: NCT01307202. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 9, 2015 Category: Anesthesiology Source Type: research

Implementing and measuring change to enhance perioperative outcomes
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 9, 2015 Category: Anesthesiology Source Type: research

Unrecognized arterial cannulation due to the backflow feature of the BD Insyte™ Autoguard™ BC cannula
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 9, 2015 Category: Anesthesiology Source Type: research

Another pressurization system for invasive monitoring
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 9, 2015 Category: Anesthesiology Source Type: research

In reply: Another pressurization system for invasive monitoring
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 9, 2015 Category: Anesthesiology Source Type: research

Celecoxib pharmacogenetics and pediatric adenotonsillectomy: a double-blinded randomized controlled study
Conclusions A three-day course of oral celecoxib reduces early pain and co-analgesic consumption; however, an increase in dose, dose frequency, and duration of dose may be required for sustained pain relief in the pediatric setting. The CYP2C9*3 allele may influence recovery. This trial was registered at: ClinicalTrials.gov: NCT00849966. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 7, 2015 Category: Anesthesiology Source Type: research

Reversal of warfarin anticoagulation for urgent surgical procedures
Conclusion Reversal of warfarin anticoagulation can be achieved in a safe and timely manner when the appropriate agent is selected and administered correctly. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 7, 2015 Category: Anesthesiology Source Type: research

Reading in the operating room
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 31, 2015 Category: Anesthesiology Source Type: research

Risk factors for oxygen desaturation on arrival in the postanesthesia care unit
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 26, 2015 Category: Anesthesiology Source Type: research

A technique to facilitate laryngeal passage during flexible bronchoscopic intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 25, 2015 Category: Anesthesiology Source Type: research

Residents’ reluctance to challenge negative hierarchy in the operating room: a qualitative study
Conclusions Study results showed that hierarchy played a dominant role in the functioning of the operating room. Participants spoke of both the positive and negative effects of such a hierarchical learning environment. The majority of participants described a negative perception of hierarchy as the norm, and they employed many coping strategies. This study provides insight into how a negative hierarchical culture can adversely impact patient safety, resident learning, and team functioning. We propose a theoretical model to describe challenging authority in this context. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 20, 2015 Category: Anesthesiology Source Type: research

Using qualitative and mixed methodologies to explore hierarchy in the operating room
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 19, 2015 Category: Anesthesiology Source Type: research

Thoracoscopic visualization of a misdirected paravertebral catheter
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 14, 2015 Category: Anesthesiology Source Type: research

Confirmation of endotracheal tube depth using ultrasound in adults
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 12, 2015 Category: Anesthesiology Source Type: research

Low serum vitamin D levels are not associated with increased postoperative pain and opioid requirements: a historical cohort study
Conclusion We did not find any association between preoperative vitamin D levels and postoperative pain scores/opioid consumption in morbidly obese patients undergoing bariatric surgery. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 10, 2015 Category: Anesthesiology Source Type: research

Pain Management: Essential Topics for Examinations
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 6, 2015 Category: Anesthesiology Source Type: research

In reply: Unrecognized arterial cannulation due to the backflow feature of the BD Insyte™ Autoguard™ BC cannula
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 5, 2015 Category: Anesthesiology Source Type: research

An explanation and invitation: making space for conversation in the digital world
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 2, 2015 Category: Anesthesiology Source Type: research

Safety-engineered intravenous catheter utilization among Canadian pediatric anesthesiologists
Abstract Introduction Compared with other specialties, anesthesiologists are at increased risk of acquiring a blood-borne pathogen (BBP) through needle-stick injuries (NSIs). Safety-engineered intravenous catheters (SEICs) have been designed to reduce NSIs but have not been well received. Our objective was to determine SEIC usage by pediatric anesthesiologists, including availability, utilization, perceived utility, and sources of NSI before and after legislation mandating their use in Canada. Methods After Ethics Committee approval, we conducted two ele...
Source: Canadian Journal of Anesthesia - February 28, 2015 Category: Anesthesiology Source Type: research

Increased postoperative day one discharges after implementation of a hysterectomy enhanced recovery pathway: a retrospective cohort study
Abstract Purpose In 2011, the hysterectomy enhanced recovery (HER) pathway, a multi-disciplinary, evidence-based care plan designed to improve recovery after open gynecologic surgery for non-malignant lesions, was introduced at The Ottawa Hospital (TOH). This before-and-after study examined the impact of the HER pathway on postoperative day (POD) 1 hospital discharge. Methods Ethical approval was obtained. This retrospective cohort study included patients who had undergone open abdominal gynecologic surgery for non-malignant lesions at TOH Civic Campus b...
Source: Canadian Journal of Anesthesia - February 28, 2015 Category: Anesthesiology Source Type: research

Engineering solutions for safety: not always as simple as they seem
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 28, 2015 Category: Anesthesiology Source Type: research

Anesthetic considerations in organ procurement surgery: a narrative review
Conclusion Anesthesiologist-guided physiological optimization of the brain-dead donor may be a factor in determining the outcome of the organ recipient. Additionally, anesthesiologists have an important role in helping to ensure that the highest quality and most appropriate care are rendered to non-heart-beating donors. This is achieved through establishing protocols in their hospitals for donation after cardiac death that maximize the number of available organs with the best chance for long-term graft viability. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 26, 2015 Category: Anesthesiology Source Type: research

Évaluation de la courbe d’apprentissage du bloc du plan transverse abdominal: étude prospective observationnelle
Conclusion Cette étude démontre que le TAP bloc est un bloc d’acquisition rapide même si son apprentissage est soumis à une variabilité inter-individuelle due à une différence de dextérité des opérateurs tant technique que d’acquisition des images échographiques. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 26, 2015 Category: Anesthesiology Source Type: research

Syndrome coronarien aigu après injection de carbétocine 100 µg au cours d’une césarienne en urgence
Conclusion L’analyse rétrospective de l’utilisation de carbétocine dans notre établissement sur l’année 2012 permet de suspecter une incidence d’événement coronaire de 1/245 (0,34 %) proche de celles rapportées dans différentes études. Nous discutons la prise en charge de douleurs angineuses chez les patientes au cours des césariennes et la prise en charge ultérieure de cette patiente. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 26, 2015 Category: Anesthesiology Source Type: research

Les différentes alternatives d’anticoagulation au couple héparine/protamine en chirurgie cardiaque sous circulation extra-corporelle
Conclusion L’anticoagulant idéal pouvant être utilisé en chirurgie cardiaque sous CEC n’existe pas. L’héparine et de la protamine reste la stratégie d’anticoagulation de référence. La Bivalirudine est la molécule la plus prometteuse à ce jour malgré l’absence de stratégie d’antagonisation facile et un coût d’utilisation élevé. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 20, 2015 Category: Anesthesiology Source Type: research

Evolution of Thoracic Surgery in Canada
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 20, 2015 Category: Anesthesiology Source Type: research

A simple maneuver for confirmation of the guidewire during ultrasound-guided internal jugular vein cannulation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 20, 2015 Category: Anesthesiology Source Type: research

Transient abdominal motor block after a transversus abdominis plane block in an elderly patient
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 18, 2015 Category: Anesthesiology Source Type: research

Intraoperative awareness risk, anesthetic sensitivity, and anesthetic management for patients with natural red hair: a matched cohort study
Abstract Purpose The red-hair phenotype, which is often produced by mutations in the melanocortin-1 receptor gene, has been associated with an increase in sedative, anesthetic, and analgesic requirements in both animal and human studies. Nevertheless, the clinical implications of this phenomenon in red-haired patients undergoing surgery are currently unknown. Methods In a secondary analysis of a prospective trial of intraoperative awareness, red-haired patients were identified and matched with five control patients, and the relative risk for intraoperati...
Source: Canadian Journal of Anesthesia - February 14, 2015 Category: Anesthesiology Source Type: research

A comparison between left molar direct laryngoscopy and the use of a Bonfils intubation fibrescope for tracheal intubation in a simulated difficult airway
Abstract Background Tracheal intubation in patients with an immobilized cervical spine can be difficult because of a restricted mouth opening and limited neck movements. Use of the Bonfils intubation fibrescope (BIF) or left molar (LM) laryngoscopy may be suitable options for tracheal intubation in such patients. Intubation adjuncts, such as an endotracheal tube introducer, may improve the overall intubation success rate with the LM approach. Formal studies are currently lacking on the use of LM laryngoscopy with a tube introducer. Methods After Institut...
Source: Canadian Journal of Anesthesia - February 14, 2015 Category: Anesthesiology Source Type: research

Erratum to: Perioperative fellowship curricula in anesthesiology: a systematic review
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 14, 2015 Category: Anesthesiology Source Type: research

Does intravenous lidocaine infusion during video-assisted thoracoscopic surgery reduce postoperative analgesia? A randomized controlled study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 11, 2015 Category: Anesthesiology Source Type: research

Reliability of a point-of-care device for international normalized ratio testing during the three surgical phases of orthotopic liver transplantation: a retrospective observational study
Conclusion Point-of-care INR was accurate prior to hepatic reperfusion, but reliability decreased in the neohepatic phase. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 10, 2015 Category: Anesthesiology Source Type: research

Ultrasound-guided supraclavicular brachial plexus block in a patient with a cervical rib
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 6, 2015 Category: Anesthesiology Source Type: research

Intubation with VivaSight or conventional left-sided double-lumen tubes: a randomized trial
Conclusion The VivaSight DLT camera allowed faster insertion and facilitated initial positioning. It also confirmed proper tube positioning intraoperatively and facilitated repositioning when necessary. This trial was registered at clinicaltrials.gov: NCT01807676. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 6, 2015 Category: Anesthesiology Source Type: research

Novel use of the Nexfin HD monitor for hemodynamic management during electroconvulsive therapy in a patient with an unrepaired abdominal aortic aneurysm
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - February 6, 2015 Category: Anesthesiology Source Type: research