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Tracheal bronchus: an unusual cause of difficult ventilation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Ultrasound-guided radial nerve block to relieve cannulation-induced radial arterial spasm
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 10, 2017 Category: Anesthesiology Source Type: research

Massive pneumopericardium
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 9, 2017 Category: Anesthesiology Source Type: research

Bronchoesophageal fistula
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 7, 2017 Category: Anesthesiology Source Type: research

A primer on nerve agents: what the emergency responder, anesthesiologist, and intensivist needs to know
ConclusionWhile it is unlikely that most medical practitioners will ever encounter nerve agent poisoning, it is critical to be aware of the presenting symptoms and how best to treat patients exposed to these deadly agents. History has shown that rapid medical treatment can easily mean the difference between life and death for a patient in this situation. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 1, 2017 Category: Anesthesiology Source Type: research

The association between the time from oxytocin cessation during labour to Cesarean delivery and postpartum blood loss: a retrospective cohort study
We examined the association between oxytocin recovery interval, i.e., the time from discontinuing oxytocin to Cesarean delivery (CD) for labour arrest, and blood loss.MethodsThis retrospective cohort study included women who underwent CD for labour arrest following oxytocin-augmented labour from July 1, 2013 to July 19, 2015 at our institution. Data were collected on patient demographics, labour and delivery characteristics, oxytocin induction and augmentation, recovery interval, and PPH risk factors. The primary outcome was estimated blood loss (EBL), calculated using the hematocrit variation method.ResultsData on 490 wom...
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Perioperative considerations for patients with sickle cell disease: a narrative review
ConclusionEffective management of SCD patients in the perioperative setting requires familiarity with the epidemiology, pathophysiology, clinical manifestations, and treatment of SCD. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Anesthesia and Perioperative Care for Organ Transplantation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Evaluation of the analgesia nociception index (ANI) in healthy awake volunteers
AbstractBackgroundAnalgesia might be evaluated with simple changes in vital signs, a non-specific and non-sensitive method. Heart rate variability (HRV) correlates with autonomous nervous system activity and can be used to evaluate painful stimuli. Heart rate variability is then transformed into a numeric scale called the analgesia nociception index (ANI), where higher values represent predominant parasympathetic tone, thus low nociception. Under general anesthesia, the ANI decreases following painful stimuli and increases after administration of analgesia, but significant interindividual variability is present. The goal o...
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Erector spinae plane block for postoperative analgesia in pediatric oncological thoracic surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Continuous ventilation using a modified laparoscopic port and laryngeal mask airway during flexible bronchoscopic intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Manual of Pediatric Anesthesia – Seventh Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

In reply: Glottic impersonation, perhaps, but direct visualization remains vital to confirm successful intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Improving trial design in cancer anesthesia (onco-anesthesia) research
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Glottic impersonation, perhaps, but direct visualization remains vital to confirm successful intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 11, 2017 Category: Anesthesiology Source Type: research

Obstructing pathology of the upper airway in a post-NAP4 world: time to wake up to its optimal management
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 10, 2017 Category: Anesthesiology Source Type: research

A retrospective assessment of prognostication in 456,685 patients undergoing elective major non-cardiac surgery
AbstractBackgroundThe accuracy of patient prognostication varies extensively in studies of select populations. Prognostication is an important component of patient selection for elective surgery. This retrospective study assessed patient prognostication prior to elective surgery by comparing the observed with the expected number of deaths in such patients.Study designWe used population-based administrative data to identify all adults undergoing one of 13 most common elective major non-cardiac gender-neutral surgeries in Ontario, Canada from 2002 –2014. Survival status within one year of surgery was determined by link...
Source: Canadian Journal of Anesthesia - July 5, 2017 Category: Anesthesiology Source Type: research

Remote solutions for telementoring point-of-care ultrasound echocardiography: The RESOLUTE study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 5, 2017 Category: Anesthesiology Source Type: research

Malignant hyperthermia susceptibility in patients with exertional rhabdomyolysis: a retrospective cohort study and updated systematic review
ConclusionFindings from the Canadian patient cohort and the systematic review all signal a potential association between MH susceptibility and ER. The presence of MH-causative mutations and putative deleteriousRYR1 variants in ER patients without a history of adverse anesthetic reactions suggests their possible increased risk for MH. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Effect of magnesium sulfate on oxytocin-induced contractility in human myometrium: an in vitro study
AbstractPurposeThe purpose of this study was to determine the contractile patterns induced by oxytocin in myometrium exposed to magnesium sulfate (MgSO4). We hypothesized that MgSO4 pretreatment would reduce oxytocin-induced myometrial contractions in both oxytocin-na ïve and oxytocin-desensitized myometrium.MethodsIn this prospectivein vitro study, myometrial samples were obtained from 26 women undergoing elective Cesarean deliveries. Samples were divided into six groups. Four groups were apportioned to no pretreatment (control group), oxytocin 10−5 M pretreatment (desensitization group), MgSO4 3.5 mM pretreatm...
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Pediatric tonsillectomy is a resource-intensive procedure: a study of Canadian health administrative data
The objective of this Ontario-based study was to determine the rates and risks of hospital readmission, emergency department (ED) visits, or deaths within 30 days following common pediatric surgeries, with an emphasis on AT.MethodsInpatient and day surgery children who were
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Proc édures anesthésiques liées aux techniques chirurgicales, 2 e édition Procédures anesthésiques liées aux terrains
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Effects of training on resident physician emergency airway management skills
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Mentorship in a Canadian residency program: faculty and resident needs and experiences
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

The electronic medical record in anesthesiology: a standard of quality healthcare and patient safety
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Recurrent non-epileptiform seizure-like phenomena secondary to propofol administration
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Evaluation of two novel techniques for increasing radial artery size: a pilot study utilizing volunteers
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Electronic medical record interventions and recurrent perioperative antibiotic administration: a before-and-after study
AbstractPurposePerioperative antibiotics decrease rates of surgical-site infections. Numerous interventions have improved administration of the first antibiotic dose; however, failures in the administration of subsequent doses frequently occur. We hypothesized that modifications to the electronic medical record (EMR) would improve the administration of the second antibiotic dose and that such improvements would be sustained over time.MethodsThis historical cohort before-and-after study of multipronged alerts in the EMR analyzed 1,348 operations on adult patients. The operations lasted ≥ 240 min, utilized cefazolin as th...
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

All Blood Counts: A Manual for Blood Conservation and Patient Blood Management
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Ultrasonography-guided modified thoracolumbar interfascial plane block: a new approach
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 9, 2017 Category: Anesthesiology Source Type: research

Airway management changes in patients with mucopolysaccharidoses: the role of video laryngoscopy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 7, 2017 Category: Anesthesiology Source Type: research

Anaesthesia for the Elderly Patient (Second Edition)
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 5, 2017 Category: Anesthesiology Source Type: research

Ultrasound Guided Regional Anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 2, 2017 Category: Anesthesiology Source Type: research

Expanding the circle of care: Can children find a perioperative surgical home?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 2, 2017 Category: Anesthesiology Source Type: research

Internal jugular vein blood flow in the upright position during external compression and increased central venous pressure: an ultrasound study in healthy volunteers
ConclusionsCompression of the internal jugular veins or an increase in intrathoracic pressure does not reduce venous drainage but actually may increase intracranial venous volume. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 2, 2017 Category: Anesthesiology Source Type: research

Situational awareness: a tacit yet viable concept
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 2, 2017 Category: Anesthesiology Source Type: research

Exploring anesthesiologists ’ understanding of situational awareness: a qualitative study
ConclusionAlthough SA is an essential concept in anesthesiology, its use remains rather tacit, primarily due to the lack of a common operational definition of the term. Faculty development is required to help anesthesiologists teach and assess SA more explicitly in the clinical environment. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 1, 2017 Category: Anesthesiology Source Type: research

In reply: Apneic oxygenation: Let ’s all just take a deep breath
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 23, 2017 Category: Anesthesiology Source Type: research

Early rise in postoperative creatinine for identification of acute kidney injury after cardiac surgery
ConclusionIn patients undergoing cardiac surgery with cardiopulmonary bypass, an early rise in postoperative creatinine is a useful marker for the early identification of AKI patients. This could allow inclusion of such patients in clinical trials of promising therapeutic strategies that need to be initiated soon after the onset of injury. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 19, 2017 Category: Anesthesiology Source Type: research

Transcranial Doppler monitoring guided by cranial two-dimensional ultrasonography
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 16, 2017 Category: Anesthesiology Source Type: research

Sublingual heterotopic large cyst in a newborn: anesthetic management
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 15, 2017 Category: Anesthesiology Source Type: research

Managing the perioperative patient on direct oral anticoagulants
ConclusionPerioperative management of anticoagulation due to DOACs is a growing concern as the number of patients prescribed these medications increases each year. These patients can be safely optimized for urgent or emergent surgery by giving appropriate consideration to timing, monitoring, and reversal agents. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Relation between bispectral index measurements of anesthetic depth and postoperative mortality: a meta-analysis of observational studies
AbstractIntroductionThe association between anesthesia depth and mortality is still controversial. There are a number of narrative reviews on this topic that affirm this association, but their conclusions were based only on qualitative analyses. The aim of this meta-analysis of observational studies was to examine the potential association between depth of anesthesia as a low bispectral index (BIS) and mortality using appropriate quantitative methods.MethodsThe literature was systematically reviewed in three main electronic databases (MEDLINE, EMBASE, Google Scholar) to identify all articles from inception through December...
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Factors that influence effective perioperative temperature management by anesthesiologists: a qualitative study using the Theoretical Domains Framework
ConclusionThis study identified several potential target areas for future interventions from nine of the TDF behavioural domains that anesthesiologists perceive to drive their temperature management practices. Future interventions that aim to close the evidence-practice gap in perioperative temperature management may include these targets. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Predictors of intraoperative testing in adults undergoing noncardiac surgery within a regional hospital system
AbstractBackgroundThe use of intraoperative testing is central to anesthesia practice, and point-of-care testing (POCT) is often used. Nevertheless, POCT is costly and its contribution to patient outcome is unknown. There is a lack of guidelines to describe which patients should undergo intraoperative testing or how results should be applied. As such, we undertook a historical cohort study evaluating intraoperative testing practices within our region where POCT is not used.MethodsIn 2012, we obtained a random sample of 1,000 adult patients undergoing noncardiac surgery in three of our health system hospitals. Patient, surg...
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Measurement of faculty anesthesiologists ’ quality of clinical supervision has greater reliability when controlling for the leniency of the rating anesthesia resident: a retrospective cohort study
We examined all 13,664 ratings of the 97 anesthesiologists (ratees) by the 65 residents (raters). Testing for internal consistency among answers to questions (large Cronbach ’s alpha> 0.90) was performed to rule out that one or two questions accounted for leniency. Mixed-effects logistic regression was used to compare ratees while controlling for rater leniencyvs using Studentt tests without rater leniency.ResultsThe mean supervision scale score was calculated for each combination of the 65 raters and nine questions. The Cronbach ’s alpha was very large (0.977). The mean score was calculated for each of the ...
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

A technique for optimizing ultrasonography-guided radial arterial catheter insertion
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Anesthesia and postoperative delirium: the agent is a strawman – the problem is CO 2
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Effects of an alveolar recruitment maneuver on subdural pressure, brain swelling, and mean arterial pressure in patients undergoing supratentorial tumour resection: a randomized crossover study
AbstractPurpose Although recruitment maneuvers have been advocated as part of a lung protective ventilation strategy, their effects on cerebral physiology during elective neurosurgery are unknown. Our objectives were to determine the effects of an alveolar recruitment maneuver on subdural pressure (SDP), brain relaxation score (BRS), and cerebral perfusion pressure among patients undergoing supratentorial tumour resection.MethodsIn this prospective crossover study, patients scheduled for resection of a supratentorial brain tumour were randomized to undergo either a recruitment maneuver (30 cm of water for 30 sec) or a &ldq...
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research

Red urinary discolouration following hydroxocobalamin treatment for vasoplegic syndrome
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 13, 2017 Category: Anesthesiology Source Type: research