Incidence of non-physiologically complex surgical procedures performed in children: an Ontario population-based study of health administrative data
AbstractPurposeQuantification of surgical procedures undertaken by hospitals is necessary for informing resource allocation and modelling healthcare services. Our objective was to quantify the incidence, similarity, and diversity of non-physiologically complex surgical procedures performed at pediatric specialist hospitals and other hospitals performing pediatric surgery.MethodsWe conducted a population-based cohort study of children aged 28 days to 18 yr who underwent surgery in the province of Ontario from 2007 to 2015 using healthcare administrative databases. We estimated the incidence of non-physiologically complex pr...
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

Withholding and withdrawing life support: difficult decisions around care at the end of life
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

Correction to: A primer on nerve agents: what the emergency responder, anesthesiologist, and intensivist needs to know
AbstractIn the article entitled: “A primer on nerve agents: what the emergency responder, anesthesiologist, and intensivist needs to know” published in the October 2017 issue of theJournal, Can J Anesth 2017; 64: 1059-1070, two doses in Table  3 contained errors and have now been corrected (and highlighted in bold) in the revised table herein. In the table on page 1064, next to “Pralidoxime/Obidoxime/HI-6”, the second column should read: “Pralidoxime- Mild cases:1-2 giv over 5-10 min orim”. Also in the same row, the third column should read: “Individual doses should not exceed...
Source: Canadian Journal of Anesthesia - December 22, 2017 Category: Anesthesiology Source Type: research

T éléconsultation d’anesthésie au domicile : une enquête d’acceptabilité
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 20, 2017 Category: Anesthesiology Source Type: research

The Leech airway: precursor to the modern supraglottic airway
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 20, 2017 Category: Anesthesiology Source Type: research

Review of the enhanced recovery pathway for children: perioperative anesthetic considerations
ConclusionAlthough adult ERAS pathways have been successful at reducing patient morbidity, the translation, creation, and utility of instituting pediatric ERAS pathways have yet to be realized. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 19, 2017 Category: Anesthesiology Source Type: research

A randomized comparison between interscalene and combined infraclavicular-suprascapular blocks for arthroscopic shoulder surgery
AbstractBackgroundThis randomized trial aimed to evaluate combined infraclavicular-suprascapular blocks (ICB-SSBs) as a diaphragm-sparing alternative to interscalene blocks (ISBs) for arthroscopic shoulder surgery. We hypothesized that ICB-SSB would provide equivalent postoperative analgesia to ISB 30 min after surgery without the risk of hemidiaphragmatic paralysis.MethodsFollowing research ethics board approval and written informed consent, participants in the ISB group received an ultrasound-guided ISB with 20  mL of levobupivacaine 0.25% and epinephrine 5 µg·mL−1. In the ICB-SSB group, ultr...
Source: Canadian Journal of Anesthesia - December 19, 2017 Category: Anesthesiology Source Type: research

The physiologic basis for goal-directed hemodynamic and fluid therapy: the pivotal role of the venous circulation
ConclusionsThe physiologic basis of goal-directed hemodynamic therapy is complex and not necessarily reflected in the information received from hemodynamic monitors. Understanding the physiologic basis of such therapy is a logical step towards its optimal use. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

Benzodiazepine administration during adult cardiac surgery: a survey of current practice among Canadian anesthesiologists working in academic centres
ConclusionsBenzodiazepine use is common among academic cardiac anesthesiologists in Canada. Nonetheless, heterogeneity exists between individual practices, suggesting clinical equipoise between restrictive and liberal administration of benzodiazepines for cardiac anesthesia. L ’administration de benzodiazépines pendant la chirurgie cardiaque chez l’adulte: évaluation de la pratique actuelle des anesthésiologistes canadiens exerçant en milieu universitaire (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

Case Studies in Adult Intensive Care Medicine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

The utility and safety of flexible bronchoscopy in critically ill acute leukemia patients: a retrospective cohort study
ConclusionsFlexible bronchoscopy with BAL is relatively safe and helps to guide medical management among patients with AL admitted to the ICU. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

Correction to: Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review
AbstractThe following row on page 691 of Table  3, as highlighted in bold under Incidence of Retention (%) should read “0” instead of “N/A”. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 18, 2017 Category: Anesthesiology Source Type: research

St. Ren é Goupil: the patron saint of anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 15, 2017 Category: Anesthesiology Source Type: research

Guidelines to the Practice of Anesthesia – Revised Edition 2018
OverviewThe Guidelines to the Practice of Anesthesia Revised Edition 2018 (the Guidelines) were prepared by the Canadian Anesthesiologists ’ Society (CAS), which reserves the right to determine their publication and distribution. The Guidelines are subject to revision and updated versions are published annually. The Guidelines to the Practice of Anesthesia Revised Edition 2018 supersedes all previously published versions of this docu ment. Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the CAS cannot guarantee any specific patient outco...
Source: Canadian Journal of Anesthesia - December 14, 2017 Category: Anesthesiology Source Type: research

Interventions to improve the mechanical ventilation fidelity of the Laerdal SimMan ® 3G simulation mannequin
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 14, 2017 Category: Anesthesiology Source Type: research

History of the crest and motto of the Canadian Anesthesiologists ’ Society
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 14, 2017 Category: Anesthesiology Source Type: research

Basics of Anesthesia, Seventh Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 12, 2017 Category: Anesthesiology Source Type: research

Point-of-care gastric ultrasound and aspiration risk assessment: a narrative review
AbstractThis narrative review summarizes the current knowledge on point-of-care ultrasound (POCUS) of gastric contents in order to inform an assessment of aspiration risk and guide anesthetic management at the bedside. An I-AIM framework (Indication, Acquisition, Interpretation, and Medical decision-making) is used to summarize and organize the content areas. This narrative review spans the breadth of the literature on pediatric and adult subjects as well as on special patient populations such as obstetric and severely obese individuals. Areas that need further investigation include the diagnostic accuracy of gastric POCUS...
Source: Canadian Journal of Anesthesia - December 11, 2017 Category: Anesthesiology Source Type: research

Statistical reporting and table construction guidelines for publication in the Canadian Journal of Anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 5, 2017 Category: Anesthesiology Source Type: research

Hydroxocobalamin for the treatment of cardiac surgery-associated vasoplegia: a case series
ConclusionThese data indicate considerable heterogeneity in patient response to B12, potentially dependent on both patient preoperative condition and non-standardized time of administration. B12 may provide a useful alternative therapy for refractory hypotension and vasoplegia, but controlled clinical trials to assess efficacy are needed. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 5, 2017 Category: Anesthesiology Source Type: research

A randomized trial of phenylephrine infusion versus bolus dosing for nausea and vomiting during Cesarean delivery in obese women
AbstractPurposeHypotension is common after spinal anesthesia for Cesarean delivery. It is associated with nausea, vomiting, and fetal acidosis. Previous research on phenylephrine excluded obese subjects. We compared the incidence of intraoperative nausea and vomiting (IONV) in obese patients who received a prophylactic phenylephrine infusionvs those who received bolus dosing for the treatment of spinal-induced hypotension.MethodsIn this multicentre, double-blinded randomized controlled trial, 160 obese women undergoing elective Cesarean delivery under spinal anesthesia were randomized to receive a prophylactic phenylephrin...
Source: Canadian Journal of Anesthesia - December 5, 2017 Category: Anesthesiology Source Type: research

Preventing hypotension-induced nausea and vomiting during spinal anesthesia for Cesarean delivery in obese parturients: a small solution for a big problem?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 5, 2017 Category: Anesthesiology Source Type: research

Subclavian and axillary vessel anatomy: a prospective observational ultrasound study
AbstractPurposeThe primary objective of this study was to define the ultrasound-derived anatomy of the axillary/subclavian vessels. As a secondary objective, we evaluated the relationship between the vascular anatomy and demographic, anthropometric, and hemodynamic data of patients.MethodsThis observational anatomical study used bedside ultrasound with 150 cardiac surgical patients in the operating room. Bilateral axillary and subclavian anatomy was determined using a high-frequency ultrasound probe with fixed reference points. Images were recorded and analyzed, and correlation with demographic, anthropometric, and hemodyn...
Source: Canadian Journal of Anesthesia - December 5, 2017 Category: Anesthesiology Source Type: research

Continuing education: from FRCPC to ACGME fellowship
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 4, 2017 Category: Anesthesiology Source Type: research

High intraoperative endotracheal tube cuff pressure incidence and clinical impact
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 4, 2017 Category: Anesthesiology Source Type: research

Focused assessment with sonography in trauma: a review of concepts and considerations for anesthesiology
AbstractThe use of point-of-care ultrasound in trauma provides diagnostic clarity and routinely influences management. A scanning protocol known as the Focused Assessment with Sonography in Trauma (FAST) has been widely adopted by trauma providers of all specialties. The FAST exam addresses a broad array of pathologic conditions capable of causing instability, including hemoperitoneum, hemopericardium, hemothorax, and pneumothorax. The exam is an integral component to the primary assessment of injured patients and an iconic application of point-of-care ultrasound.This review article aims to summarize the application of the...
Source: Canadian Journal of Anesthesia - December 4, 2017 Category: Anesthesiology Source Type: research

Abstracts 2017
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 4, 2017 Category: Anesthesiology Source Type: research

Eye taping and chlorhexidine exposure: caution when interpreting scarce evidence
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - December 1, 2017 Category: Anesthesiology Source Type: research

Mapping intracerebral steal during a hypercapnic challenge
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 8, 2017 Category: Anesthesiology Source Type: research

Special announcement: Guidelines to the Practice of Anesthesia – Revised Edition 2018
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 3, 2017 Category: Anesthesiology Source Type: research

Pre- and postoperative anemia, acute kidney injury, and mortality after coronary artery bypass grafting surgery: a retrospective observational study
AbstractBackgroundPreoperative and postoperative anemia have been identified individually as potential risk factors for postoperative complications after coronary artery bypass grafting (CABG) surgery. Their interrelationship with acute kidney injury (AKI) and long-term mortality, however, has  not been clearly defined and was the purpose of this study.MethodsWe retrospectively evaluated 6,130 adult patients undergoing CABG surgery  performed at a single large academic medical center. Preoperative and postoperative hemoglobin concentrations were used as continuous predictors of postoperative AKI and mortality. Ad...
Source: Canadian Journal of Anesthesia - November 2, 2017 Category: Anesthesiology Source Type: research

Initial experience with dexmedetomidine for acute pain crises
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 2, 2017 Category: Anesthesiology Source Type: research

Anesth ésie-réanimation en chirurgie thoracique
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 2, 2017 Category: Anesthesiology Source Type: research

Use of contrast ultrasonography to confirm correct peripheral intravenous access before general anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 2, 2017 Category: Anesthesiology Source Type: research

A change to the surgical safety checklist to reduce patient identification errors
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 2, 2017 Category: Anesthesiology Source Type: research

Inferior vena cava tumour thrombus and renal cell carcinoma
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 1, 2017 Category: Anesthesiology Source Type: research

An early Canadian-made chloroform inhaler
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 1, 2017 Category: Anesthesiology Source Type: research

Interpretation of sleep studies for patients with sleep-disordered breathing: What the anesthesiologist needs to know
AbstractThere is increased interest in the perioperative management of patients with sleep-disordered breathing (SDB). Anesthesiologists must distill information from clinical reports to make key decisions for optimizing perioperative care. A patient with SDB may present with a sleep study report at the time of surgery. Knowledge of the essential components of such a report can help the anesthesiologist evaluate the patient and optimize the perioperative management. In this narrative review, we describe how level I (i.e., laboratory-based) polysomnography (PSG) data are collected and scored using the recommended scoring gu...
Source: Canadian Journal of Anesthesia - October 30, 2017 Category: Anesthesiology Source Type: research

Limitations of pediatric supraglottic airway devices as conduits for intubation - an in vitro study
ConclusionsThe use of combinations of SGA and ETTs with a size mismatch can lead to airway complications during intubation or to accidental extubation and tearing of the cuff pilot balloon line when removing the SGA. To avoid these problems, we devised a table that simplifies the choice of an appropriate SGA and ETT combination. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 20, 2017 Category: Anesthesiology Source Type: research

Recognizing the 75th anniversary of the Canadian Anesthesiologists ’ Society: a special series of “Images” from our past
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 20, 2017 Category: Anesthesiology Source Type: research

An unusual blood pressure reading
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 16, 2017 Category: Anesthesiology Source Type: research

Frontoethmoidal encephalocele: a pediatric airway challenge
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 16, 2017 Category: Anesthesiology Source Type: research

Flexible bronchoscopic intubation through the AuraGain ™ laryngeal mask versus a slit Guedel tube: a non-inferiority randomized-controlled trial
ConclusionWe conclude that flexible bronchoscopic intubation through an AuraGain laryngeal mask can be achieved at least as fast as standard bronchoscopic intubation without contributing to additional patient morbidity or postoperative discomfort.Trial registrationwww.clinicaltrials.gov, NCT 02570269. Registered 23 September 2015. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 12, 2017 Category: Anesthesiology Source Type: research

Risk factors for delirium after cardiac surgery: a historical cohort study outlining the influence of cardiopulmonary bypass
ConclusionsThe use and duration of cardiopulmonary bypass were associated with an increased risk of delirium in patients undergoing CABG surgery.Trial registrationwww.clinicaltrials.gov, NCT02548975. Registered 4 September 2015. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 12, 2017 Category: Anesthesiology Source Type: research

Reducing Mortality in the Perioperative Period, Second Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 12, 2017 Category: Anesthesiology Source Type: research

The effect of virtual endoscopy on diagnostic accuracy and airway management strategies in patients with head and neck pathology: a prospective cohort study
AbstractPurposeThere is growing evidence to suggest a deficiency in anesthesiologists ’ diagnosis of airway pathology and subsequent airway management planning, and conventional instruments have not shown increases in safety. Virtual endoscopy (VE) is a tool that can detail intraluminal anatomical “fly-through” information in a format visually similar to the flexible endoscopic views familiar to anesthesiologists. We aimed to determine the effect of VE on diagnostic accuracy and airway management strategies when compared with conventional tools.MethodsClinical scenarios, along with computerized tomography...
Source: Canadian Journal of Anesthesia - October 12, 2017 Category: Anesthesiology Source Type: research

Eye taping during anesthesia and chlorhexidine exposure
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 12, 2017 Category: Anesthesiology Source Type: research

Spinal cord injury after thoracic endovascular aortic aneurysm repair
ConclusionFurther experimental and clinical research is needed to aid in the discovery of novel neuroprotective strategies for the protection and treatment of SCI following TEVAR. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 10, 2017 Category: Anesthesiology Source Type: research

Clinical Airway Management: An Illustrated Case-Based Approach
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 10, 2017 Category: Anesthesiology Source Type: research

Handbook of Anaesthesia and Peri-Operative Medicine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 10, 2017 Category: Anesthesiology Source Type: research