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Special announcement: Guidelines to the Practice of Anesthesia – Revised Edition 2017
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 25, 2016 Category: Anesthesiology Source Type: research

Isoflurane use is not associated with prolonged intensive care unit stay following routine cardiac surgery when compared to sevoflurane
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 24, 2016 Category: Anesthesiology Source Type: research

In reply: Isoflurane use is not associated with prolonged intensive care unit stay following routine cardiac surgery when compared to sevoflurane
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 24, 2016 Category: Anesthesiology Source Type: research

Real-time physiologic monitoring and physician feedback: Are we ready?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 23, 2016 Category: Anesthesiology Source Type: research

Pre-clerkship teaching: Are we missing an opportunity?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 23, 2016 Category: Anesthesiology Source Type: research

An easily assembled phantom for teaching ultrasound-guided vascular access
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 23, 2016 Category: Anesthesiology Source Type: research

In defense of succinylcholine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 20, 2016 Category: Anesthesiology Source Type: research

In reply: In defense of succinylcholine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 20, 2016 Category: Anesthesiology Source Type: research

In reply: Perioperative nocturnal hypoxemia matters in surgical patients with obstructive sleep apnea
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 19, 2016 Category: Anesthesiology Source Type: research

Perioperative nocturnal hypoxemia matters in surgical patients with obstructive sleep apnea
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 19, 2016 Category: Anesthesiology Source Type: research

Survey of neuroanesthesia fellowships in Canada
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 17, 2016 Category: Anesthesiology Source Type: research

Pharmacogenomics and pharmacogenetics for the intensive care unit: a narrative review
ConclusionApplication of pharmacogenetics and pharmacogenomics has seen improvements in drug therapy. Ongoing study and incorporation of these concepts into clinical decision making in the ICU has the potential to affect patient outcomes. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 16, 2016 Category: Anesthesiology Source Type: research

Drugs in Anaesthesia and Intensive Care: Fifth Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 13, 2016 Category: Anesthesiology Source Type: research

Aspiration of a fractured tracheostomy cannula in a pediatric patient
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 11, 2016 Category: Anesthesiology Source Type: research

In reply: Anesthesia scavenging in critical care areas: beware of possible hazards and questionable efficacy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 6, 2016 Category: Anesthesiology Source Type: research

Anesthesia scavenging in critical care areas: beware of possible hazards and questionable efficacy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 6, 2016 Category: Anesthesiology Source Type: research

Chronic Pain Management for the Hospitalized Patient
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 3, 2016 Category: Anesthesiology Source Type: research

Postoperative dysglycemia in elective non-diabetic surgical patients: a prospective observational study
This study included 257 non-diabetic adults scheduled for inpatient surgery. Preoperatively, capillary blood glucose (CBG) and HbA1c were measured and patients completed the Canadian Diabetes Risk Questionnaire (CANRISK). Capillary blood glucose was measured for two days or until hospital discharge at the following time points: postoperatively, before all meals, and at 22:00 hr. The mean CBG and incidence of hyperglycemia were compared between HbA1c levels: Group I
Source: Canadian Journal of Anesthesia - October 2, 2016 Category: Anesthesiology Source Type: research

Anesthesia for hip arthroscopy: a narrative review
ConclusionsUntil now, the anesthetic technique for hip arthroscopy has not been well studied. Thus, increasing emphasis should be directed towards examining relevant clinical outcomes that can better inform evidence-based decision-making in the anesthetic management of hip arthroscopy patients. In the meantime, awareness of potential complications and vigilant monitoring are paramount in providing safe anesthetic care for patients undergoing hip arthroscopy. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Transesophageal lung ultrasonography: a novel technique for investigating hypoxemia
ConclusionAnesthesiologists and intensivists who already use transesophageal echocardiography on a regular basis should consider adding TELU to their clinical assessment of hypoxemia and related pulmonary pathologies. Nevertheless, the literature specifically supporting TELU is relatively limited, and further validation studies are needed. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Effect of intravenous lidocaine on the transcerebral inflammatory response during cardiac surgery: a randomized-controlled trial
ConclusionWhile lidocaine did not affect the systemic or transcerebral activation of platelets or leukocytes, we did observe a reduction in the transcerebral activation of platelet-monocyte conjugates after aortic cross-clamp release. This may be a manifestation of reduced cerebral inflammation during cardiopulmonary bypass in response to treatment with lidocaine. This trial was registered at ClinicalTrials.gov (NCT00938964). (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Can we create a Canadian Perioperative Anesthesia Clinical Trials Group? We review the first five years and glimpse into the future
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Mode of anesthesia and clinical outcomes of patients undergoing Cesarean delivery for invasive placentation: a retrospective cohort study of 50 consecutive cases
AbstractPurposeInvasive placentation is one of the most important causes of postpartum hemorrhage and Cesarean hysterectomies (CHyst). The optimal mode of anesthesia in the management of these patients remains uncertain. The purpose of this study was to review the impact of mode of anesthesia on maternal and neonatal outcomes in women with invasive placentation undergoing Cesarean delivery (CD).MethodsA retrospective cohort study was conducted in women with invasive placentation who delivered at our hospital during 2000-2012. Patients ’ charts and electronic health records were searched for relevant data, including o...
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Failure of the air-Q ® laryngeal airway to facilitate exchange with the Arndt Airway Exchange Catheter
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Anesthesia Student Survival Guide: A Case-Based Approach, 2nd Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Monitoring waste anesthetic gas in the pediatric postanesthesia care unit
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Perioperative visual loss following transurethral resection surgery: not always a transurethral resection syndrome
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Multidetector computed tomography-derived emphysema index for preoperative quantification of emphysema severity
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Transesophageal lung ultrasound: to boldly go …
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

In reply: Management of blood pressure alters cerebral oxygen saturation values in the beach chair position
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

The Airway App
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Management of blood pressure alters cerebral oxygen saturation values in the beach-chair position
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 30, 2016 Category: Anesthesiology Source Type: research

Late diagnosis of post-traumatic ruptured pericardium with cardiac herniation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 25, 2016 Category: Anesthesiology Source Type: research

Perceptions of purpose, value, and process of the mini-Clinical Evaluation Exercise in anesthesia training
ConclusionGreater clarity of purpose and consistency of time commitment are necessary to embed the mini-CEX in the culture of the workplace, to realize the full potential for trainee learning, and to reach decisions on trainee progression. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 22, 2016 Category: Anesthesiology Source Type: research

A randomized comparison between intravenous and perineural dexamethasone for ultrasound-guided axillary block
AbstractBackgroundThis randomized double-blinded trial compared the effect of intravenous and perineural dexamethasone (8  mg) on the duration of motor block for ultrasound (US)-guided axillary brachial plexus block (AXB).MethodsPatients undergoing upper limb surgery with US-guided AXB were randomly allocated to receive preservative-free dexamethasone (8  mg) via intravenous (n = 75) or perineural (n = 75) administration. The local anesthetic agent, 1% lidocaine −0.25% bupivacaine (30 mL) with epinephrine 5 µg·mL−1, was identical in all subjects. Operators an...
Source: Canadian Journal of Anesthesia - September 22, 2016 Category: Anesthesiology Source Type: research

Choosing wisely and preoperative hemoglobin A1c testing: what should it mean?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 20, 2016 Category: Anesthesiology Source Type: research

Professionalism in anesthesia
ConclusionConsiderable evidence exists to suggest that professionalism must be treated seriously, particularly in these times of social accountability and budgetary pressures. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 19, 2016 Category: Anesthesiology Source Type: research

Preparing anesthesiology faculty for competency-based medical education
ConclusionsFaculty development must be considered in the rollout of any new educational initiative. Experts suggest that faculty development for CBME should incorporate educational activities using multiple teaching and delivery methods, and should be offered longitudinally through the planning, development, and implementation phases of curriculum change. Additionally, these educational activities must continue until all faculty have demonstrated an acceptable level of competence. Faculty buy-in is paramount to the successful delivery of any faculty development program that is not mandatory in nature. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 18, 2016 Category: Anesthesiology Source Type: research

Sugammadex as rescue therapy for residual neuromuscular blockade in the intensive care unit
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 18, 2016 Category: Anesthesiology Source Type: research

Simulation-based assessment of anesthesiology residents ’ competence: development and implementation of the Canadian National Anesthesiology Simulation Curriculum (CanNASC)
AbstractThe specialty of anesthesiology will soon adopt the Competence By Design (CBD) approach to residency education developed by the Royal College of Physicians and Surgeons of Canada (RCPSC). A foundational component of CBD is frequent and contextualized assessment of trainees. In 2013, the RCPSC Anesthesiology Specialty Committee assembled a group of simulation educators, representing each of the 17 Canadian anesthesiology residency programs, to form the Canadian National Anesthesiology Simulation Curriculum (CanNASC) Task Force. The goals were to develop, implement, and evaluate a set of consensus-driven standardized...
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Effects of anesthetics on early postoperative cognitive outcome and intraoperative cerebral oxygen balance in patients undergoing lung surgery: a randomized clinical trial
AbstractPurposeOne-lung ventilation (OLV) may impair cerebral oxygen balance and induce postoperative cognitive dysfunction (POCD). It is unclear whether the type of anesthetic influences the incidence of POCD in patients undergoing OLV. This prospective study compared the incidence of POCD and intraoperative cerebral oxygen desaturation in OLV patients anesthetized with propofolvs sevoflurane during lung surgery.MethodsThere were 148 participants enrolled in this study and randomized equally to either the propofol or the sevoflurane group. Anesthesia was maintained with either propofol or sevoflurane combined in both grou...
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Comparison of isoflurane and sevoflurane in cardiac surgery: a randomized non-inferiority comparative effectiveness trial
AbstractPurposeVolatile anesthetics possess cardioprotective properties, but it is unknown if the cardioprotective effects extend equally to all members of the class. Although sevoflurane is a relatively newer anesthetic than isoflurane, its introduction into practice was not preceded by a head-to-head comparison with isoflurane in a trial focusing on clinically important outcomes. Our objective was to determine whether sevoflurane was non-inferior to isoflurane on a clinically important primary outcome in a heterogeneous group of adults undergoing cardiac surgery.MethodsThis was a pragmatic randomized non-inferiority comp...
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Evaluation of failed and high blocks associated with spinal anesthesia for Cesarean delivery following inadequate labour epidural: a retrospective cohort study
AbstractPurposeThe purpose of this retrospective cohort study was to investigate factors associated with failed and high spinal blocks in patients who received spinal anesthesia for Cesarean delivery following a labour epidural that was inadequate for surgical anesthesia.MethodsWe searched our perioperative database for women with a labour epidural who received spinal or combined spinal-epidural anesthesia for Cesarean delivery due to the inadequacy of the existing epidural. The primary outcome was the occurrence of failed spinal blocks, and the secondary outcome was the occurrence of high blocks following spinal administr...
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Transversus abdominal plane block for postoperative analgesia: a systematic review and meta-analysis of randomized-controlled trials
AbstractPurposeThe transversus abdominal plane (TAP) block has been described as an effective pain control technique after abdominal surgery. We performed a systematic review and meta-analysis of randomized-controlled trials (RCTs) to account for the increasing number of TAP block studies appearing in the literature. The primary outcome we examined was the effect of TAP block on the postoperative pain score at six, 12, and 24 hr. The secondary outcome was 24-hr morphine consumption.SourceWe searched the United States National Library of Medicine database, the Excerpta Medica database, and the Cochrane Central Register of C...
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients
AbstractPurposeInhaled milrinone (iMil) has been used for the treatment of pulmonary hypertension (PH) but its efficacy, safety, and prophylactic effects in facilitating separation from cardiopulmonary bypass (CPB) and preventing right ventricular (RV) dysfunction have not yet been evaluated in a clinical trial. The purpose of this study was to investigate if iMil administered before CPB would be superior to placebo in facilitating separation from CPB.MethodsHigh-risk cardiac surgical patients with PH were randomized to receive iMil or placebo after the induction of anesthesia and before CPB. Hemodynamic parameters and RV ...
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Newer isn ’t always better: comparative effectiveness of sevoflurane and isoflurane in cardiac surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Oxford Handbook of Anaesthesia, Fourth Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

An ultrasound-guided ABCDE approach with a sniff test to evaluate diaphragmatic function without acoustic windows
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

“Winding down” guidelines for anesthesiologists: The Ottawa Hospital plan
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Linshom respiratory monitoring device: a novel temperature-based respiratory monitor
ConclusionsRespiratory rates using the LRMD, a novel temperature-based respiratory instrument, were consistent with those using capnometry. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research