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Inhaled milrinone for pulmonary hypertension in high-risk cardiac surgery: silver bullet or just part of a broader  management strategy?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

External carotid compression: a novel technique to improve cerebral perfusion during selective antegrade cerebral perfusion for aortic arch surgery
ConclusionsDirect ultrasound visualization and cautious partial compression of the left carotid artery may address asymmetrical CBF that occurs with SACP during HCA for aortic arch surgery. This strategy may lead to improved symmetry of CBF and corresponding cerebral oximetry measurements during aortic arch surgery. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

In reply: Combined use of flexible bronchoscopy and video laryngoscopy for endotracheal intubation in patients with King laryngeal tube in situ
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Bifid epiglottis in a patient with Pallister-Hall syndrome
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Combined use of flexible bronchoscopy and video laryngoscopy for endotracheal intubation in patients with King laryngeal tube in situ
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 15, 2016 Category: Anesthesiology Source Type: research

Postoperative orthostatic intolerance: a common perioperative problem with few available solutions
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 13, 2016 Category: Anesthesiology Source Type: research

Opioid use after propofol or sevoflurane anesthesia: a randomized trial
ConclusionIntraoperative sevoflurane did not reduce postoperative analgesia. This finding is consistent with the results in most previous reports. This trial was registered at ClinicalTrials.gov: NCT00712517. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 13, 2016 Category: Anesthesiology Source Type: research

REctus Sheath block for postoperative analgesia in gynecological ONcology Surgery (RESONS): a randomized-controlled trial
AbstractBackgroundOpioid-sparing pain management is important for Enhanced Recovery After Surgery. Rectus sheath (RS) blocks are emerging as a promising modality for pain relief following midline laparotomy; however, there are limited prospective clinical trials testing their efficacy. The purpose of this randomized-controlled trial is to assess the morphine-sparing effect of local anesthetic (LA) boluses through RS catheters following elective gynecological oncology surgery.MethodAfter patients ’ informed consent, bilateral RS catheters were placed intraoperatively in 74 females (American Society of Anesthesiologist...
Source: Canadian Journal of Anesthesia - September 13, 2016 Category: Anesthesiology Source Type: research

A two-stage review process for randomized controlled trials: the ultimate solution for publication bias?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 12, 2016 Category: Anesthesiology Source Type: research

In reply: A two-stage review process for randomized controlled trials: the ultimate solution for publication bias?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - September 12, 2016 Category: Anesthesiology Source Type: research

Surgical Pain Management: A Complete Guide to Implantable and Interventional Pain Therapies
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 23, 2016 Category: Anesthesiology Source Type: research

Neuroanesthesia and Cerebrospinal Protection
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 22, 2016 Category: Anesthesiology Source Type: research

Difficultintubationapp.com – A difficult airway electronic record
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 17, 2016 Category: Anesthesiology Source Type: research

Complications in Neuroanesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 15, 2016 Category: Anesthesiology Source Type: research

The Anatomical Foundations of Regional Anesthesia and Acute Pain Medicine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 14, 2016 Category: Anesthesiology Source Type: research

Guest Reviewers
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 11, 2016 Category: Anesthesiology Source Type: research

Revisiting the consequences of inadequate Canadian physician resource planning: a renewed call to action
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 9, 2016 Category: Anesthesiology Source Type: research

Same-day discharge after craniotomy for supratentorial tumour surgery: a retrospective observational single-centre study
ConclusionSame-day discharge from hospital is possible in carefully selected patients after both GA and AC for supratentorial tumour surgery. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 9, 2016 Category: Anesthesiology Source Type: research

In reply: Monitoring recovery from neuromuscular block using acceleromyography at the trapezius muscle: problems that must be considered
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 8, 2016 Category: Anesthesiology Source Type: research

Monitoring recovery from neuromuscular block using acceleromyography at the trapezius muscle: problems that must be considered
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 7, 2016 Category: Anesthesiology Source Type: research

Takotsubo cardiomyopathy and its relevance to anesthesiology: a narrative review
ConclusionPerioperative TTCM is more common than appreciated and should be considered in any hospitalized patient presenting with acute coronary syndrome and/or hemodynamic instability, acute respiratory distress, as well as cardiac arrhythmias and arrest. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Clinical prediction model to identify vulnerable patients in ambulatory surgery: towards optimal medical decision-making
ConclusionThis study identified a substantial group of vulnerable patients in ambulatory surgery. The proposed clinical prediction model could allow healthcare professionals the opportunity to identify vulnerable patients in ambulatory surgery, although additional modification and validation are needed. (ClinicalTrials.gov number, NCT01441843). (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Preoperative hemostatic assessment: a new and simple bleeding questionnaire
AbstractPurposeCurrent recommendations for the assessment of the risk of perioperative bleeding limit coagulation testing to patients with a personal and/or family history of bleeding. As no simple preoperative screening questionnaire is currently available, we assessed the performance of a novel screening questionnaire for its ability to detect bleeding disorders.MethodsA dichotomized, seven-point questionnaire named HEMSTOP (Hematoma, hEmorrhage,  Menorrhagia, Surgery, Tooth extraction, Obstetrics, Parents) was applied to three groups of subjects: patients referred to hemostasis specialists for bleeding symptom...
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Gabapentin for the hemodynamic response to intubation: systematic review and meta-analysis
ConclusionIt remains unknown whether gabapentin improves clinically relevant outcomes such as death and myocardial infarction since studies failed to report on these. Nevertheless, gabapentin attenuated increases in heart rate and blood pressure following intubation when compared with the control group. Even so, the studies included in this review were at potential risk of bias. Moreover, they did not include high-risk patients or report adverse hemodynamic outcomes. Future studies are required to address these limitations. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Assessment of fluid responsiveness with end-tidal carbon dioxide using a simplified passive leg raising maneuver: a prospective observational study
AbstractBackgroundAssessing fluid responsiveness is important in the management of patients with hemodynamic instability. Passive leg raising (PLR) is a validated dynamic method to induce a transient increase in cardiac preload and predict fluid responsiveness. Variations in end-tidal carbon dioxide (ETCO2) obtained by capnography correlate closely with variations in cardiac output when alveolar ventilation and carbon dioxide production are kept constant. In this prospective observational study, we tested the hypothesis that variations in ETCO2 induced by a simplified PLR maneuver can track changes in the cardiac inde...
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Hypertensive disorders of pregnancy
ConclusionsHypertensive disorders of pregnancy are on the rise worldwide, and this trend is expected to continue. The major contributors to maternal mortality are failure to recognize HDP promptly or to treat the condition adequately. It is essential that anesthesiologists understand the disease process and acquire knowledge of the guidelines governing current obstetrical care in order to provide evidence-based multidisciplinary quality care to these patients. Anesthetic management helps prevent potentially deleterious maternal and fetal outcomes. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Postoperative environmental anesthetic vapour concentrations following removal of the airway device in the operating room versus the postanesthesia care unit
ConclusionsAfter a volatile-based anesthetic, our results suggest that removal of the airway device in the PACUvs in the OR increases the amount of waste anesthetic gas in a patient ’s breathing zone and thus potentially in the PACU nurse’s working zone. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Detection of inherited and acquired hemostatic disorders in surgical patients
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Point-of-Care Tests for Severe Hemorrhage - A Manual for Diagnosis and Treatment
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Dual-route tranexamic acid to reduce blood loss in coronary artery bypass graft surgery: a randomized controlled trial
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Does your reinforced tube have a Murphy EYE ?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

What mediates postoperative risk in obstructive sleep apnea: airway obstruction, nocturnal hypoxia, or both?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Optimization and outcomes of patients who decline blood transfusion during complex spine surgery: a retrospective cohort study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

A place that is easier to get into than to get out of!
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

In reply: Deliberately restricted laryngeal view with GlideScope ® video laryngoscope: ramifications for airway research and teaching
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Dr. Charles Leslie MacAdams
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Erratum to: Should ancillary brain blood flow analyses play a larger role in the neurological determination of death?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Tracheal diverticulum as a cause of subcutaneous emphysema following positive-pressure ventilation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Deliberately restricted laryngeal view with GlideScope ® video laryngoscope: ramifications for airway research and teaching
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 5, 2016 Category: Anesthesiology Source Type: research

Parental presence at induction of anesthesia is feasible with minimal preparation and resources
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - August 3, 2016 Category: Anesthesiology Source Type: research

A randomized-controlled trial of high- or low-volume intravenous Plasma-Lyte ® to prevent hypotension during sedation for colonoscopy
Abstract Purpose The purpose of this study was to compare the incidence of hypotension during sedation in adults presenting for elective colonoscopy and randomized to intravenous Plasma-Lyte 148® at either 2 mL·kg−1 (low volume) or 20 mL·kg−1 (high volume). Methods Patients aged ≥ 18 yr presenting for elective colonoscopy, with or without gastroscopy, after oral bowel preparation were randomized to receive the intervention immediately before the start of the procedure. Hypotension was defined as a ≥ 25% decrease...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

“Must do CPR??”: strategies to cope with the new College of Physicians and Surgeons of Ontario policy on end-of-life care
Abstract The College of Physicians and Surgeons of Ontario recently released a new policy, Planning for and Providing Quality End-of-Life Care. The revised policy is more accurate in its consideration of the legal framework in which physicians practice and more reflective of ethical issues that arise in end-of-life (EOL) care. It also recognizes valid instances for not offering cardiopulmonary resuscitation (CPR). Nevertheless, the policy poses a significant ethical and legal dilemma—i.e., if disputes over EOL care arise, then physicians must provide CPR even when resuscitation would fall outside this medic...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

The alignment approach to nasotracheal intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Physical Diagnosis of Pain: an Atlas of Signs and Symptoms - 3rd Edition
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Utility of transesophageal echocardiography in identifying spinal canal structures and epidural catheter position: a prospective observational study of intraoperative hemodynamics and postoperative analgesia
Abstract Purpose The aims of this study were to determine the utility of transesophageal echocardiography (TEE) for identifying spinal canal structures and epidural catheter position and to assess the effect of catheter position on intraoperative hemodynamics and quality of postoperative analgesia. Methods Twenty-six adult patients undergoing thoracic surgery were included in this prospective, observational study. An epidural catheter was inserted 7.5 cm or more into the thoracic epidural space using a midline approach and a loss-of-resistance tec...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Prolonged transesophageal echocardiography during percutaneous closure of the left atrial appendage without general anesthesia: the utility of the Janus mask
Conclusion Deep sedation with noninvasive ventilation may be a reasonable and safe alternative to general endotracheal anesthesia in patients requiring prolonged TEE for noninvasive cardiac procedures, including LAA closure. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Rationale for a modified endotracheal tube for intubation using video laryngoscopy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Objective Structured Clinical Examination in Intensive Care Medicine
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

The future of regional anesthesia education: lessons learned from the surgical specialty
Conclusion In this narrative review, we describe the theory behind the evolution of surgical skills training. We also outline how we can apply these learning theories and simulation models to a competency-based curriculum for training in ultrasound-guided regional anesthesia. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Latex sensitization in patients with myelomeningocele undergoing urological procedures: prevalence and associated factors
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research