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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

Low oxygen content in medical air outlets mounted on movable ceiling pendants
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Anesthetic management for Cesarean delivery in parturients with a diagnosis of dwarfism
Abstract Purpose The literature on the anesthetic management of parturients with dwarfism is sparse and limited to isolated case reports. Pregnancy complications associated with dwarfism include an increased risk of respiratory compromise, an increased risk of Cesarean delivery, and an unpredictable degree of anesthesia with neuraxial techniques. Therefore, we conducted this retrospective review to evaluate the anesthetic management of parturients with a diagnosis of dwarfism. Methods We used a query of billing data to identify short statured wome...
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Emergency airway management: What are the roles for surgical cricothyroidotomy and the Ventrain ® device?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Echocardiographic guidance for MitraClip implantation
(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

A technique for advancing an endotracheal tube over a stylet during intubation when an assistant is not available
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Spinal prilocaine for same-day surgery: the importance of equipotent doses
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - July 8, 2016 Category: Anesthesiology Source Type: research

Curriculum reform for residency training: competence, change, and opportunities for leadership
Conclusion Canadian anesthesia residency programs will soon transition to CBME in order to promote better transparency, accountability, fairness, fiscal responsibility, and patient safety. Competency-based medical education offers significant potential advantages for healthcare stakeholders. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Dosing and efficacy of intranasal dexmedetomidine sedation for pediatric transthoracic echocardiography: a retrospective study
Conclusion We found that aerosolized intranasal dexmedetomidine offers satisfactory conditions for TTE in children three months to three years of age with an optimal dose of 2.5-3.0 µg·kg−1administered under the supervision of a pediatric cardiac anesthesiologist. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

A qualitative study exploring mentorship in anesthesiology: perspectives from both sides of the relationship
Conclusion We identified three key factors that facilitate or hinder mentorship relationships and proposed solutions for designing effective mentorship programs for postgraduate training programs. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Safety and comparative costs of preoperative assessments for cataract surgery: traditional mandatory assessment versus a novel graded assessment system
Conclusion The graded system resulted in no major complications and a low rate of minor complications. The information obtained from the mandatory assessment is unlikely to prevent complications. Additionally, the cost effectiveness of the mandatory system was poor. This novel graded preoperative assessment system for cataract surgery patients can save time and resources by eliminating unnecessary patient visits. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Intracuff 160 mg alkalinized lidocaine reduces cough upon emergence from N 2 O-free general anesthesia: a randomized controlled trial
This study evaluates the benefits of endotracheal tube (ETT) intracuff alkalinized lidocaine during N2O-free general anesthesia by 1) assessing the in vitro effect of alkalinization on lidocaine diffusion kinetics across the cuff’s membrane and 2) evaluating, in a randomized controlled clinical trial, the impact of 160 mg of intracuff alkalinized lidocaine on cough upon emergence from anesthesia for surgery lasting> 120 min. Methods In the in vitro study, diffusion kinetics of various intracuff alkalinized lidocaine amounts (40, 80, and 160 mg) were compared to their non...
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Competency-based medical education: Its time has arrived
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Embolie amniotique compliquant une interruption médicale de la grossesse
Conclusion L’embolie amniotique est un diagnostique rare et difficile surtout lors de situations inhabituelles mais qui peut être facilité par la recherche sérique de marqueurs amniotiques et de la tryptase. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Performing post-tetanic count during rocuronium blockade has limited impact on subsequent twitch height or train-of-four responses
Conclusion A small but clinically insignificant increase in T1 is seen for at least ten minutes after PTC without any detectable change in T4/T1 values. The TOF responses are reliable as early as one minute after PTC. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Lung Ultrasound in the Critically Ill – The BLUE Protocol
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Methylene blue-induced serotonin syndrome presenting with ocular clonus and failure of emergence from general anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research