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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

The C-MAC ® D-BLADE™: use of the guide rail as a guiding channel for a gum elastic bougie
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Strategies for lung isolation: to block or not to block?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Lack of data on standardized metrics for surgical care in a developing country with middle total expenditure on health
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Novel maneuvers to increase the internal jugular vein diameter during ultrasound-guided cannulation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

In Reply: Fellowships and subspecialization in anesthesia: Are they good, bad, or both?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

The “William Tell” sign: difficult airway resulting from cranial transfixion by an arrow
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

In reply: Neuromuscular monitoring should be required when neuromuscular blocking drugs are used: Is it time to change the Canadian guidelines?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Fellowships and subspecialization in anesthesia: Are they good, bad, or both?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Neuromuscular monitoring should be required when neuromuscular blocking drugs are used: Is it time to change the Canadian guidelines?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - June 8, 2016 Category: Anesthesiology Source Type: research

Postoperative awake paralysis in the intensive care unit after cardiac surgery due to residual neuromuscular blockade: a case report and prospective observational study
Conclusion Postoperative residual paralysis after fast-track cardiac surgery was common in our institution and likely contributed to the reported case of postoperative awake paralysis. We suggest that an NMB not be administered after intubation in fast-track patients. If given, however, it must be well communicated to the ICU team upon ICU admission. We further recommend routine assessment of neuromuscular function before sedation is weaned prior to extubation. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Managing critically ill patients with severe traumatic brain injury: How should we season the recipe?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

A randomized clinical trial of prone position extubation to reduce the severity of coughing in patients undergoing dorsolumbar spine surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

The relationship between study findings and publication outcome in anesthesia research: a retrospective observational study examining publication bias
Abstract Purpose Many areas of medicine have shown bias towards the publication of studies with positive results. To estimate publication bias in the anesthesia literature, we reviewed all abstracts presented at the American Society of Anesthesiologists (ASA) annual meetings over a four-year period and compared study results (positive vs negative) with publication outcomes. Methods This review included all abstracts from the 2001-2004 ASA annual meetings performed as randomized-controlled trials in humans. We scored their outcome results as positi...
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Stress ulcer prophylaxis in critical illness: a Canadian survey
Conclusions Stress ulcer prophylaxis is reportedly used primarily for the duration of mechanical ventilation. The CCCTG physicians believe that a placebo-controlled RCT is needed to evaluate the effectiveness and safety of contemporary SUP with PPIs. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Pre-procedural ultrasonography and marking for neuraxial anesthesia: an observational study
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Thinking globally, training locally
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Intraperitoneal ketorolac for post-cholecystectomy pain: a double-blind randomized-controlled trial
Conclusion This study did not demonstrate any advantage for the off-label topical intraperitoneal administration of ketorolac in this surgical population. Intraperitoneal and IV ketorolac showed comparable analgesic efficacy following laparoscopic cholecystectomy. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Monitoring recovery from rocuronium-induced neuromuscular block using acceleromyography at the trapezius versus the adductor pollicis muscle: an observational trial
Conclusions We conclude that recording evoked acceleromyographic responses at the trapezius muscle is an acceptable alternative when monitoring from the adductor pollicis muscle is compromised. Nevertheless, we caution that recording a 90% TOF response at the trapezius muscle may overestimate functional recovery from the neuromuscular blockade. This trial was registered at ClinicalTrials.gov identifier, NCT01849198. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Publication bias in the anesthesiology literature: shifting the focus from the “positive” to the “truth”
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Anesthetic management of the first pediatric bilateral hand transplant
Conclusion This report describes the anesthetic management of the first pediatric bilateral hand transplant. This procedure required considerable preoperative planning and communication between various teams to ensure all resources needed to deliver the care for this complex and novel transplant surgery were readily available. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Reply to book review of Neonatal Anesthesia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Erratum to: Potential strategies for preventing chronic postoperative pain: a practical approach: Continuing Professional Development
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

A modified device for removing large regurgitation volume during tracheal intubation
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 7, 2016 Category: Anesthesiology Source Type: research

Early recovery of tricuspid annular isovolumic acceleration after mitral valve surgery – an observational study
Conclusion Persistent, significant depression of longitudinal markers of RV function despite functional improvement (discharge from hospital) make it difficult to assess recovery during the early perioperative period. Isovolumic acceleration, a load-independent measure of contractility, might be a more reliable measure of early recovery in RV function in this patient population. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 4, 2016 Category: Anesthesiology Source Type: research

Deficiencies in locating the cricothyroid membrane by palpation: We can’t and the surgeons can’t, so what now for the emergency surgical airway?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 4, 2016 Category: Anesthesiology Source Type: research

Breath alcohol of anesthesiologists using alcohol hand gel and the “five moments for hand hygiene” in routine practice
Conclusion Anesthesia practitioners using alcohol hand gel in a manner that conforms with recommended hand hygiene can test positive for alcohol on a breathalyzer assay. Positive tests probably arose from inhalation of alcohol vapour into the respiratory dead space following gel application. If workplace breath testing for alcohol is implemented, it should be completed more than 15 min after applying alcohol hand gel. Positive results should be verified with a BAC test. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 2, 2016 Category: Anesthesiology Source Type: research

Our love-hate relationship with succinylcholine: Is sugammadex any better?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - May 2, 2016 Category: Anesthesiology Source Type: research

Bronchial blocker versus left double-lumen endotracheal tube in video-assisted thoracoscopic surgery: a randomized-controlled trial examining time and quality of lung deflation
Abstract Introduction Double-lumen endotracheal tubes (DL-ETT) and bronchial blockers (BB) have both been used for lung isolation in video-assisted thoracic surgery (VATS). Though not well studied, it is widely thought that a DL-ETT provides faster and better quality lung collapse. The aim of this study was to compare a BB technique vs a left-sided DL-ETT strategy with regard to the time and quality of lung collapse during one-lung ventilation (OLV) for elective VATS. Methods Forty patients requiring OLV for VATS were randomized to receive a BB (n = 20) ...
Source: Canadian Journal of Anesthesia - May 1, 2016 Category: Anesthesiology Source Type: research

Alpha-stat, beach chair, cerebral autoregulation… But who is at risk?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 4, 2016 Category: Anesthesiology Source Type: research

Narrowing the blockade field: development of an optimal postoperative analgesia regimen for total knee arthroplasty
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - April 4, 2016 Category: Anesthesiology Source Type: research

Perioperative complications in adults with a posterior mediastinal mass: a retrospective observational cohort study
Abstract Background We studied the incidence of perioperative complications in patients presenting with a posterior mediastinal mass and the possible predictors of complications in these patients. Methods We conducted a review of the perioperative records of patients aged over 18 years with a posterior mediastinal mass confirmed by computed tomography (CT) who were admitted for surgical procedures relating to the mass during 2004-2014. Perioperative complications were defined as 1) hypoxemia (pulse oximetry 40 cm H2O or respiratory acidosis with P...
Source: Canadian Journal of Anesthesia - March 4, 2016 Category: Anesthesiology Source Type: research

Bonfils intubation in parallel with a supraglottic air-Q® intubating laryngeal airway
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 4, 2016 Category: Anesthesiology Source Type: research

Cathéters sciatiques: une alternative analgésique chez les patients diabétiques
Conclusion L’utilisation de cathéters périnerveux sciatique, comme technique analgésique alternative au sein d’un milieu extra chirurgical, chez des patients diabétiques douloureux chroniques, a été possible et efficace. (Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - March 4, 2016 Category: Anesthesiology Source Type: research