The biology of addiction
AbstractIn this narrative review, the neurobiological mechanisms underlying substance abuse and addiction are discussed with a particular emphasis on the mechanisms that promote ongoing use and relapse. Addiction is estimated to affect 10-15% or more of the adult population, including physicians. Genetic predisposition, psychological and environmental risk factors, the timing of exposure to the substance, the type of substance used, and the frequency of use influence the individual ’s susceptibility to addiction. Abused substances act on the brain’s reward system, a neural circuit that produces pleasurable feel...
Source: Canadian Journal of Anesthesia - November 10, 2016 Category: Anesthesiology Source Type: research

Thermal softening of polyvinyl chloride nasotracheal tubes: effect of temperature on tube navigability
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 6, 2016 Category: Anesthesiology Source Type: research

Leukocyte larceny: a cause of pseudohypoxemia
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 5, 2016 Category: Anesthesiology Source Type: research

Multifidus cervicis plane block is effective for cervical spine surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 2, 2016 Category: Anesthesiology Source Type: research

Life-threatening lingual artery hemorrhage after cardiac surgery
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - November 1, 2016 Category: Anesthesiology Source Type: research

Button battery ingestion in children: a role for angiography?
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 31, 2016 Category: Anesthesiology Source Type: research

Rupture of an infected radial artery false aneurysm
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 31, 2016 Category: Anesthesiology Source Type: research

Emergency ventilation with the Ventrain ® through an airway exchange catheter in a porcine model of complete upper airway obstruction
AbstractPurposeDuring difficult airway management, oxygen insufflation through airway-exchange and intubating catheters (AEC/IC) can lead to life-threatening hyperinflation. Ventrain® was originally designed to facilitate emergency ventilation using active expiration through short, small-bore cannulas. Herein, we studied its efficacy (oxygenation and ventilation) and safety (avoidance of hyperinflation) in a long, small-bore AEC.MethodsIn six anesthetized pigs, the upper airway was obstructed, except for a 100 cm long, 3 mm internal diameter AEC. After apneic desaturation to a peripheral oxygen saturation (SpO2) of
Source: Canadian Journal of Anesthesia - October 27, 2016 Category: Anesthesiology Source Type: research

Point of care diaphragmatic ultrasonography made easy
(Source: Canadian Journal of Anesthesia)
Source: Canadian Journal of Anesthesia - October 27, 2016 Category: Anesthesiology Source Type: research

Erratum to: 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 - October 26, 2016 Category: Anesthesiology Source Type: research

Using physiological monitoring data for performance feedback: an initiative using thermoregulation metrics
AbstractBackgroundFeedback of performance data can improve professional practice and outcomes. Vital signs are not routinely used for quality improvement because of their limited access. Intraoperative hypothermia has been associated with deleterious effects, including surgical site infections and bleeding. We speculated that providing feedback could help keep temperature monitoring and management a priority in the anesthesiologist ’s mind, thereby improving perioperative temperature management. We hypothesized that feedback on thermoregulation metrics, without changes in policy, could reduce temperature-monitoring d...
Source: Canadian Journal of Anesthesia - October 25, 2016 Category: Anesthesiology Source Type: research

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