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jrgAnesthesia

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By Jesse Guscott McMaster Family Practice Anesthesia program director. Medical educator, ER, Anesthesia Twitter:@GuscottJesse
https://www.readbyqxmd.com/read/27609430/2016-focused-update-of-the-canadian-cardiovascular-society-guidelines-for-the-management-of-atrial-fibrillation
#1
Laurent Macle, John Cairns, Kori Leblanc, Teresa Tsang, Allan Skanes, Jafna L Cox, Jeff S Healey, Alan Bell, Louise Pilote, Jason G Andrade, L Brent Mitchell, Clare Atzema, David Gladstone, Mike Sharma, Subodh Verma, Stuart Connolly, Paul Dorian, Ratika Parkash, Mario Talajic, Stanley Nattel, Atul Verma
The Canadian Cardiovascular Society (CCS) Atrial Fibrillation (AF) Guidelines Committee provides periodic reviews of new data to produce focused updates that address clinically important advances in AF management. This 2016 Focused Update deals with: (1) the management of antithrombotic therapy for AF patients in the context of the various clinical presentations of coronary artery disease; (2) real-life data with non-vitamin K antagonist oral anticoagulants; (3) the use of antidotes for the reversal of non-vitamin K antagonist oral anticoagulants; (4) digoxin as a rate control agent; (5) perioperative anticoagulation management; and (6) AF surgical therapy including the prevention and treatment of AF after cardiac surgery...
October 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27820738/an-update-on-pain-management-for-elderly-patients-undergoing-ambulatory-surgery
#2
Xuezhao Cao, Ofelia L Elvir-Lazo, Paul F White, Roya Yumul, Jun Tang
PURPOSE OF REVIEW: The aim of this review is to provide an overview of the drugs and techniques used for multimodal postoperative pain management in the older population undergoing surgery in the ambulatory setting. RECENT FINDINGS: Interest has grown in the possibility of adding adjuncts to a single shot nerve block in order to prolong the local anesthetic effect. The rapid and short-acting local anesthetics for spinal anesthesia are potentially beneficial for day-case surgery in the older population because of shorter duration of the motor block, faster recovery, and less transient neurologic symptoms...
December 2016: Current Opinion in Anaesthesiology
https://www.readbyqxmd.com/read/28067707/dural-puncture-epidural-technique-improves-labor-analgesia-quality-with-fewer-side-effects-compared-with-epidural-and-combined-spinal-epidural-techniques-a-randomized-clinical-trial
#3
Anthony Chau, Carolina Bibbo, Chuan-Chin Huang, Kelly G Elterman, Eric C Cappiello, Julian N Robinson, Lawrence C Tsen
BACKGROUND: The dural puncture epidural (DPE) technique is a modification of the combined spinal epidural (CSE) technique, where a dural perforation is created from a spinal needle but intrathecal medication administration is withheld. The DPE technique has been shown to improve caudal spread of analgesia compared with epidural (EPL) technique without the side effects observed with the CSE technique. We hypothesized that the onset of labor analgesia would follow this order: CSE > DPE > EPL techniques...
February 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/19860753/risk-of-pulmonary-aspiration-with-laryngeal-mask-airway-and-tracheal-tube-analysis-on-65-712-procedures-with-positive-pressure-ventilation
#4
COMPARATIVE STUDY
A Bernardini, G Natalini
We compared the risk of pulmonary aspiration in patients whose lungs were mechanically ventilated through a laryngeal mask airway (35 630 procedures) or tracheal tube (30 082 procedures). Three cases of pulmonary aspiration occurred with the laryngeal mask airway and seven with the tracheal tube. There were no deaths related to pulmonary aspiration. The incidence and outcome of pulmonary aspiration detected in this study were similar to those previously reported. The adjusted odds ratio (OR) for pulmonary aspiration with the laryngeal mask airway was 1...
December 2009: Anaesthesia
https://www.readbyqxmd.com/read/27496655/-to-reverse-or-not-to-reverse-the-answer-is-clear
#5
Glenn S Murphy, Aaron F Kopman
No abstract text is available yet for this article.
October 2016: Anesthesiology
https://www.readbyqxmd.com/read/27443376/hypertensive-disorders-of-pregnancy
#6
Ana Sjaus, Dolores M McKeen, Ronald B George
PURPOSE: In this continuing professional development module, we review recent Society of Obstetricians and Gynaecologists of Canada (SOGC) guidelines for the classification and diagnosis of hypertensive disorders of pregnancy (HDP) as well as review the clinical features, laboratory investigations, and outcomes of HDP. We explore the evidence for anesthetic management and prevention of end-organ damage in women with HDP and describe the role and contribution of anesthesiologists as part of a multidisciplinary care team...
September 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/27442772/society-of-anesthesia-and-sleep-medicine-guidelines-on-preoperative-screening-and-assessment-of-adult-patients-with-obstructive-sleep-apnea
#7
Frances Chung, Stavros G Memtsoudis, Satya Krishna Ramachandran, Mahesh Nagappa, Mathias Opperer, Crispiana Cozowicz, Sara Patrawala, David Lam, Anjana Kumar, Girish P Joshi, John Fleetham, Najib Ayas, Nancy Collop, Anthony G Doufas, Matthias Eikermann, Marina Englesakis, Bhargavi Gali, Peter Gay, Adrian V Hernandez, Roop Kaw, Eric J Kezirian, Atul Malhotra, Babak Mokhlesi, Sairam Parthasarathy, Tracey Stierer, Frank Wappler, David R Hillman, Dennis Auckley
The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of adult patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading to indicate the level of evidence upon which recommendations were based...
August 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27258078/society-of-anesthesia-and-sleep-medicine-guideline-on-preoperative-screening-and-assessment-of-patients-with-obstructive-sleep-apnea
#8
Frances Chung, Stavros Memtsoudis, Satya Krishna Ramachandran, Mahesh Nagappa, Mathias Opperer, Crispiana Cozowicz, Sara Patrawala, David Lam, Anjana Kumar, Girish P Joshi, John Fleetham, Najib Ayas, Nancy Collop, Anthony Doufas, Matthias Eikermann, Marina Englesakis, Bhargavi Gali, Peter Gay, Adrian Hernandes, Roop Kaw, Eric Kezirian, Atul Malhotra, Babak Mokhlesi, Sairam Parthasarathy, Tracey Stierer, Frank Wappler, David R Hillman, Dennis Auckley
The purpose of the Society of Anesthesia and Sleep Medicine guideline on preoperative screening and assessment of patients with obstructive sleep apnea (OSA) is to present recommendations based on the available clinical evidence on the topic where possible. As very few well-performed randomized studies in this field of perioperative care are available, most of the recommendations were developed by experts in the field through consensus processes involving utilization of evidence grading to indicate the level of evidence upon which recommendations were based...
June 1, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27167445/restrictive-versus-liberal-transfusion-strategy-in-the-perioperative-and-acute-care-settings-a-context-specific-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#9
Frédérique Hovaguimian, Paul S Myles
BACKGROUND: Blood transfusions are associated with morbidity and mortality. However, restrictive thresholds could harm patients less able to tolerate anemia. Using a context-specific approach (according to patient characteristics and clinical settings), the authors conducted a systematic review to quantify the effects of transfusion strategies. METHODS: The authors searched MEDLINE, EMBASE, CENTRAL, and grey literature sources to November 2015 for randomized controlled trials comparing restrictive versus liberal transfusion strategies applied more than 24 h in adult surgical or critically ill patients...
July 2016: Anesthesiology
https://www.readbyqxmd.com/read/27149883/deficiencies-in-locating-the-cricothyroid-membrane-by-palpation-we-can-t-and-the-surgeons-can-t-so-what-now-for-the-emergency-surgical-airway
#10
EDITORIAL
J Adam Law
No abstract text is available yet for this article.
July 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/24096762/impact-of-epidural-analgesia-on-mortality-and-morbidity-after-surgery-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
REVIEW
Daniel M Pöpping, Nadia Elia, Hugo K Van Aken, Emmanuel Marret, Stephan A Schug, Peter Kranke, Manuel Wenk, Martin R Tramèr
OBJECTIVE: To quantify benefit and harm of epidural analgesia, compared with systemic opioid analgesia, in adults having surgery under general anesthesia. BACKGROUND: It remains controversial whether adding epidural analgesia to general anesthesia decreases postoperative morbidity and mortality. METHODS: We searched CENTRAL, EMBASE, PubMed, CINAHL, and BIOSIS till July 2012. We included randomized controlled trials comparing epidural analgesia (with local anesthetics, lasting for ≥ 24 hours postoperatively) with systemic analgesia in adults having surgery under general anesthesia, and reporting on mortality or any morbidity endpoint...
June 2014: Annals of Surgery
https://www.readbyqxmd.com/read/27139292/methemoglobinemia-secondary-to-topical-benzocaine-application-to-gastrostomy-site
#12
Matthew Lipton, Sarah M Szlam, Kim Barker, John G Benitez
Benzocaine is a common topical anesthetic that has the ability to induce methemoglobinemia (MetHgb) in large doses. We describe a 4-year-old girl who received a standard dose of topical benzocaine to her gastrostomy mucosa that resulted in rapid, severe MetHgb. She required intubation, mechanical ventilation, and multiple doses of methylene blue for treatment. The resultant tissue hypoxia from MetHgb caused profound confusion, cyanosis, and myocardial infarction. Although the patient did not sustain any permanent disability, this case demonstrates the need for emergency providers to rapidly identify and treat MetHgb to reverse tissue hypoxia and prevent long-term sequelae...
May 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27093675/postoperative-acute-kidney-injury-risk-factors-and-possible-interventions
#13
Jonathan P Wanderer, James P Rathmell
No abstract text is available yet for this article.
May 2016: Anesthesiology
https://www.readbyqxmd.com/read/27090535/a-deliberately-restricted-laryngeal-view-with-the-glidescope%C3%A2-video-laryngoscope-is-associated-with-faster-and-easier-tracheal-intubation-when-compared-with-a-full-glottic-view-a-randomized-clinical-trial
#14
Yuqi Gu, Joshua Robert, George Kovacs, Andrew D Milne, Ian Morris, Orlando Hung, Kirk MacQuarrie, Sean Mackinnon, J Adam Law
INTRODUCTION: During video laryngoscopy (VL) with angulated or hyper-curved blades, it is sometimes difficult to complete tracheal intubation despite a full view of the larynx. When using indirect VL, it has been suggested that it may be preferable to obtain a deliberately restricted view of the larynx to facilitate passage of the endotracheal tube. We used the GlideScope® GVL video laryngoscope (GVL) to test whether deliberately obtaining a restricted view would result in faster and easier tracheal intubation than with a full view of the larynx...
August 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26968337/post-anaesthetic-emergence-delirium-in-adults-incidence-predictors-and-consequences
#15
L Munk, G Andersen, A M Møller
BACKGROUND: Emergence delirium (ED) after general anaesthesia (GA) is a well-known phenomenon, yet the risk factors are still unclear. The aims of this study were to determine the incidence and independent predictors of ED and secondly to determine to which degree ED has any relevant, clinical consequences to medical staff as well as to patients. METHOD: This prospective, observational cohort study assessed adult patients emerging from GA in the operating room, using the Richmond Agitation-Sedation Scale (RASS)...
September 2016: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/26809929/ketamine-propofol-combination-ketofol-vs-propofol-for-procedural-sedation-and-analgesia-systematic-review-and-meta-analysis
#16
REVIEW
Mohammad Jalili, Maryam Bahreini, Amin Doosti-Irani, Rasoul Masoomi, Mona Arbab, Hadi Mirfazaelian
OBJECTIVE: This meta-analysis of trials was conducted to evaluate the analgesic and side effects of ketamine-propofol combination (ketofol) in comparison to propofol in procedural sedation and analgesia (PSA). METHODS: Medline, EMBASE, Scopus, CINHAL, and Cochrane Central Register of Controlled Trials were searched for clinical trial. The administration complications were the key outcomes of interest. RESULT: Eighteen clinical trials that met our criteria were included in the analysis...
March 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26771910/inferior-vena-cava-ultrasonography-before-general-anesthesia-can-predict-hypotension-after-induction
#17
Jie Zhang, Lester Augustus Hall Critchley
BACKGROUND: Hypotension is a common side effect of general anesthesia induction, and when severe, it is related to adverse outcomes. Ultrasonography of inferior vena cava (IVC) is a reliable indicator of intravascular volume status. This study investigated whether preoperative ultrasound IVC measurements could predict hypotension after induction of anesthesia. METHODS: One hundred four adult patients, conforming to American Society of Anesthesiologists physical status I to III, scheduled for elective surgery after general anesthesia were recruited...
March 2016: Anesthesiology
https://www.readbyqxmd.com/read/26481938/perioperative-management-of-patients-with-obstructive-sleep-apnea-a-survey-of-canadian-anesthesiologists
#18
Ligia Cordovani, Frances Chung, Geneviève Germain, Kim Turner, Alexis F Turgeon, Richard Hall, Peter C Gay, Gregory L Bryson, Peter T Choi
INTRODUCTION: Obstructive sleep apnea (OSA) may increase the incidence of postoperative complications when undiagnosed. The purpose of this study was to evaluate the perspectives of Canadian anesthesiologists regarding the perioperative management of patients with diagnosed or suspected OSA. METHODS: This study was conducted as a survey of Canadian anesthesiologists using a self-administered scenario-based questionnaire. We initially mailed the survey questionnaire and then mailed it again to non-respondents six weeks later...
January 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26481939/mismanagement-of-obstructive-sleep-apnea-may-result-in-finding-these-patients-dead-in-bed
#19
EDITORIAL
Jonathan L Benumof
No abstract text is available yet for this article.
January 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/26497721/can-anesthetic-analgesic-technique-during-primary-cancer-surgery-affect-recurrence-or-metastasis
#20
REVIEW
Kathryn Byrne, Kirk J Levins, Donal J Buggy
PURPOSE: Mortality among cancer patients is more commonly due to the effects of metastasis and recurrence as opposed to the primary tumour. Various perioperative factors have been implicated in tumour growth, including anesthetic agents and analgesia techniques. In this narrative review, we integrate this information to present a summary of the best available evidence to guide the conduct of anesthesia for primary cancer surgery. SOURCE: We conducted a search of the PubMed database up to May 31, 2015 to identify relevant literature using the search terms "anesthesia and metastases", "anesthetic drugs and cancer", "volatile anesthetic agents and cancer", and "anesthetic technique and cancer"...
February 2016: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
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