Canadian Journal of Anesthesia-Journal Canadien D Anesthesie最新文献_第3页

Assessment of residual gastric volume by ultrasound prior to upper endoscopy: a prospective cohort study. 上胃镜检查前超声评估残胃容量：一项前瞻性队列研究。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-16 DOI: 10.1007/s12630-024-02885-0

Emanuella F A Pinto, Mariana L S Bastos, Cassiana G Prates, Guilherme B Sander, Daniela B Bumaguin, Airton Bagatini

{"title":"Assessment of residual gastric volume by ultrasound prior to upper endoscopy: a prospective cohort study.","authors":"Emanuella F A Pinto, Mariana L S Bastos, Cassiana G Prates, Guilherme B Sander, Daniela B Bumaguin, Airton Bagatini","doi":"10.1007/s12630-024-02885-0","DOIUrl":"https://doi.org/10.1007/s12630-024-02885-0","url":null,"abstract":"Purpose: Pulmonary aspiration is an adverse event with high morbidity and mortality. Despite fasting for > 8 hr, some patients still have residual gastric volume and are thus at risk of aspiration. We aimed to determine the accuracy of gastric ultrasound in assessing residual gastric content in patients undergoing upper gastrointestinal endoscopy.Methods: In a prospective cohort study, we performed gastric ultrasound immediately before upper gastrointestinal endoscopy in a sample of 294 patients. We categorized the ultrasound results as high risk of aspiration when the fluid volume was > 1.5 mL·kg-1 or when there was thick/solid content. We applied Spearman's test to determine the correlation between aspirated volume and ultrasound-estimated volume using three mathematical models. We assessed the method's accuracy by calculating its sensitivity and specificity.Results: We included 282 patients in the analysis. The incidence of residual gastric contents was 5%. There were no aspiration events. Prokinetic use (relative risk [RR], 7.5; 95% confidence interval [CI], 1.9 to 29.1; P < 0.01), previous stroke (RR, 4.0; 95% CI, 1.2 to 13.6; P = 0.02), and male sex (RR, 3.3; 95% CI, 1.2 to 9.4; P = 0.02) were significantly more frequent among those with residual gastric content. The ultrasonography's specificity and sensitivity to predict gastric content at risk of aspiration were 100% and 77%, respectively, with a positive predictive value of 100% and a negative predictive value of 99%.Conclusion: Ultrasonography was an effective way to assess residual gastric content, which can help improve patient safety.","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ambulatory pediatric adenotonsillectomy. 门诊小儿腺样体切除术。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-16 DOI: 10.1007/s12630-024-02872-5

Calvin Lo, Kimmo Murto

{"title":"Ambulatory pediatric adenotonsillectomy.","authors":"Calvin Lo, Kimmo Murto","doi":"10.1007/s12630-024-02872-5","DOIUrl":"https://doi.org/10.1007/s12630-024-02872-5","url":null,"abstract":"Purpose: This Continuing Professional Development module aims to help the general anesthesiologist recognize common pitfalls in ambulatory pediatric adenotonsillectomy and perform appropriate risk stratification, analgesic management, and disposition planning.Principal findings: Pediatric adenotonsillectomy is a widely performed procedure. An updated approach to preoperative risk assessment of commonly associated comorbidities allows the practitioner to anticipate and plan for adverse events. Risks include obstructive sleep apnea, airway hyperresponsiveness, asthma, recent upper respiratory tract infections, obesity, and young age. Risk-modifying interventions consist of delaying surgery, preoperative bronchodilator therapy, recognizing the limitations of volatile agents, and referral of high-risk patients to specialized pediatric centres. Appropriate selection of intraoperative and postoperative analgesia can optimize patient comfort, avoid readmission, and limit adverse events such as postoperative hemorrhage or respiratory depression.Conclusions: Ambulatory pediatric adenotonsillectomy is a common surgical procedure, performed both in the community as well as tertiary care pediatric centres. To optimize outcomes in this heterogenous patient population, anesthesiologists must risk stratify and anticipate perioperative respiratory adverse events.","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Intraoperative diaphragmatic stimulation by a cardiac resynchronization therapy defibrillator presenting as hiccups. 心脏再同步治疗除颤器的术中横膈膜刺激表现为打嗝。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-12 DOI: 10.1007/s12630-024-02880-5

Hüseyin Aybar

引用次数: 0

The anesthetic and recovery profiles of low-dose hypobaric mepivacaine and bupivacaine for spinal anesthesia in total hip and knee arthroplasty: a prospective observational study. 低剂量低压甲哌卡因和布比卡因用于全髋关节和膝关节置换术脊柱麻醉的麻醉和恢复概况：一项前瞻性观察研究。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-10 DOI: 10.1007/s12630-024-02887-y

Joanne M H Tan, Wendy Wang, Takayuki Yoshida, Sara Abdullah, Jayanta Chowdhury, Ki Jinn Chin

{"title":"The anesthetic and recovery profiles of low-dose hypobaric mepivacaine and bupivacaine for spinal anesthesia in total hip and knee arthroplasty: a prospective observational study.","authors":"Joanne M H Tan, Wendy Wang, Takayuki Yoshida, Sara Abdullah, Jayanta Chowdhury, Ki Jinn Chin","doi":"10.1007/s12630-024-02887-y","DOIUrl":"https://doi.org/10.1007/s12630-024-02887-y","url":null,"abstract":"Purpose: Same-day mobilization and early hospital discharge is increasingly emphasized following hip and knee arthroplasty. One challenge of spinal anesthesia in this setting is achieving adequate block height while avoiding excessively large local anesthetic doses and prolonged motor and sensory blockade. Using a hypobaric local anesthetic solution is one potential strategy, as its intrathecal distribution can be reliably manipulated by patient positioning to achieve adequate block height independent of dose.Methods: We conducted a prospective observational study to determine the clinical characteristics of spinal anesthesia with low-dose hypobaric mepivacaine and bupivacaine in patients undergoing hip and knee arthroplasty. Thirty patients scheduled for same-day discharge received 51 mg of hypobaric 1.5% mepivacaine and 30 patients scheduled for inpatient stay received 10 mg of hypobaric 0.33% bupivacaine.Results: The mean (standard deviation) time to achieve sensory blockade at or above L1 and T10 in the operative limb was 5.7 (1.8) and 7.3 (3.3) min with mepivacaine and 6.2 (2.6) and 8.1 (4.8) min with bupivacaine, respectively. Anesthesia was adequate for surgical commencement in all patients regardless of spinal injection level. Four patients required anesthetic supplementation for surgical completion. Sensory block duration at or above T10 and L1 in the operative limb was 97 (27) and 115 (37) min with mepivacaine and 127 (32) and 161 (34) min with bupivacaine, respectively. Motor function returned by 145 (37) and 217 (43) min in mepivacaine and bupivacaine groups, respectively.Conclusion: The anesthetic profiles of low-dose hypobaric mepivacaine and bupivacaine were favorable for fast-track hip and knee arthroplasty with short and predictable operating times.","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142803475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Guest Reviewers. 客人的评论家。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-02 DOI: 10.1007/s12630-024-02892-1

引用次数: 0

Simulation-based medical education in Canadian anesthesiology academic institutions: a national survey. 加拿大麻醉学术机构的模拟医学教育：全国调查。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-01 Epub Date: 2024-03-07 DOI: 10.1007/s12630-024-02720-6

Yuqi Gu, Marshall Tenenbein, Linda Korz, Jason W Busse, Michelle Chiu

{"title":"Simulation-based medical education in Canadian anesthesiology academic institutions: a national survey.","authors":"Yuqi Gu, Marshall Tenenbein, Linda Korz, Jason W Busse, Michelle Chiu","doi":"10.1007/s12630-024-02720-6","DOIUrl":"10.1007/s12630-024-02720-6","url":null,"abstract":"Purpose: Simulation-based medical education (SBME) is provided by all anesthesiology residency programs in Canada. The purpose of this study was to characterize SBME in Canadian anesthesiology residency training programs.Methods: We administered a 21-question survey to the simulation director/coordinator for all 17 Canadian academic departments of anesthesiology from October 2019 to January 2020. The survey consisted of questions pertaining to the characteristics of the simulation centres, their faculty, learners, curriculum, and assessment processes.Results: All 17 residency training programs participated in the survey and reported large variability in the number and formal training of simulation faculty and in content delivery. Five programs (29%) did not provide faculty recognition for curriculum design and running simulation sessions. Most programs offered one to four simulation sessions per academic year for each year of residency. All programs offered mannequin-based and part-task trainers for teaching technical and nontechnical skills. Fourteen programs (82%) offered interprofessional and interdisciplinary simulation sessions, and ten programs (59%) did not include in situ simulation training. Commonly reported barriers to faculty involvement were lack of protected time (12 programs, 71%), lack of financial compensation (ten programs, 59%), and lack of appreciation for SBME (seven programs, 41%).Conclusion: Large variability exists in the delivery of SBME in Canadian anesthesiology residency simulation programs, in part because of differences in financial/human resources and educational content. Future studies should explore whether training and patient outcomes differ between SBME programs and, if so, whether additional standardization is warranted.","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"1725-1734"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

David Richard Bevan, MA, MB, BChir (Cantab) with Distinction, MRCP (London), FRCA, RCPSC, FRCPC. 大卫-理查德-贝文（David Richard Bevan），硕士、医学博士、荣誉学士（坎塔布）、MRCP（伦敦）、FRCA、RCPSC、FRCPC。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-01 Epub Date: 2024-06-28 DOI: 10.1007/s12630-024-02796-0

Robert Byrick, Beverley A Orser

引用次数: 0

Professional fulfillment, burnout, and wellness: a repeated cross-sectional survey in the COVID-19 pandemic era. 职业成就感、职业倦怠和健康：COVID-19 大流行时代的重复横断面调查。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-01 Epub Date: 2024-07-16 DOI: 10.1007/s12630-024-02807-0

Mary Ellen Walker, Rashid Mehmood, Justina Koshinsky, Peter Hedlin, Anita Chakravarti, Una Goncin, Darcie Earle, Jennifer M O'Brien

引用次数: 0

Reality check-an urgent call for innovation in Canadian anesthesia care delivery. 现实检查--加拿大麻醉护理服务创新的紧急呼吁。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-01 Epub Date: 2024-11-25 DOI: 10.1007/s12630-024-02875-2

Sylvie Aucoin, Mateen Raazi

引用次数: 0

The anesthesia human resources crisis in Canada. 加拿大麻醉人力资源危机。

IF 3.4 3区医学

Canadian Journal of Anesthesia-Journal Canadien D Anesthesie Pub Date : 2024-12-01 Epub Date: 2024-11-25 DOI: 10.1007/s12630-024-02869-0

Sarah A Leir, Tyler J Law, M Dylan Bould

{"title":"The anesthesia human resources crisis in Canada.","authors":"Sarah A Leir, Tyler J Law, M Dylan Bould","doi":"10.1007/s12630-024-02869-0","DOIUrl":"10.1007/s12630-024-02869-0","url":null,"abstract":"Human resources are essential to the safe and effective functioning of any health care system. Pressure on the health care workforce is of active global concern. There appears to be an anesthesia service delivery crisis in Canada. Recent media headlines have featured vacant physician anesthesiologist positions, closure of maternity units, and postponement of elective surgeries because of a shortage of anesthesiologists. This shortage is most serious in rural and remote communities. This has prompted the Canadian Anesthesiologists' Society to publish a position statement on \"Strategies to Address the Surgical Backlog and Health Human Resource Issues in Anesthesia.\"In this article, we discuss the composition and organization of the anesthesia workforce in Canada. We compare the Canadian anesthesia workforce to other Organisation for Economic Co-operation and Development countries. We contend that the current anesthesia provision model in Canada is not meeting population needs and outline potential solutions to the anesthesia human resources crisis. These include increasing the numbers of anesthesiologists in training, encouraging international medical graduates to migrate to Canada, and various different approaches to task shifting and task sharing.","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"1612-1626"},"PeriodicalIF":3.4,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142717951","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0