Canadian Journal of Anesthesia-Journal Canadien D Anesthesie最新文献

{"title":"Use of opioids and opioid alternatives during general anesthesia: a pan-Canadian survey among anesthesiologists.","authors":"Michael Verret, Manoj M Lalu, Alexandre Assi, Stuart G Nicholls, Alexis F Turgeon, Francois M Carrier, Daniel I McIsaac, Ian Gilron, Fiona Zikovic, Megan Graham, Maxime Lê, Allison Geist, Guillaume Martel, Jason A McVicar, Husein Moloo, Dean Fergusson","doi":"10.1007/s12630-024-02847-6","DOIUrl":"10.1007/s12630-024-02847-6","url":null,"abstract":"<p><strong>Purpose: </strong>While there is limited patient-centred evidence (i.e., evidence that is important for patients and end-users) to inform the use of pharmacologic opioid minimization strategies (i.e., the use of opioid alternatives) for adult surgical patients requiring general anesthesia, such strategies are increasingly being adopted into practice. Our objectives were to describe anesthesiologists' beliefs regarding intraoperative opioid minimizing strategies use and utility, and to explore important clinical decision-making factors.</p><p><strong>Methods: </strong>We conducted a pan-Canadian web-based survey of anesthesiologists that was distributed using a modified Dillman technique. Our multidisciplinary team, including a patient partners panel, participated in the process of domains and items generation, items reduction, formatting, and composition. Our sampling frames were members of the Canadian Anesthesiologists' Society and members of the Association des Anesthésiologistes du Québec. We used the newsletters of each organization to distribute our survey, which was available in English and French and housed on the LimeSurvey (LimeSurvey GmbH, Hamburg, Germany) platform.</p><p><strong>Results: </strong>From our eligible sampling frame, 18% completed the survey (356 respondents out of 2,008 eligible participants). Most of the respondents believed that using opioid minimization strategies during general anesthesia could improve postoperative clinical outcomes, including pain control (84% agree or strongly agree, n = 344/409). Reported use of pharmacologic opioid minimization strategies was variable; however, most respondents believed that nonsteroidal anti-inflammatory drugs, acetaminophen, N-methyl-D-aspartate receptor antagonists (ketamine), α₂-adrenoceptor agonists (dexmedetomidine), corticosteroids, and intravenous lidocaine improve prostoperative clinical outcomes. The primary factors guiding decision-making regarding the use of opioid minimization strategies were postoperative acute pain intensity, the impact of acute pain on functioning, patient well-being (i.e., quality of recovery) and patient satisfaction with care. A lack of evidence was the most important barrier limiting the use of opioid minimization strategies.</p><p><strong>Conclusion: </strong>In our survey of Canadian anesthesiologists, several opioid minimization strategies were believed to be effective complements to general anesthesia, although there was substantial variation in their reported use. Future randomized controlled trials and systematic reviews evaluating the effectiveness of opioid minimization strategies should prioritize patient-centred outcome measures assessment such as the quality of recovery or the impact of acute pain on functioning.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513722","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}

{"title":"A survey of Canadian perioperative medicine practices regarding surveillance for myocardial injury after noncardiac surgery.","authors":"Julius Dale-Gandar, Anthony Chau, Su-Yin MacDonell, Alana M Flexman","doi":"10.1007/s12630-024-02850-x","DOIUrl":"https://doi.org/10.1007/s12630-024-02850-x","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142513721","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}

{"title":"Exploration of the optimal programmed intermittent epidural bolus volume with the dural puncture epidural technique for labour analgesia: a biased-coin up-and-down sequential allocation study.","authors":"Yujie Song, Yingcai Song, Zhihao Sheng, Qingsong Zhao, Wei Liu, Yujie Li, Yu Zang, Zhendong Xu, Zhiqiang Liu","doi":"10.1007/s12630-024-02855-6","DOIUrl":"https://doi.org/10.1007/s12630-024-02855-6","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the optimal programmed intermittent epidural bolus (PIEB) volume for providing effective analgesia in 90% of patients (EV₉₀) during the first stage of labour using the dural puncture epidural (DPE) technique to initiate labour analgesia.</p><p><strong>Methods: </strong>We conducted a biased-coin up-and-down sequential allocation study. We included 40 nulliparous women requiring epidural labour analgesia. We used a 25G Whitacre spinal needle to puncture the dural mater and then administered a loading dose of 12 mL of ropivacaine 0.1% and sufentanil 0.3 μg·mL^-1. Subsequently, the PIEB pump delivered boluses with an identical solution at a fixed 40-min interval, starting 1 hr after epidural initiation. The bolus volume for the first patient was 7 mL and was adjusted for subsequent patients according to the study protocol (bolus volume, 7-12 mL). The primary endpoint was effective analgesia, indicated by no need for patient-controlled or manual boluses within 6 hr after analgesia initiation or until complete cervical dilation, whichever came first. Outcome evaluators assessed the patients' pain ratings, Bromage scores, sensory blockade level, and maternal blood pressure hourly.</p><p><strong>Results: </strong>Using the truncated Dixon and Mood method, the estimated EV₉₀ was 9.2 mL (95% confidence interval [CI], 8.5 to 9.9) whereas the isotonic regression method yielded a value of 8.8 mL (95% CI, 8.6 to 9.8). None of the patients experienced a motor block. Two patients experienced hypotension without the need for vasopressors.</p><p><strong>Conclusions: </strong>The estimated PIEB EV₉₀ for ropivacaine 0.1% and sufentanil 0.3 μg·mL^-1 approached 9 mL when DPE was combined with a fixed 40-min interval.</p><p><strong>Study registration: </strong>ChiCTR.org.cn ( ChiCTR2300067281 ); first submitted 3 January 2023.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481872","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}

{"title":"Incidence, outcomes, and risk factors of postlaparoscopic subcutaneous emphysema: a historical cohort study.","authors":"Kazutoshi Onitsuka, Kohei Godai, Shiroh Tanoue, Eri Sakurai, Mayumi Nakahara, Chihaya Koriyama, Akira Matsunaga","doi":"10.1007/s12630-024-02859-2","DOIUrl":"https://doi.org/10.1007/s12630-024-02859-2","url":null,"abstract":"<p><strong>Purpose: </strong>Subcutaneous emphysema is a common complication of laparoscopic surgery. We aimed to determine the incidence, outcomes, and risk factors of postlaparoscopic subcutaneous emphysema.</p><p><strong>Methods: </strong>We conducted a single-centre historical cohort study of adult patients who underwent laparoscopic surgery at Kagoshima University Hospital between 1 April 2018 and 31 March 2021. We used multivariable logistic regression analysis to identify independent factors associated with postlaparoscopic subcutaneous emphysema.</p><p><strong>Results: </strong>We included 1,642 patients with a median [interquartile range] age of 65 [53-72] yr. Postlaparoscopic subcutaneous emphysema was diagnosed in 600 (37%) patients. Female sex (odds ratio [OR], 1.82; 99.5% confidence interval [CI], 1.29 to 2.58), peak end-tidal carbon dioxide ≥ 45 mm Hg (OR, 2.07; 99.5% CI, 1.43 to2.98), and use of the AirSeal® Intelligent Flow System (CONMED Corp., Largo, FL, USA) (OR, 3.37; 99.5% CI, 2.34 to 4.87) were independent factors associated with postlaparoscopic subcutaneous emphysema. In addition, a lower body mass index was significantly associated with increased postlaparoscopic subcutaneous emphysema (P for trend < 0.001). No complications were associated with postlaparoscopic subcutaneous emphysema.</p><p><strong>Conclusions: </strong>This historical cohort study showed a relatively high incidence of postlaparoscopic subcutaneous emphysema. In addition to previously reported risk factors, female sex and use of the AirSeal Intelligent Flow System were found to be associated with postlaparoscopic subcutaneous emphysema.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481873","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}

{"title":"Transcutaneous carbon dioxide monitoring in children undergoing rigid bronchoscopy: a prospective blinded observational study.","authors":"Martina Bordini, Julia M Olsen, Jennifer M Siu, Jason Macartney, Nikolaus E Wolter, Evan J Propst, Clyde T Matava","doi":"10.1007/s12630-024-02862-7","DOIUrl":"https://doi.org/10.1007/s12630-024-02862-7","url":null,"abstract":"<p><strong>Purpose: </strong>Anesthetic management during rigid bronchoscopy in children can be challenging, and continuous end-tidal carbon dioxide (EtCO₂) monitoring is often unachievable. Transcutaneous carbon dioxide (TcCO₂) monitoring is strongly correlated with the partial pressure of carbon dioxide (PaCO₂) and EtCO₂. We aimed to investigate the incidence of hypercapnia in children undergoing rigid bronchoscopy.</p><p><strong>Methods: </strong>We enrolled patients aged < 18 yr scheduled for rigid bronchoscopy in a prospective observational study. We recorded TcCO₂ values from anesthesia induction to the postanesthesia care unit (PACU) stay. We ended monitoring when TcCO₂ reached values ≤ 50 mm Hg. The operating room (OR) team was blinded to the TcCO₂. The outcome of primary interest was the incidence of hypercapnia (TcCO₂ > 50 mm Hg) in the OR. Other outcomes were the incidences of hypercapnia in the PACU and severe hypercapnia (TcCO₂ > 90 mm Hg), factors possibly related to hypercapnia (patient, surgery, or anesthesia factors), and the incidence of perioperative adverse events.</p><p><strong>Results: </strong>A total of 30 patients were enrolled. The median [interquartile range (IQR)] age was 3.5 [1.5-8.0] yr. The incidence of hypercapnia was 100% in the OR and 60% in the PACU. Five cases (17%) presented with severe hypercapnia in the OR. The highest median [IQR] TcCO₂ was 69 [61-79] mm Hg. The most common adverse event was oxygen desaturation (57%, 17/30). Patients with severe hypercapnia had long stays in the PACU.</p><p><strong>Conclusion: </strong>Hypercapnia was a frequent event in children undergoing rigid bronchoscopy and severe hypercapnia was associated with a long PACU stay. Further studies are needed to assess the utility of TcCO₂ monitoring in guiding ventilatory interventions during these cases.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481875","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}

{"title":"Cervical spine motion during videolaryngoscopic intubation using a Macintosh-style blade with and without the anterior piece of a cervical collar: a randomized controlled trial.","authors":"Woo-Young Jo, Jae-Hyun Choi, Jay Kim, Kyung Won Shin, Seungeun Choi, Hee-Pyoung Park, Hyongmin Oh","doi":"10.1007/s12630-024-02849-4","DOIUrl":"https://doi.org/10.1007/s12630-024-02849-4","url":null,"abstract":"<p><strong>Purpose: </strong>Applying a cervical collar during videolaryngoscopic intubation can increase the lifting force required to achieve adequate glottic view, potentially increasing cervical spine motion. We aimed to compared cervical spine motion during videolaryngoscopic intubation between applying only the posterior piece (posterior-only group) and applying both the anterior and posterior pieces (anterior-posterior group) in patients wearing a cervical collar.</p><p><strong>Methods: </strong>We conducted a dingle-centre, parallel-group, randomized controlled trial in 102 patients (each group, N = 51). We used a videolaryngoscope (AceScope™, Ace Medical, Seoul, Republic of Korea) with a Macintosh-style blade (AceBlade™, Ace Medical, Seoul, Republic of Korea) for videolaryngoscopic intubation. In each group (posterior-only vs anterior-posterior), we measured cervical spine motion during intubation, defined as change in cervical spine angle (calculated as cervical spine angle at intubation minus that before intubation) at three cervical spine segments on lateral cervical spine radiographs.</p><p><strong>Results: </strong>The differences in mean cervical spine motion during intubation between the posterior-only and anterior-posterior groups were 1.2° (98.3% confidence interval [CI], -0.7 to 3.0), 1.0° (98.3% CI, -0.6 to 2.6), and -0.3° (98.3% CI, -2.2 to 1.7) at the occiput-C1, C1-C2, and C2-C5 segments, respectively. Mean (standard deviation) cervical spine angles at the occiput-C1, C1-C2, and C2-C5 segments in the posterior-only vs anterior-posterior groups were 10.8° (4.2) vs 9.6° (3.3) (P = 0.13), 5.6° (3.0) vs 4.7° (3.5) (P = 0.14), and 1.2° (3.7) vs 1.5° (4.3) (P = 0.74), respectively. Intubation times were shorter in the posterior-only group (median [interquartile range], 23 [19-28] sec vs 33 [20-47] sec; P = 0.003).</p><p><strong>Conclusions: </strong>In patients wearing a cervical collar, the differences in mean cervical spine motions during intubation between applying only the posterior piece and applying both the anterior and posterior pieces were approximately 1°. Intubation times were significantly shorter without the anterior piece of a cervical collar. These findings can be referred to when removal of the anterior piece of a cervical collar is considered to address difficult videolaryngoscopic intubation conditions.</p><p><strong>Study registration: </strong>CRIS.nih.go.kr ( KCT0008151 ); first submitted 17 January 2023.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142481871","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}

{"title":"The impact of spinal versus general anesthesia on the variability of surgical times: a systematic review and meta-analysis.","authors":"Andrea Taborsky, Franklin Dexter, Alexander Novak, Jennifer L Espy, Rakesh V Sondekoppam","doi":"10.1007/s12630-024-02848-5","DOIUrl":"https://doi.org/10.1007/s12630-024-02848-5","url":null,"abstract":"<p><strong>Background: </strong>With spinal anesthesia, when cases are taking longer than usual, there may be behavioural tendencies for surgical teams to work more quickly. We conducted a systematic review with meta-analysis to examine standard deviations of surgical times for single-dose spinal anesthetics versus general anesthesia. We compared ratios of mean surgical times as a secondary endpoint.</p><p><strong>Methods: </strong>We included randomized trials of humans where general or spinal anesthesia was used for one category of surgical procedure (e.g., hip arthroplasty) and the article reported the means and standard deviations of operative durations. We used statistical methods suitable for surgical times following log-normal distributions. We used generalized confidence intervals to calculate point estimates of ratios and standard errors for each study, followed by pooling among studies using DerSimonian and Laird random-effects meta-analysis with Knapp-Hartung adjustment.</p><p><strong>Results: </strong>Among the 77 included studies, 96% were of high quality for our endpoint (i.e., had a low risk of bias), as no (0%) study focused on comparing variability of surgical times and none had surgical time as the primary endpoint. Spinal anesthesia was associated with 6.6% smaller standard deviations than general anesthesia (95% confidence interval, 15.8% smaller to 1.9% larger, P = 0.13). By meta-regression, there was no significant association of the ratios of standard deviations with study quality (P = 0.39), year of publication (P = 0.76), or categories of procedures (all five P ≥ 0.28). Spinal anesthesia was associated with 1.1% smaller means than general anesthesia (95% confidence interval, 3.7% smaller to 1.5% larger, P = 0.42). There were no significant associations between the ratios of means and study quality (P = 0.47), year of publication (P = 0.95), or categories of procedures (all five, P ≥ 0.63).</p><p><strong>Conclusions: </strong>The results of this systematic review and meta-analysis show with high confidence that the effect of choosing spinal anesthesia on variability in surgical time, if present, is sufficiently small to have no substantive direct economic effect. The same conclusion applies to mean surgical time. Therefore, although anesthetic choice has a clinical (biological) impact and affects anesthesia times, the direct effects on surgical times and workflow are minimal at most. Anesthetic choice does not influence operating theatre productivity via changes to surgical times. The impact of spinal anesthetic effects is limited to nonoperative times (e.g., reducing anesthesia-controlled times by using a block room before the patient enters the operating room).</p><p><strong>Study registration: </strong>PROSPERO ( CRD42023461952 ); first submitted 8 September 2023.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407291","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}

{"title":"John Matthew Cowan, MBChB, FRCPC.","authors":"Homer Yang","doi":"10.1007/s12630-024-02856-5","DOIUrl":"https://doi.org/10.1007/s12630-024-02856-5","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2024-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395577","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}

{"title":"Maintenance infusion rate of oxytocin after initial 1-IU bolus for elective Cesarean delivery: a dose-finding study.","authors":"Linda Boonstra, Jose C A Carvalho, William Turner, Kristi Downey, Xiang Y Ye, Jackie Thomas, Mrinalini Balki","doi":"10.1007/s12630-024-02828-9","DOIUrl":"10.1007/s12630-024-02828-9","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of our study was to determine the minimum effective dose of oxytocin maintenance infusion required to maintain adequate uterine tone in 90% of patients (ED₉₀) after administration of the initial bolus at elective Cesarean delivery (CD) under spinal anesthesia.</p><p><strong>Methods: </strong>We conducted a prospective, double-blind dose-finding study with biased coin up-down design. Immediately after delivery, a 1-IU oxytocin bolus was administered, followed by a maintenance infusion. The obstetrician assessed the uterine tone by palpation as satisfactory or unsatisfactory. In case of unsatisfactory response, the dose for the next patient was increased by 2 IU·hr^-1. For satisfactory response, the dose for the next patient was either decreased by 2 IU·hr^-1 with a probability of 1/9, or remained unchanged. The primary outcome was a satisfactory uterine tone from five minutes after delivery until discharge from postanesthesia care unit. The secondary outcomes were blood loss, need for additional uterotonics, and side effects.</p><p><strong>Results: </strong>We analyzed data for 40 patients. The ED₉₀ of oxytocin maintenance infusion was 4.5 IU·hr^-1 (95% confidence interval, 3.3 to 5.5) based on the isotonic regression estimator. The median [interquartile range] blood loss was 861 [553-1,181] mL; 18% received additional uterotonics, and 38% developed hypotension post delivery.</p><p><strong>Conclusion: </strong>Based on the results of this dose-finding study, we recommend a maintenance infusion rate of 4.5 IU·hr^-1 following an oxytocin bolus of 1 IU for adequate uterine tone in pregnant patients undergoing elective CDs. This infusion rate is four-fold lower than that required without an initial bolus.</p><p><strong>Study registration: </strong>ClinicalTrials.gov ( NCT04946006 ); first submitted 25 June 2021.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"1363-1371"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142301816","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}

{"title":"Point-of-care ultrasonography in Ukraine: a survey of anesthesiologists-intensivists participating in ultrasonography courses.","authors":"Vladyslav Dieiev, Sergii Dubrov, José L Díaz-Gómez, Rom A Stevens, Pedro Salinas, Vadim Gudzenko, Nataliya Matolinets, Olga Kravets, Daria Krishtafor, Oleksandr Pavlysh, Stepan Cherniaiev, Aliaksei Pustavoitau","doi":"10.1007/s12630-024-02789-z","DOIUrl":"10.1007/s12630-024-02789-z","url":null,"abstract":"<p><strong>Purpose: </strong>Despite the potential value of point-of-care ultrasonography (POCUS) in resource-limited environments, it is not widely used in low- and middle-income countries compared with high-income countries. We sought to evaluate the current POCUS practice of Ukrainian anesthesiologists who attended POCUS courses to guide future POCUS training in Ukraine.</p><p><strong>Methods: </strong>We conducted a 25-question web-based survey. It was distributed to 255 participants of POCUS courses held in Ukraine in 2023. The survey sections described current POCUS practice, perception of POCUS value, POCUS skills self-assessment, and perceived barriers to implementing POCUS in clinical practice.</p><p><strong>Results: </strong>Two hundred and forty-four out of 255 course participants completed the survey, representing 214 unique respondents. Those who self-rated their skills identified themselves as either novices or beginners in areas of POCUS knowledge (118/157, 75%), image acquisition (110/158, 70%), image interpretation (117/158, 74%), and integration into clinical decision-making (105/155, 68%). Among all survey responders, 55% (118/214) reported using POCUS for vascular access procedures, 45% (97/214) for trauma assessment, and 44% (93/214) for regional anesthesia. Reported barriers to POCUS implementation included lack of ultrasound devices (101/214, 47%) and lack of trained faculty (112/214, 52%).</p><p><strong>Conclusion: </strong>Among anesthesiologists who participated in POCUS courses in Ukraine, the majority were in early stages of ultrasound practice. Respondents identified POCUS applications not currently practiced and evaluated barriers to POCUS use. Based upon these survey findings, we propose the following measures in Ukraine: 1) developing a standardized national POCUS curriculum; 2) increasing the number of experienced instructors of POCUS; and 3) acquiring ultrasound devices to support clinical applications of POCUS, especially in the Central, Southern, and Eastern regions.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"1379-1387"},"PeriodicalIF":3.4,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141452319","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}