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

{"title":"Comment on: Channelled versus nonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial.","authors":"Atsushi Kobayashi, Shingo Kawashima, Tetsuro Kimura, Hiroyuki Kinoshita","doi":"10.1007/s12630-025-02969-5","DOIUrl":"https://doi.org/10.1007/s12630-025-02969-5","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175980","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":"In reply: Comment on: Channelled versus nonchannelled Macintosh videolaryngoscope blades in patients with a cervical collar: a randomized controlled noninferiority trial.","authors":"Kyung Won Shin, Hyongmin Oh","doi":"10.1007/s12630-025-02970-y","DOIUrl":"https://doi.org/10.1007/s12630-025-02970-y","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144175912","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":"Hypoxic-ischemic spinal cord injury following resuscitated cardiac arrest: a case series and rapid literature review.","authors":"Conall Francoeur, Laura Hornby, Anab Lehr, Ahmed Alkharusi, J Gordon Boyd, Christine Saint Martin, Chantal Poulin, Fiona Slater, Matthew P Kirschen, Sam D Shemie","doi":"10.1007/s12630-025-02937-z","DOIUrl":"https://doi.org/10.1007/s12630-025-02937-z","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiac arrest can cause hypoxic-ischemic injury and result in both spinal cord injury and death determination by neurologic criteria (DNC). The presence and severity of hypoxic-ischemic spinal cord injury (HISCI) impacts neuro-prognostication, rehabilitation, and may confound DNC evaluation in patients by interfering with motor responses and respiratory muscle function in apnea testing. We describe five children with postarrest HISCI detected on magnetic resonance imaging (MRI) and supplement our observations with a literature review.</p><p><strong>Clinical features: </strong>Postarrest HISCI was identified in five consecutive pediatric cases of prolonged cardiac arrest and hypoxic-ischemic brain injury in a single centre. All patients had cardiopulmonary resuscitation for > 30 min and resultant severe hypoxic-ischemic brain injury. Spinal MRI indications were loss of rectal tone (n = 3), focal deficit (n = 1), and practice change related to recent cases (n = 1). A rapid review of the literature yielded case reports, case series, and retrospective reviews describing 90 patients (81 adults; nine pediatric) with postarrest HISCI. Ischemia distribution was variable, most frequently reported at the cervical and thoracic levels, although some patients had ischemia of the entire cord. Paraplegia was the most common deficit among survivors. There were no reports of HISCI in patients who underwent assessment for DNC.</p><p><strong>Conclusions: </strong>This case series and rapid literature review highlights that both adults and children may be at risk of HISCI after prolonged cardiac arrest. Our findings suggest that further research should focus on determining the incidence and sequelae of HISCI after resuscitated cardiac arrest, as well as evaluating its potential impact on DNC practice and neuro-prognostication.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112896","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":"Hypoxic ischemic spinal cord injury after cardiac arrest: just because we are not looking for it does not mean it is not there.","authors":"Ariane Lewis, Alex Manara, James L Bernat","doi":"10.1007/s12630-025-02938-y","DOIUrl":"https://doi.org/10.1007/s12630-025-02938-y","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112892","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 cross-sectional study of diversity in regional anesthesia and acute pain medicine fellowships.","authors":"Uchenna O Umeh, Mandip S Kalsi, Maya Tailor, Haoyan Zhong, Shivani Mehta, Niyant Jain, Poonam Pai, Bridget Pulos, Rodney Gabriel, Raymond S Joseph, Justas Lauzadis, Mary J Hargett, Meg A Rosenblatt","doi":"10.1007/s12630-025-02947-x","DOIUrl":"10.1007/s12630-025-02947-x","url":null,"abstract":"<p><strong>Purpose: </strong>The number of underrepresented in medicine (URiM) physicians is disproportionately low compared with the general population. Patient-physician racial concordance may increase patient satisfaction and therapeutic adherence. In this study, we evaluated diversity within 2023-2024 regional anesthesia and acute pain medicine (RA/APM) fellowship programs and discuss methods to increase diversity and inclusion.</p><p><strong>Methods: </strong>The Hospital for Special Surgery Institutional Review Board (IRB no. 2023-1862) approved this cross-sectional survey study. We distributed a questionnaire to RA/APM fellowship directors (FDs) on 2 October 2023 and present responses as counts and percentages or medians and interquartile ranges.</p><p><strong>Results: </strong>We sent questionnaires to 84 FDs with 44 responses (52%)-39 from the USA and five from Canada. Overall, 4/44 (9%) FDs identified as URiM. Many FDs reported no URiM (57%) or lesbian, gay, bisexual, transgender, queer, intersex, asexual, or other (LGBTQIA +) fellows (50%). We observed no differences regarding gender identity, with 46% cisgender female FDs and 46% female fellows reported. While 35 (80%) FDs considered themselves successful at having a diverse program, 27 (61%) reported no outreach programs targeted to underrepresented groups. Thirty-two (73%) programs reported Accreditation Council for Graduate Medical Education accreditation and 33 (75%) reported participation in the 2023 San Francisco Residency and Fellowship Match.</p><p><strong>Conclusions: </strong>Organizational diversity offers several advantages; however, there is a discrepancy between the diversity of RA/APM FDs and fellows compared with the general US and Canadian population. Methods to further increase URiM representation at the trainee and FD levels should be further explored.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"801-810"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011493","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 ultrasound-guided fluid management to prevent hypotension after induction of general anesthesia-a conundrum to conquer!","authors":"Anisha Pauline Paul, Aruna Parameswari, Priadharsan Pavazhakannan, Mahalakshmi Sankar, Jabeena Salim","doi":"10.1007/s12630-025-02954-y","DOIUrl":"10.1007/s12630-025-02954-y","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"865-866"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055019","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":"Metrics to assess the quality of anesthesia, perioperative care, and acute pain management in Canada: a scoping review.","authors":"Janny X C Ke, Kathryn Sparrow, Mindy A Smith, Kang Mu Yoo, May-Sann Yee, Louise Y Sun, W Scott Beattie, Edlyn Lim, Matthias Görges","doi":"10.1007/s12630-025-02943-1","DOIUrl":"10.1007/s12630-025-02943-1","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this scoping review was to consolidate a list of metrics that can be used to measure quality in anesthesiology, perioperative medicine, and acute pain management in Canada.</p><p><strong>Methods: </strong>We included English-language full-text articles involving metrics (including patient-reported outcome and patient-reported experience measures, quality and safety indicators, and practice standards) for adults aged 18 yr and older undergoing inpatient non-cardiac surgery requiring an anesthesiologist. We searched MEDLINE®, Embase, CINAHL, Web of Science™, the Cochrane Database of Systematic Reviews, and grey literature to find articles on the topic from January 2015 to March 2022. In addition, we contacted 64 Canadian hospitals for existing anesthesia quality assurance and improvement metrics; they responded from June to October 2022. Two independent reviewers performed screening and data extraction. We grouped and condensed similar candidate metrics using thematic analysis.</p><p><strong>Results: </strong>We assessed 4,493 publications, of which 63 met the inclusion criteria. We extracted 662 candidate metrics and consolidated them into 94 distinct metrics. Metrics reflected themes of perioperative management (n = 47), safety and standards (n = 23), patient-centredness (n = 11), intraoperative anesthetic care (n = 5), perioperative team leadership (n = 4), and efficiency (n = 4). Metrics spanned all quality-of-care categories (process, outcome, and structure) and perioperative phases but were limited by poor supporting evidence.</p><p><strong>Conclusions: </strong>We consolidated a list of 94 metrics that can be used to evaluate the quality of anesthesia care. Further work will require verification of feasibility and validity prior to adoption, with operationalization of these metrics into practical indicators that are measurable and comparable.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"822-854"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112899","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":"Concerns with inflation line position in preformed nasal endotracheal tubes-proximal or distal?","authors":"Banupriya Ravichandrane, Janani Vijayasundaram, Santhosh Arulprakasam, Priya Rudingwa","doi":"10.1007/s12630-025-02953-z","DOIUrl":"10.1007/s12630-025-02953-z","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"860-861"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062585","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 standardized set of metrics to assess the quality of anesthesia, perioperative care, and acute pain management in Canada: a multidisciplinary modified Delphi study.","authors":"Janny X C Ke, Mindy A Smith, Kathryn Sparrow, Nicholas West, May-Sann Yee, Kang Mu Yoo, Louise Y Sun, W Scott Beattie, Matthias Görges","doi":"10.1007/s12630-025-02951-1","DOIUrl":"10.1007/s12630-025-02951-1","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to develop a consensus list of metrics to measure the quality of care in anesthesia, perioperative care, and acute pain management in Canada.</p><p><strong>Methods: </strong>We sought to conduct a modified Delphi study involving a multidisciplinary panel of perioperative health care professionals (anesthesiologists, surgeons, nurses, internal medicine and family medicine physicians, and hospital administrators), patients, and caregivers. Participants reviewed a candidate list of metrics synthesized from a previous scoping review and performed three rounds of independent iterative scoring and feedback to achieve consensus. In round 3, we asked participants to identify priority metrics to include in a list of core metrics, and we also asked health care professionals to assess the feasibility of implementing each metric.</p><p><strong>Results: </strong>There were 80 participants (49 health care professionals, 22 patients, and 9 caregivers) who completed at least one round of voting, with 56 completing all three rounds. The panel achieved consensus on 87 metrics, of which they deemed 33 to be priority core metrics. The health care professional and patient/caregiver subgroups differed in prioritizing core metrics. Most participants voted airway complications, no residual neuromuscular blockade, difficult airway documentation, complication or critical incident reporting, and complications from pain management the highest priority metrics. Most health care professional participants considered the core metrics to be already measured, currently feasible, or likely feasible by 2025.</p><p><strong>Conclusions: </strong>A multidisciplinary panel developed a list of metrics for measuring the quality of anesthesiology care in Canada. Many metrics require further refinement and validation, and future research is required to guide the measurement techniques and implementation approaches.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"698-720"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144112858","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":"Prevention of hypotension after neuraxial anesthesia in nonobstetric surgery: a systematic review.","authors":"Sandra Lee, Nehal Islam, Karim S Ladha, Mark C Bicket, Duminda N Wijeysundera","doi":"10.1007/s12630-025-02925-3","DOIUrl":"10.1007/s12630-025-02925-3","url":null,"abstract":"<p><strong>Purpose: </strong>Hypotension occurs frequently during neuraxial anesthesia and is associated with increased risks of perioperative complications. We sought to conduct a systematic review and meta-analysis of randomized controlled trials that evaluated interventions intended to mitigate exposure to intraoperative hypotension and prevent complications following the administration of neuraxial anesthesia for major nonobstetric noncardiac surgery.</p><p><strong>Source: </strong>We searched MEDLINE, Embase, PubMed®, and the Cochrane Controlled Register of Trials (database inception to 2 August 2023) for randomized controlled trials (RCTs) that evaluated interventions intended to reduce hypotension during neuraxial anesthesia in major noncardiac nonobstetric surgery, without any restrictions on the comparator type. The outcomes of interest were any measure of intraoperative hypotension (e.g., incidence, duration) and postoperative complications.</p><p><strong>Principal findings: </strong>Among 33 included RCTs (n = 3,880) evaluating six classes of interventions, interventions that reduced the risk of hypotension included colloid preload (vs crystalloid, risk ratio [RR], 0.48; 95% confidence interval [CI], 0.30 to 0.80; P = 0.004; I² = 12%; very-low-certainty evidence) and prophylactic ondansetron (vs placebo; RR, 0.64; 95% CI, 0.53 to 0.78; P < 0.001; I² = 39%; moderate-certainty evidence). Prophylactic ephedrine was also associated with reduced time spent in hypotension. Nevertheless, crystalloid preloading did not reduce risks of hypotensive events compared with no preload (RR, 1.36; 95% CI, 0.96 to 1.92; P = 0.09; I² = 0%; very-low-certainty evidence). There were no compelling data showing that these interventions reduced the risks of complications.</p><p><strong>Conclusions: </strong>Several interventions hold promise for mitigating exposure to hypotension following neuraxial anesthesia, albeit supported by very-low to moderate-certainty evidence. It remains unclear whether these interventions reduce the risks of postoperative complications.</p><p><strong>Study registration: </strong>PROSPERO ( CRD42022336197 ); first submitted 29 May 2022.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"721-737"},"PeriodicalIF":3.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053898","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}