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

{"title":"Emergence delirium in pediatric anesthesia: the urgent need for evidence-based guidelines.","authors":"Jonathan J Gamble","doi":"10.1007/s12630-024-02888-x","DOIUrl":"10.1007/s12630-024-02888-x","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"373-377"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517496","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 use of extended reality in anesthesiology education: a scoping review.","authors":"Gianluca Bertolizio, Yu Tong Huang, Marta Garbin, Elena Guadagno, Dan Poenaru","doi":"10.1007/s12630-025-02909-3","DOIUrl":"10.1007/s12630-025-02909-3","url":null,"abstract":"<p><strong>Purpose: </strong>Extended reality, an umbrella term for virtual, augmented, and mixed reality, is increasingly used in health care education as it requires fewer human and logistical resources and offers reduced costs compared with high-fidelity simulations. Nevertheless, the impact of extended reality on education and training in anesthesiology is largely unknown. We aimed to explore the existing extended reality tools and applications in anesthesiology, identify current knowledge gaps, and highlight future research needs in anesthesiology education.</p><p><strong>Methods: </strong>We conducted a scoping review of studies published from January 2010 to December 2023 that focused on extended reality training in anesthesiology and included comparative analyses with other methods. We excluded publications investigating topics unrelated to anesthesiology or not involving interaction with extended reality.</p><p><strong>Results: </strong>After screening 5,419 studies, we included 62 manuscripts in the final analysis. The definitions and uses of extended reality in anesthesiology education were very heterogeneous. Thirty-seven studies compared extended reality with other forms of training. Neuraxial procedures, peripheral blocks, central venous catheters, and bronchoscopy were primarily investigated. Extended reality improved technical skills, knowledge retention, confidence, and student satisfaction. Six studies reported at least one negative result related to learning, sense of realism, and usefulness.</p><p><strong>Conclusion: </strong>The results of this scoping review highlight the increasing interest of extended reality in anesthesiology education. Nevertheless, many studies lack objective outcome measures and relevant comparisons with existing standards. In addition, extended reality needs to be consistently defined in anesthesiology education to derive optimal benefit and impact. Future studies should also focus on defining extended reality's learning objectives and clinical assessments of trainees' performance, which are commonly missing compared with high-fidelity simulation teaching.</p><p><strong>Study registration: </strong>Open Science Framework ( https://doi.org/10.17605/OSF.IO/PDT2F ); first submitted 28 June 2023.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"492-505"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517479","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":"Using the Theoretical Domains Framework to identify barriers and facilitators to peripheral nerve block use in older adult patients with a hip fracture: a national survey.","authors":"Yuqi Gu, Daniel I McIsaac, Emily Hladkowicz, Keely Barnes, Sylvain Boet, Colin McCartney, Reva Ramlogan","doi":"10.1007/s12630-025-02912-8","DOIUrl":"10.1007/s12630-025-02912-8","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral nerve blocks (PNBs) in older adult patients with a hip fracture improve morbidity and mortality, reduce health care costs, and improve quality of care. Despite the benefits, PNB use rates remain low. We aimed to use the Theoretical Domains Framework to investigate the barriers and facilitators to PNB use in patients with a hip fracture from the perspective of Canadian anesthesiologists.</p><p><strong>Methods: </strong>We created an online survey that collected both quantitative and qualitative responses. After research ethics board approval, the survey was distributed among all Canadian Anesthesiologists' Society (CAS) members. We present five-point Likert responses as medians and interquartile ranges [IQRs], conducted thematic analysis on the narrative feedback, and performed cluster analysis to explore patterns associated with survey responses.</p><p><strong>Results: </strong>We obtained responses from 256/2,498 (10.2%) CAS members. Of these respondents, 215 (84%) performed PNBs for patients with a hip fracture. The median [IQR] five-point Likert responses showed that participants felt confident placing a PNB (4 [4-5]) and agreed they possessed adequate knowledge and skills for PNB placement (4 [4-5]). Participants' responses showed lower ratings with greater variability for availability of adequate time (3 [3-4]), collaboration with the perioperative team (4 [2-4]), and adequate resources (4 [3-5]). Barriers to PNB use identified through thematic analysis included time pressure as well as inadequate human resources, training opportunities, and multidisciplinary collaboration with other health care professionals. Facilitators included more education, dedicated resources, and clinical care pathways.</p><p><strong>Conclusion: </strong>Our results identified several barriers and facilitators related to physical resources, operational support, and educational factors that may inform future interventions to increase PNB use in older patients with a hip fracture. The results of this study may not be generalizable to all Canadian practice settings because of a low response rate and high proportion of respondents who performed PNBs at their local institution.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"460-472"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425807","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":"Pain profiles and opioid consumption following joint replacement surgery: a prospective observational cohort study.","authors":"Rachel Chin, Sarah Tierney, Sanjho Srikandarajah, Yasmine Hoydonckx, Abeer Alomari, Danielle Alvares, Vincent Chan, Anuj Bhatia","doi":"10.1007/s12630-025-02910-w","DOIUrl":"10.1007/s12630-025-02910-w","url":null,"abstract":"<p><strong>Purpose: </strong>We sought to analyze postoperative discharge opioid prescription, consumption, and pain over three months following total hip arthroplasty (THA) and total knee arthroplasty (TKA).</p><p><strong>Methods: </strong>We conducted a prospective observational study in patients undergoing THA and TKA at two centres in Toronto, ON, Canada. We contacted study participants at two, six, and 12 weeks after discharge to collect data on analgesic satisfaction, pain relief, time point of stopping opioids, quantity of unconsumed opioid pills, quality of pain, and mental health. We also evaluated patient factors that may have contributed to a higher opioid consumption or dissatisfaction with the analgesic prescription at six weeks.</p><p><strong>Results: </strong>The median [interquartile range] opioid pill count prescribed at the time of discharge for the 443 participants was 60 [50-80]. At 12 weeks after surgery, 33.9% of participants had more than one-third of their prescribed quantity remaining. Three-quarters of the cohort indicated that pain relief after arthroplasty was appropriate at all postoperative follow-ups. The incidence of neuropathic pain reduced from 24.1% before TKA or THA to 4.3% at 12 weeks after arthroplasty. Female sex (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.08 to 2.95; P = 0.03), a history of preoperative opioid use (OR, 2.46; 95% CI, 1.25 to 5.1; P = 0.01), and TKA vs THA (OR, 2.46; 95% CI, 1.47 to 4.17; P = 0.001) were associated with higher opioid consumption at six weeks after arthroplasty.</p><p><strong>Conclusion: </strong>A discharge prescription of 60 opioid pills may be excessive for patients undergoing THA or TKA. Identifying patients with risk factors for higher postoperative opioid consumption may result in more appropriate analgesic regimens.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"448-459"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143470089","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":"Risk factors for pediatric emergence delirium: a systematic review.","authors":"Kazuyoshi Aoyama, Machiko Furuta, Lieven Ameye, Maria-Alexandra Petre, Marina Englesakis, Mehwish Rana, Nan Gai, Arie Peliowski, Bibek Saha","doi":"10.1007/s12630-024-02889-w","DOIUrl":"10.1007/s12630-024-02889-w","url":null,"abstract":"<p><strong>Purpose: </strong>Emergence delirium (ED) impacts approximately 25% of pediatric patients undergoing general anesthesia and is associated with with concerning consequences, including injury to patients and health care personnel. Risk prediction models with good usability for pediatric ED are lacking. We aimed to identify published risk factors in this systematic review.</p><p><strong>Methods: </strong>We conducted a systematic literature search of prospective observational studies and clinical trials through eight major databases from inception to 11 January 2023. We included prospective studies published in English that examined the pediatric population (< 18 yr old) undergoing general anesthesia for any surgical or imaging procedure, that measured the risk factor(s) for ED preoperatively/intraoperatively, and that reported the incidence of ED. We excluded studies investigating therapeutic or prophylactic interventions of ED. We assessed the quality of eligible articles according to a modified version of the Scottish Intercollegiate Guidelines Network quality checklists and rated them as high, acceptable, or low quality. Risk factors discovered were qualitatively evaluated and synthesized with the following levels of evidence: strong evidence, moderate evidence, inconclusive evidence, or lack of evidence.</p><p><strong>Results: </strong>Thirty-one studies, comprising a total of 6,068 patients, met the inclusion criteria. The median incidence of ED was 32%. Twelve studies were rated as high quality, 15 as acceptable quality, and the remaining four as low quality. Younger age and agitated/excited induction behaviour with strong evidence, followed by sevoflurane with moderate evidence, were identified as risk factors for pediatric ED. Quantitative synthesis was not feasible as there were no more than two studies that explored the same risk factor with the same cut-off.</p><p><strong>Conclusion: </strong>Although quantitative analyses were not feasible, the current systematic review qualitatively identified three risk factors for pediatric ED with robust evidence.</p><p><strong>Study registration: </strong>PROSPERO ( CRD42020192221 ); first submitted 18 June 2020.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"384-396"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143517477","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":"Pseudoaneurysm of the superior thyroid artery following central venous catheter placement.","authors":"Zhuan Jin, Daisuke Sugiyama, Kimio Hosaka, Kenichi Ueda","doi":"10.1007/s12630-025-02916-4","DOIUrl":"10.1007/s12630-025-02916-4","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"506-507"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143607309","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":"Effects of intraoperative hyperoxia on cerebral blood flow and dynamic cerebral autoregulation.","authors":"Rokus E C van den Dool, Lariza Batelaan, Denise P Veelo, Jimmy Schenk, Markus W Hollmann, Alexander P J Vlaar, Nicolaas H Sperna Weiland, Rogier V Immink","doi":"10.1007/s12630-025-02935-1","DOIUrl":"10.1007/s12630-025-02935-1","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"511-513"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659804","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":"Dexmedetomidine versus propofol for postoperative recovery after cardiac surgery: a historical cohort study.","authors":"Aubrey A Euteneuer, Misty A Radosevich, Toby N Weingarten, Troy G Seelhammer, Darrell Schroeder, Erica D Wittwer","doi":"10.1007/s12630-024-02877-0","DOIUrl":"10.1007/s12630-024-02877-0","url":null,"abstract":"<p><strong>Purpose: </strong>The impact of postoperative dexmedetomidine sedation on outcomes following cardiac surgery remains controversial. We sought to compare postoperative sedation techniques with dexmedetomidine vs propofol infusions on postoperative recovery outcomes following cardiac surgery to assess whether dexmedetomidine is associated with longer time to achieve recovery milestones.</p><p><strong>Methods: </strong>In this historical cohort study, we abstracted the electronic medical records of a convenience sample of cardiac surgery patients either receiving dexmedetomidine (0.5-1.5 µg·kg^-1·hr^-1) or propofol (5-80 µg·kg^-1·min^-1) infusions for postoperative sedation. The study period included time periods where the standard postoperative sedation practice included dexmedetomidine (March 2019-January 2022) or propofol (January 2022-June 2022) infusions. Measured outcomes for both groups included time to tracheal extubation and intensive care unit and hospital length of stay.</p><p><strong>Results: </strong>Two thousand and sixty-five patients receiving dexmedetomidine and 510 patients receiving propofol were included. Postoperative sedation after cardiac surgery with dexmedetomidine was associated with a 1.8-hr longer time to tracheal extubation than propofol (98.3% confidence interval, 1.5 to 2.1; P < 0.001).</p><p><strong>Conclusions: </strong>Dexmedetomidine administration for postoperative sedation in a convenience sample of over 2,000 cardiac surgery patients was associated with a longer time to tracheal extubation than propofol.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"409-416"},"PeriodicalIF":3.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677867","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":"\"All models are wrong; some are useful:\" gastric ultrasound in anesthesia practice.","authors":"Laura Girón-Arango, Vincent Chan, Anahi Perlas","doi":"10.1007/s12630-024-02886-z","DOIUrl":"10.1007/s12630-024-02886-z","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"226-229"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840361","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: The evolution and formalization of anesthesia assistant roles across Canada.","authors":"Homer Yang, Judith Littleford, Beverley A Orser, Marco Zaccagnini, Hamed Umedaly, Monica Olsen, Mateen Raazi, Kenneth LeDez, J Adam Law, Mitch Giffin, Jason Foerster, Brandon D'Souza, Irfaan Ali, Derek Dillane, Chris Christodoulou, Natalie Buu, Rob Bryan","doi":"10.1007/s12630-025-02914-6","DOIUrl":"10.1007/s12630-025-02914-6","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"371-372"},"PeriodicalIF":3.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143257417","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}