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

{"title":"Intraoperative diaphragmatic stimulation by a cardiac resynchronization therapy defibrillator presenting as hiccups.","authors":"Hüseyin Aybar","doi":"10.1007/s12630-024-02880-5","DOIUrl":"10.1007/s12630-024-02880-5","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"211-213"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142820235","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":"Hydroxocobalamin treatment for refractory hypotension and shock: a case series.","authors":"Liran Shechtman, Varinder Kaur Randhawa, Jutamas Saoraya, Marcela Amaral, Romina Marchesano, Laura Tsang, Sharon Yamashita, Neill K J Adhikari, Damon C Scales, Robert Fowler","doi":"10.1007/s12630-024-02881-4","DOIUrl":"10.1007/s12630-024-02881-4","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"208-210"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142840372","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":"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":"91-105"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","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":"Effects of dexamethasone on opioid consumption in pediatric tonsillectomy: a systematic review with meta-analysis.","authors":"Naoko Niimi, Makoto Sumie, Marina Englesakis, Alan Yang, Julia Olsen, Richard Cheng, Jason T Maynes, Paolo Campisi, Jason Hayes, William C K Ng, Kazuyoshi Aoyama","doi":"10.1007/s12630-024-02817-y","DOIUrl":"10.1007/s12630-024-02817-y","url":null,"abstract":"<p><strong>Purpose: </strong>Tonsillectomy is one of the most common ambulatory procedures performed in children worldwide, with around 40,000 procedures performed in Canada every year. Although a prior systematic review indicated a clear role for dexamethasone as an analgesic adjunct, the quantity effect on opioid consumption is unknown. In the current systematic review with meta-analysis, we hypothesized that the use of dexamethasone reduces perioperative opioid consumption in pediatric tonsillectomy but does not increase rates of postoperative hemorrhage.</p><p><strong>Source: </strong>We systemically searched MEDLINE, Embase, Cochrane Databases, and Web of Science from inception to 23 April 2024. Randomized controlled trials that compared intravenous dexamethasone to placebo in pediatric tonsillectomy were included in the study. The primary outcome was perioperative opioid consumption, and the secondary outcomes included the incidence of postoperative hemorrhage. We used a random effects meta-analysis to compute the mean difference (MD) or risk ratio (RR) with 95% confidence interval (CI) for each outcome.</p><p><strong>Principal findings: </strong>Of the 1,329 studies identified in the search, we included 16 in the final analysis. Intravenous dexamethasone administration significantly reduced opioid consumption (MD, -0.11 mg·kg^-1 oral morphine equivalent; 95% CI, -0.22 to -0.01) without increasing the incidence of readmission (RR, 0.69; 95% CI, 0.28 to 1.67) or reoperation due to postoperative hemorrhage (RR, 3.67; 95% CI, 0.79 to 17.1).</p><p><strong>Conclusions: </strong>Intravenous dexamethasone reduced perioperative opioid consumption in pediatric tonsillectomy without increasing the incidence of postoperative hemorrhage.</p><p><strong>Study registration: </strong>PROSPERO ( CRD42023440949 ); first submitted 4 September 2023.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"106-118"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142082720","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 novel supraglottic airway device breathing monitor for use during patient transfer from the operating room to the postanesthesia care unit.","authors":"Adel Al-Izzi","doi":"10.1007/s12630-024-02901-3","DOIUrl":"10.1007/s12630-024-02901-3","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"217-218"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142959587","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":"An analysis of women's authorship in five leading anesthesiology journals.","authors":"Sören Verleysen, Sander Janssens, Annemie Bauters, Stefan De Hert, Annelies Moerman","doi":"10.1007/s12630-024-02895-y","DOIUrl":"10.1007/s12630-024-02895-y","url":null,"abstract":"<p><strong>Purpose: </strong>Over the last decade, there has been an increasing interest in gender equity. The present study explored the gender gap in five leading anesthesiology journals worldwide, covering the period from 1980 to 2020.</p><p><strong>Methods: </strong>We included all articles published in Anaesthesia, the British Journal of Anaesthesia, Anesthesiology, Anesthesia & Analgesia, and the Canadian Journal of Anesthesia in the years 1980, 1990, 2000, 2010, and 2020, analyzing trends in women's authorship. We explored its association with variables including study type, subspecialty, continent of the corresponding author, number of authors, and gender of coauthors.</p><p><strong>Results: </strong>There was a significant increase in women's authorship across all positions (first, second, and last) over the years (P < 0.001). Despite this progress, a substantial gender disparity remains evident. Women's authorship positions were notably associated with the type of study, the subspecialty, and the continent of the corresponding author. There was a strong positive correlation (0.82) between the total number of authors and women's first authorship position, whereas the correlation was negative (-0.54) for women's last authorship position. Furthermore, women's first and last authorship, as well as first and second authorship, were strongly associated, with odds ratios of 2.13 and 1.99, respectively.</p><p><strong>Conclusion: </strong>The trajectory of women's authorship in anesthesiology shows an upward trend, yet women continue to be underrepresented in the field. Particularly noteworthy is the finding that, when a woman is either the first or last author, there is a notable increase in the probability of having a woman as the second or first author, respectively. Understanding these dynamics is crucial for fostering inclusivity and diversity within the discipline.</p>","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"64-74"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873617","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":"Special announcement: Guidelines to the Practice of Anesthesia-Revised Edition 2025.","authors":"Gregory R Dobson","doi":"10.1007/s12630-025-02907-5","DOIUrl":"10.1007/s12630-025-02907-5","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"1-9"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124232","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":"Addressing gender disparities in academic anesthesiology through structural change.","authors":"Alana M Flexman, Louise Y Sun, Gianni R Lorello","doi":"10.1007/s12630-024-02896-x","DOIUrl":"10.1007/s12630-024-02896-x","url":null,"abstract":"","PeriodicalId":56145,"journal":{"name":"Canadian Journal of Anesthesia-Journal Canadien D Anesthesie","volume":" ","pages":"10-14"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873615","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":"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":"142-151"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821687/pdf/","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":"OA","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":"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":"152-161"},"PeriodicalIF":3.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821732/pdf/","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":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}