Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Intrathecal sufentanil-morphine shortens the duration of intubation and improves analgesia in fast-track cardiac surgery.
To compare the effect of combined intrathecal morphine and sufentanil with low-dose iv sufentanil during propofol anesthesia for fast-track cardiac surgery. ⋯ In low-risk patients undergoing coronary artery bypass graft or valve surgery, combined intrathecal sufentanil and morphine with a target-controlled infusion of propofol satisfies the goals of fast-track cardiac surgery.
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Randomized Controlled Trial Clinical Trial
Iliohypogastric-ilioinguinal peripheral nerve block for post-Cesarean delivery analgesia decreases morphine use but not opioid-related side effects.
To examine if ilioinguinal-iliohypogastric nerve block could reduce the need for post-Cesarean delivery morphine analgesia and thus reduce the incidence of opioid related adverse-effects. ⋯ A multi-level ilioinguinal-iliohypogastric nerve block technique can reduce the amount of systemic morphine required to control post-Cesarean delivery pain but this reduction was not associated with a reduction of opioid related adverse effects in our study group.
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Review Case Reports
Airway management after upper cervical spine injury: what have we learned?
Survival after atlanto-axial-occipital ligamentous injury is uncommon and experience with the immediate clinical management of these patients is similarly low. There has been considerable work published recently with respect to airway management in similar patients and a review of this material was undertaken. ⋯ Patients who survive severe upper cervical ligamentous injury and present to hospital are uncommon. However, of those who do, both intact survival and survival with limited neurological sequelae do occur. Meticulous airway care with maintenance of alignment and provision of continuous cervical immobilization are an integral component of care in these patients.
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To examine the supply of physician anesthesia providers necessary to accommodate the previously described clinical and non-clinical service volume needs throughout Canada. ⋯ Canada has a current shortage of anesthesiologists. Based on the assessment of future needs in Quebec and extrapolated to all provinces, this shortage will worsen, unless Canadian training programs are expanded or other steps are taken to augment the numbers of anesthesia practitioners. Ongoing studies in each province are required to validate and update these conclusions.
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A human resource planning model for anesthesiology is described. ⋯ The model showed that the cause of the increased FTE demand for anesthesiologists is a combination of increased population and its demographic composition. The relative impact of each of these factors varies in different provinces. Effective specialty-specific planning models can be designed but they need ongoing committed resources and personnel for their usefulness to be maximized.