Canadian journal of anaesthesia = Journal canadien d'anesthésie
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This article incorporates the following objectives: to review the current evidence regarding the occurrence and management of difficult airways, to outline the role for alternative technology in the management of the difficult airway, to provide a rationale for structured airway rotations in anesthesia residency training, to discuss the barriers to establishing the rotations, to outline issues that must be considered and resolved to enhance these rotations, and to share the experience we have gained over the last decade of offering an airway rotation in the Department of Anesthesiology at the University of Ottawa. ⋯ Anesthesia training programs must provide residents with the skill sets necessary for safe independent practice in airway management. The changes in the scope and reality of residency training have exposed limitations in the traditional mentoring model of residency training; consequently, many programs have responded by offering sub-specialty rotations. In particular, advanced airway management rotations are being offered increasingly to residents in the Canadian training programs. Considerations and strategies to develop and implement a structured airway management program during anesthesia residency are discussed.
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The aim of this observational study was to assess the influence of preoperative opioid consumption on postoperative morphine consumption after leg amputation performed under combined regional and general anesthesia. ⋯ Despite the use of regional anesthesia, chronic opioid consumption before leg amputation is associated with increased postoperative morphine consumption and phantom limb pain.
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The objective of this continuing professional development module is to describe the perioperative anesthesia and pain management of patients taking opioids because of chronic pain or drug addiction. ⋯ The physiological and pharmacological changes caused by chronic opioid intake must be understood in order to provide optimal pain management with respect to each individual and the type of procedure.