Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Microlaryngeal surgery involves a delicate balance between airway control and appropriate visualization of laryngeal anatomy. When the self-centering, laser-safe Hunsaker Mon-Jet tube (Xomed, Jacksonville, FL) was introduced in 1994, to provide subglottic ventilation, the needs of both anesthesiologist and surgeon appeared to have been adequately met. However, limited data exists regarding the efficacy of this device in a large patient series. The aim of this cohort study was to explore the spectrum of patients and procedures for which this technique could be used. ⋯ Subglottic ventilation via the Hunsaker Mon-Jet tube with an automated jet ventilator may be considered an effective, safe and versatile technique for the anesthetic management of microlaryngeal surgery.
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Ropivacaine is a long-acting amino-amide local anesthetic that induces vasoconstriction in vitro and in vivo. The aim of this study was to investigate the pathways involved in arachidonic acid metabolism associated with S-ropivacaine-induced contraction of rat aortic smooth muscle in vitro. ⋯ S-ropivacaine induces dose-dependent biphasic contractions in rat aortic smooth muscle through a mechanism requiring extracellular calcium that is mediated by activation of the lipoxygenase pathway and, to a lesser extent, the cyclooxygenase pathway.
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Editorial Historical Article
Simulation-based education in Canada: will anesthesia lead in the future?
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Review
Non-cardiac implantable electrical devices: brief review and implications for anesthesiologists.
Patients with implanted electrical devices (IEDs) are vulnerable to electromagnetic interference (EMI) from electrical equipment used in the perioperative environment. As the indications for non-cardiac IEDs increase, so too does the likelihood of anesthesiologists encountering such patients who present for surgery. This article reviews the important anesthetic considerations for patients with implanted non-cardiac electrical devices. ⋯ In the absence of available anesthesia management guidelines regarding non-cardiac IEDs in the perioperative setting, anesthesiologists should appreciate the basic principles pertaining to IEDs to ensure appropriate risk reduction strategies in order to enhance patient safety.
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In response to the challenges of an aging population and decreasing workforce, the provision of critical care services has been a target for quality and efficiency improvement efforts. Reliable data on available critical care resources is a necessary first step in informing these efforts. We sought to describe the availability of critical care resources, forecast the future requirement for the highest-level critical care beds and to determine the physician management models in critical care units in Ontario, Canada. ⋯ Current utilization suggests a substantial increase in the need for the highest-level critical care beds over the next two decades. Our findings also indicate that non-intensivists direct care decisions in a large number of responding units. Unless major investments are made, significant improvements in efficiency will be required to maintain future access to these services.