Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Review Meta Analysis
Perioperative intravenous lidocaine infusion for postoperative pain control: a meta-analysis of randomized controlled trials.
Various strategies have been proposed for postoperative pain control. Among those, intravenous lidocaine infusion (IVLI) has gained in interest. However, its clinical benefit remains unclear. This systematic review is an evaluation of the analgesic efficacy and safety of IVLI during general anesthesia. ⋯ Perioperative IVLI reduced postoperative pain and opioid requirement, as well as ileus recovery time, hospital length of stay, and nausea/vomiting. Intravenous lidocaine infusion was effective mainly in abdominal surgery populations. Considering that toxic levels were detected and that adverse events were not systematically screened for in most studies, dose and safety of IVLI should be established before recommending its use.
-
Practice Guideline
Guidelines to the Practice of Anesthesia: Revised edition 2011.
The Guidelines to the Practice of Anesthesia Revised Edition 2011 (the guidelines) were prepared by the Canadian Anesthesiologists' Society (CAS), which reserves the right to determine their publication and distribution. Because the guidelines are subject to revision, updated versions are published annually. Whereas previous versions of the guidelines appeared as special supplements to the Canadian Journal of Anesthesia (the Journal), this edition of the guidelines is published within the Journal. ⋯ Although the CAS encourages Canadian anesthesiologists to adhere to its practice guidelines to ensure high-quality patient care, the society cannot guarantee any specific patient outcome. Each anesthesiologist should exercise his or her own professional judgement in determining the proper course of action for any patient's circumstances. The CAS assumes no responsibility or liability for any error or omission arising from the use of any information contained in its Guidelines to the Practice of Anesthesia.
-
Case Reports
Complications of peripheral nerve catheter removal at home: case series of five ambulatory interscalene blocks.
The placement of continuous peripheral nerve catheters on an ambulatory basis is increasing and is routine at our institution. There are few reports of complications associated with peripheral nerve catheter removal in the literature. Described herein is a case series of five patients where complications related to catheter withdrawal were observed. ⋯ There can be various causes for difficulty with catheter removal, such as a technical aspect of catheter placement, catheter design, tissue reaction at the catheter site, or a combination thereof. The majority of complications related to outpatient perineural catheters can be handled over the telephone, but our case series may highlight a potential management dilemma in placing continuous stimulating perineural catheters on an ambulatory basis.
-
Comparative Study
Systemic dextromethorphan and dextrorphan are less toxic in rats than bupivacaine at equianesthetic doses.
Dextrorphan, a major metabolite of dextromethorphan, produces the duration of spinal and cutaneous anesthesia similar to bupivacaine. The purpose of this study was to test the central nervous system and cardiovascular toxicity of bupivacaine, dextromethorphan, and dextrorphan. ⋯ At equipotent doses for local anesthesia, dextromethorphan and dextrorphan were less likely than bupivacaine to induce central nervous system and cardiovascular toxicity.
-
Transesophageal echocardiography (TEE) is becoming a standard imaging tool during cardiac surgery as well as an important diagnostic tool in cardiology and in intensive care, resulting in an increasing demand for TEE training. To address the problem of limited time for learning during TEE studies, we have developed a novel online application that allows users to visualize each of the 20 standard diagnostic TEE views in conjunction with a three-dimensional (3D) heart model that can be rotated and "cut away" above the echo plane to reveal the internal cardiac structures. This study is an evaluation of the educational benefit of this application. ⋯ The large improvement in test scores during a short period of study and the high level of satisfaction across all of the disciplines indicates that the application is a useful adjunctive tool for learning TEE. It is now being used in TEE training worldwide.