Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Despite significant contributions to medicine, anesthesiology is poorly recognized and faces the threat of "deprofessionalization". Clear articulation of its work and professional values plays an integral role in maintaining the viability of a profession. The purpose of this qualitative study is to explore anesthesiologists' perspectives in order to define the distinct elements of their work and their professional values. ⋯ Anesthesiology is characterized by its distinct work and core professional values. Under the threat of deprofessionalization, the practice of anesthesiology should be guided by its professional values in defining and envisioning its future.
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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.
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Randomized Controlled Trial Comparative Study
Less perilaryngeal gas leakage with SLIPA™ than with LMA-ProSeal™ in paralyzed patients.
The aim of this study was to compare the Streamlined Liner of the Pharynx Airway (SLIPA™) with the ProSeal Laryngeal Mask Airway (LMA-ProSeal™) in mechanically ventilated paralyzed patients undergoing laparoscopic gynecologic surgery. ⋯ Both the SLIPA and the LMA-ProSeal can be used effectively and without severe complications in paralyzed patients undergoing laparoscopic gynecological surgery. However, the SLIPA offers the advantage of less perilaryngeal gas leakage than the LMA-ProSeal with change in head position and during insufflation of the peritoneal cavity. This trial is registered with ANZCTR (ACTRN12609000914268).
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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.
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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.