Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Comparative Study Controlled Clinical Trial
Carbetocin at elective Cesarean delivery: a sequential allocation trial to determine the minimum effective dose.
The ED90 of carbetocin is approximately 15 mcg after elective cesarean section.
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Review Meta Analysis
Benzydamine hydrochloride on postoperative sore throat: a meta-analysis of randomized controlled trials.
Sore throat is a common postoperative complaint. The etiology of postoperative sore throat (POST) is considered the result of damage to airway mucosa after insertion of a laryngeal mask airway device or endotracheal tube. This paper proposes benzydamine hydrochloride (BH), a topical nonsteroidal anti-inflammatory drug (NSAID) with additional analgesic and local anesthetic properties, for POST prevention. ⋯ Our results indicate that the incidence of POST can be significantly reduced by prophylactic BH topical application to the oral cavity or airway devices. Further RCTs are required to overcome the limitations of heterogeneity and to determine the optimal dosage and application of BH for managing POST.
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Randomized Controlled Trial
Transesophageal echocardiography simulation is an effective tool in teaching psychomotor skills to novice echocardiographers.
Performance of transesophageal echocardiography (TEE) requires the psychomotor ability to obtain interpretable echocardiographic images. The purpose of this study was to determine the effectiveness of a simulation-based curriculum in which a TEE simulator is used to teach the psychomotor skills to novice echocardiographers and to compare instructor-guided with self-directed online delivery of the curriculum. ⋯ High-fidelity TEE simulators are an effective training adjunct for the acquisition of basic TEE psychomotor skills. There was no difference in improvement between the different modalities of instruction. Further research will examine the need for a faculty resource for a curriculum in which a simulator is used as an adjunct.
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Biography Historical Article
Special article: Horace Nelson MD, John Webster LDS - unrecognized Canadian anesthesia pioneers.
The timing of the earliest reported ether anesthetics in early 1847, in regions to become Canada in July 1867, was examined using information from on-line and library-based sources. Previous authors had identified the first reported ether anesthetic given by a visiting American dentist in January 1847 in Saint John, New Brunswick. Nevertheless, they had reported three different anesthetics as the second occurrence - which would denote the first anesthetic given by a resident of Canada. ⋯ Earlier authors, who may not have had access to the information now available, came to incorrect conclusions about the first ether anesthetic reported to have been given by a Canadian. Current information indicates that John Webster gave the first reported anesthetic in Montreal on February 20, 1847 following experiments with ether led by Horace Nelson. Both Webster and Nelson deserve recognition as Canadian anesthesia pioneers.
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Brain imaging studies suggest that loss of consciousness induced by general anesthetics is associated with impairment of thalamic function. There is, however, limited information on the time course of these changes. We recently obtained intracranial electroencephalogram (EEG) recordings from the ventroposterolateral (VPL) nucleus of the thalamus and from the motor cortex during induction of anesthesia in three patients to study the time course of the alterations of cortical and thalamic function. ⋯ We conclude that induction of anesthesia with propofol in these patients was associated with concurrent alterations of cortical and sensory thalamic activity.