Canadian journal of anaesthesia = Journal canadien d'anesthésie
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To determine how frequently the published operating room (OR) schedule of case start times correlated with the actual OR entry time for elective cases in the Fraser Health Authority (FHA) in British Columbia, Canada. Society guidelines recommend periods of fasting of two hours prior to the induction of general anesthesia, but patients frequently end up fasting much longer. This review aimed to determine when patients arrive in the OR-either earlier than their scheduled time or later. The premise of some is that patients often arrive earlier, and advising short fasting times on the basis of the OR slate time is unreliable. I wished to determine whether this fear is justified. ⋯ In the FHA, the OR schedule is a reliable guide to providing instructions on timing of preoperative fluid consumption in appropriately selected elective surgical patients. Quality of care and patient satisfaction will safely be enhanced by limiting the period of fasting for elective surgical patients.
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Observational Study
Accuracy of the Clinical Frailty Scale for perioperative frailty screening: a prospective observational study.
Perioperative frailty increases postoperative complications, mortality, and new functional dependence. Despite this, routine perioperative frailty screening is not widespread. We aimed to assess the accuracy of the Clinical Frailty Scale (CFS) as a screening tool prior to anesthesia, and to determine which health domains are affected by frailty. ⋯ The CFS is a valid and accurate tool to screen for perioperative frailty, which encompasses the spectrum of health-related domains.
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Comparative Study
A comparative study on adequate anesthesia depth: clinical judgement and the Narcotrend® measurement.
To compare the clinical judgement of electroencephalogram (EEG)-naïve anesthesiologists with an EEG-based measurement of anesthetic depth (AD) using the Narcotrend® monitor. ⋯ These results suggest that clinical judgement of AD during stable anesthesia was not in agreement with EEG-based assessment of anesthetic depth in 58% of cases. Nevertheless, this finding could be influenced by the lack of validated scales to clinically judge AD.
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Comment Letter
Regional anesthesia catheter tunnelling: a simpler approach.
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Multicenter Study
A qualitative study of bereaved family members with complicated grief following a death in the intensive care unit.
Grief is a normal reaction, and most family members (FMs) experience grief following a death. Typically, grief subsides without any major psychological or medical impairment. Nevertheless, some FMs may experience complicated grief (CG) reactions, with symptoms lasting months or years, and CG is particularly prominent among FMs of those who die in the intensive care unit (ICU). The purpose of this study was to examine how FMs experience grief, particularly CG, to inform future early screening and support programs in the ICU. ⋯ Bereaved FMs with CG described their experiences with grief, how ICU events influenced their bereavement, their coping strategies and sources of support, and their advice for future bereavement support programs for FMs of deceased ICU patients.