Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Meta Analysis
Effects of dexamethasone on opioid consumption in pediatric tonsillectomy: a systematic review with meta-analysis.
Tonsillectomy is one of the most common ambulatory procedures performed in children worldwide, with around 40,000 procedures performed in Canada every year. Although a prior systematic review indicated a clear role for dexamethasone as an analgesic adjunct, the quantity effect on opioid consumption is unknown. In the current systematic review with meta-analysis, we hypothesized that the use of dexamethasone reduces perioperative opioid consumption in pediatric tonsillectomy but does not increase rates of postoperative hemorrhage. ⋯ PROSPERO ( CRD42023440949 ); first submitted 4 September 2023.
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Randomized Controlled Trial Comparative Study
Cervical spine motion during videolaryngoscopic intubation using a Macintosh-style blade with and without the anterior piece of a cervical collar: a randomized controlled trial.
Applying a cervical collar during videolaryngoscopic intubation can increase the lifting force required to achieve adequate glottic view, potentially increasing cervical spine motion. We aimed to compared cervical spine motion during videolaryngoscopic intubation between applying only the posterior piece (posterior-only group) and applying both the anterior and posterior pieces (anterior-posterior group) in patients wearing a cervical collar. ⋯ CRIS.nih.go.kr ( KCT0008151 ); first submitted 17 January 2023.
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Review Meta Analysis Comparative Study
The impact of spinal versus general anesthesia on the variability of surgical times: a systematic review and meta-analysis.
With spinal anesthesia, when cases are taking longer than usual, there may be behavioural tendencies for surgical teams to work more quickly. We conducted a systematic review with meta-analysis to examine standard deviations of surgical times for single-dose spinal anesthetics versus general anesthesia. We compared ratios of mean surgical times as a secondary endpoint. ⋯ PROSPERO ( CRD42023461952 ); first submitted 8 September 2023.
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This Continuing Professional Development module aims to help the general anesthesiologist recognize common pitfalls in ambulatory pediatric adenotonsillectomy and perform appropriate risk stratification, analgesic management, and disposition planning. ⋯ Ambulatory pediatric adenotonsillectomy is a common surgical procedure, performed both in the community as well as tertiary care pediatric centres. To optimize outcomes in this heterogenous patient population, anesthesiologists must risk stratify and anticipate perioperative respiratory adverse events.
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Pragmatic Clinical Trial
Starting a surgical prehabilitation program: results from a pragmatic nonrandomized feasibility study.
We sought to assess the feasibility and estimate the effects on outcomes of a multimodal prehabilitation service implemented as an ancillary surgical service. ⋯ Multimodal surgical prehabilitation is feasible as an integrated clinical service and may be effective for improving physical and psychological outcomes. Further evaluations of clinically integrated prehabilitation programs in Canada are needed to confirm these findings.