Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Meta Analysis
Postoperative recovery after anesthesia in morbidly obese patients: a systematic review and meta-analysis of randomized controlled trials.
Obese patients present a challenge to safe general anesthesia because of impaired cardiopulmonary physiology and increased risks of aspiration and acute upper airway obstruction. Since studies are lacking regarding the postoperative effects on recovery from general anesthesia in morbidly obese patients, we conducted a systematic review and meta-analysis of recovery outcomes in morbidly obese patients who had undergone general anesthesia. ⋯ Postoperative recovery was significantly faster after desflurane than after sevoflurane, isoflurane, or propofol anesthesia in obese patients. No clinically relevant differences were observed regarding PACU discharge time, incidence of PONV, or postoperative pain scores. The systematic review was registered with PROSPERO (CRD42014009480).
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Vertebral hemangiomas are benign vascular tumours of the bony spine which are usually asymptomatic. Pregnancy-related anatomical and hormonal changes may lead to expansion of hemangiomas and development of neurological symptoms. We present an unusual case of vertebral fracture due to an undiagnosed hemangioma presenting as postpartum back pain following epidural analgesia. ⋯ Vertebral fractures secondary to acute expansion of a vertebral hemangioma rarely occur during vaginal delivery. In such cases, the labour epidural technique and analgesia may challenge the physician in making the diagnosis. Postpartum severe back pain should be thoroughly investigated even in the absence of neurological deficits, and osseous spinal pathology should be considered in the differential diagnosis.
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Retraction Of Publication
Retraction Note to: Nicorandil accelerates recovery of neuromuscular block caused by vecuronium.
Retraction Note to: Can J Anesth 2001; 1: 28–33, DOI 10.1007/BF03019810. To our readers: Further to the Expression of Concern (http://www.springer.com/medicine/anesthesiology/journal/12630) posted online, it is with considerable regret that the Canadian Journal of Anesthesia hereby retracts the above-cited article by Dr. ⋯ Fujii in this study are exceedingly unlikely; and 2) the inability of Dr. Fujii’s institution to attest to the integrity of the study and/ or the data conducted under its auspices, as set out in the Joint Editors-in-Chief Request for Determination of April 9, 2012.
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Randomized Controlled Trial
Effect of superficial cervical plexus block on postoperative quality of recovery after anterior cervical discectomy and fusion: a randomized controlled trial.
Spine surgeries are increasingly being performed as a day or short-stay surgery programs. Peripheral nerve block provide site-specific pain relief with few side effects, thereby reducing surgical stress and enhancing quality of recovery. The aim of our study was to determine the effect of a superficial cervical plexus block (SCPB) on postoperative quality of recovery and analgesia in patients undergoing elective anterior cervical discectomy and fusion (ACDF). ⋯ We showed that preoperative SCPB is an effective strategy for improving the early quality of recovery in patients undergoing single- or two-level ACDF. Nevertheless, there was no impact on opioid consumption or discharge times. This trial was registered at www.clinicaltrials.gov (NCT01662219).
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Emergency rescue plans for acute complications during transcatheter aortic valve implantation (TAVI) commonly include cardiopulmonary resuscitation, femoro-femoral cardiopulmonary bypass (CPB), and hemodynamic stabilization before definitive intervention is achieved. Nevertheless, most cases of emergency resuscitation remain chaotic and disorganized and often take longer than necessary, even in experienced centres. We sought to determine which factors and procedures may be associated with improved patient outcomes when emergencies arise during TAVI. ⋯ A well-organized regularly-rehearsed emergency rescue plan that preassigns resuscitative roles may shorten the duration of patient instability and resuscitation and improve patient outcomes when catastrophe occurs in TAVI. The anesthesia team plays a central role in preventing, detecting, and treating intraprocedural complications during TAVI.