Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Randomized Controlled Trial
The use of an online three-dimensional model improves performance in ultrasound scanning of the spine: a randomized trial.
The use of ultrasound for neuraxial blockade is a new application of technology that is rapidly becoming accepted as a standard of care. This new skill has shown to improve success, but it is a challenge to teach. To assist with teaching the use of ultrasound in regional anesthesia of the lumbar spine, we have developed an interactive educational model ( http://pie.med.utoronto.ca/vspine or http://www.usra.ca/vspine.php ). In this study, we aimed to determine whether use of this model for a two-week period would improve the performance of novice operators in determining defined landmarks during real-time ultrasound imaging of the lumbar spine. ⋯ Our results show superior performance by the residents who had access to both components of the module, indicating that access to the interactive ultrasound spine module improves knowledge and skills prior to clinical care.
-
Randomized Controlled Trial Comparative Study
Comparison of the Truview PCD™ and the GlideScope(®) video laryngoscopes with direct laryngoscopy in pediatric patients: a randomized trial.
The GlideScope(®) video laryngoscope has a 60° angled blade and the blade of the Truview PCD™ video laryngoscope has an optical lens that provides a 46° refraction of the viewing angle. Despite successful results using the GlideScope in adults, few studies have been published regarding its use in pediatric patients. We therefore tested our joint primary hypothesis that the GlideScope and the Truview PCD video laryngoscopes provide superior visualization to direct laryngoscopy and are non-inferior regarding time to intubation. ⋯ The Cormack-Lehane views attained using the GlideScope and the Truview PCD video laryngoscopes were not superior to views attained using direct laryngoscopy. Visualization with the GlideScope was significantly worse than with direct laryngoscopy. Use of the GlideScope and Truview PCD systems should be restricted to patients with specific indications.
-
The "hybrid procedure" is an alternative surgical palliation strategy for single ventricle congenital heart disease. The purported benefit is improved cognitive ability secondary to avoidance of cardiopulmonary bypass in the neonatal period when neuronal apoptosis is greater. It is unknown whether survival is improved after this procedure. Intraoperative hypotension is common in these patients, and we hypothesized that this hypotension was associated with mortality or morbidity. ⋯ In this patient cohort, we can show an association between short periods of intraoperative hypotension and mortality or return to the ICU on ECMO, but the importance of this is not certain.