Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Review Comparative Study
Efficacy of supplemental peripheral nerve blockade for hip fracture surgery: multiple treatment comparison.
This study was designed to determine the most effective peripheral nerve block supplement to standard anesthesia management for hip fracture patients. ⋯ Not all nerve blocks are equally effective in improving outcomes after hip fracture. Multiple treatment comparison, a tool to compare the effectiveness of multiple treatments simultaneously, provides useful guidance to anesthesia providers seeking effective treatment when faced with a body of RCTs wherein each investigates one treatment. More RCTs comparing multiple nerve blocks in hip fracture are needed.
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We report the presentation and management of rhabdomyolysis involving shoulder girdle and upper arm muscles in a morbidly obese patient after prolonged laparoscopic surgery. ⋯ Morbidly obese patients who undergo prolonged surgery are at risk for rhabdomyolysis, and early diagnosis and therapy are required to prevent severe complications.
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Our objective was to develop and evaluate a Generic Integrated Objective Structured Assessment Tool (GIOSAT) to integrate Medical Expert and intrinsic (non-medical expert) CanMEDS competencies with non-technical skills for crisis simulation. ⋯ Inter-rater reliability of the total GIOSAT scores using four trained raters was substantial. Significant correlation between PGY and (i) total GIOSAT score and (ii) Medical Expert competencies supports construct validity. Evidence of validity was not obtained for intrinsic CanMEDS competencies.
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The purpose of this module is to review the main ultrasound-guided approaches used for regional anesthesia of the upper limb. ⋯ Upper limb regional anesthesia has gained in popularity because of its effectiveness and the safety profile associated with ultrasound-guided techniques.
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The objective of this study was to assess if an increase in electrical impedance was associated with intraneural (sub-epineural) needle tip placement. ⋯ A > 4.3% increase in electrical impedance may indicate accidental nerve puncture during peripheral nerve block.