Canadian journal of anaesthesia = Journal canadien d'anesthésie
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In recent studies on ultrasound-guided infraclavicular block (ICB), the authors have favoured a single injection posterior to the axillary artery rather than multiple injections; however, procedural complications and success rates associated with single-injection ultrasound-guided ICB are not well known. We undertook an observational study to evaluate the success rates of experienced and non-experienced operators performing ICBs and to identify the complications associated with ultrasound-guided single-injection ICB. ⋯ We observed few complications associated with a single-injection ultrasound-guided ICB and a high success rate regardless of the operator's expertise. The technique appears to be reliable, easy to perform, and safe.
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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.
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Postdural puncture headache is a well-known complication of neuraxial anesthesia in childbirth. There are, however, many other causes of postpartum headache, some of which may present like postdural puncture headache and confuse the diagnosis. We report a case of postpartum headache due to pseudomeningocele. ⋯ This case highlights the importance of maintaining a wide differential in the workup of postpartum headache after regional anesthesia, particularly in cases refractory to blood patch. This case also reveals a T7 pseudomeningocele causing spontaneous intracranial hypotension that otherwise may not have been detected and corrected.