Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Review Meta Analysis Comparative Study
Transversus abdominis plane block for analgesia after Cesarean delivery: a systematic review and meta-analysis.
In patients not receiving intrathecal morphine, TAP block after caesarean section reduced opioid use at 6, 12 and 24 hours, along with nausea at 12h.
pearl -
Preoperative cognitive impairment is associated with the development of postoperative delirium, a common and consequential complication of major surgery in older patients. Screening for cognitive impairment should become a routine part of the preoperative evaluation of older patients; however, its implementation is hampered by limited clinical time and resources. The objective of this review was to identify cognitive screening tools that could be easily incorporated into the evaluation of older patients before major surgery. ⋯ Incorporating a cognitive screening assessment into the preoperative evaluation of older patients is feasible. More research is needed to validate cognitive screening tools in the perioperative setting.
-
The aim of this brief review is to provide an update on the theory regarding minimal fresh gas flow techniques for inhaled general anesthesia. The article also includes an update and discussion of the practical aspects associated with minimal-flow anesthesia, including the advantages, potential limitations, and safety considerations of this important anesthetic technique. ⋯ With our modern anesthesia machines, reducing the fresh gas flow of oxygen to 0.3-0.5 L·min(-1) and using third-generation inhaled anesthetics provide a reassuringly safe anesthetic technique. This environmentally friendly practice can easily be implemented for elective anesthesia; furthermore, it will facilitate cost savings and improve temperature homeostasis.
-
This article is a narrative review regarding the usage and effectiveness of introducers or catheters to facilitate tracheal intubation through a supraglottic airway (SGA) as an alternative intubation technique in normal and difficult airway management. ⋯ In failed intubation scenarios, supraglottic airways, such as the LMA Classic™ or LMA ProSeal™ can serve as a conduit for tracheal intubation. A number of techniques using introducers or catheters can facilitate the insertion of an adequately sized endotracheal tube, particularly guided by a bronchoscope. Usage of introducers or catheters through a supraglottic airway may be a useful alternative intubation technique in difficult airway management.
-
Review
Neuraxial anesthesia and bladder dysfunction in the perioperative period: a systematic review.
Urinary retention requiring catheterization carries the risk of infection. Neuraxial anesthesia causes transient impairment of bladder function ranging from delayed initiation of micturition to frank urinary retention. We undertook a review of the literature to determine the elements of neuraxial anesthesia and analgesia that prolong bladder dysfunction and increase the incidence of urinary retention. ⋯ Neuraxial anesthesia/analgesia results in transient detrusor dysfunction. The duration of dysfunction depends on the potency and dose of medication used; however, it does not appear to result in significant morbidity.