Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Randomized Controlled Trial Comparative Study Clinical Trial
Gastric air tonometry during laparoscopic cholecystectomy: a comparison of two PaCO2 levels.
Pneumoperitoneum can cause disturbances in acid-base balance and splanchnic perfusion. We studied the effect of ventilation on acid-base balance and gastric mucosal tonometric values in patients undergoing laparoscopic cholecystectomy. ⋯ Despite inter-group differences in arterial and tonometric PCO2 and pH values during CO2 pneumoperitoneum, the patients did not develop splanchnic hypoperfusion detectable by air tonometric method, as indicated by normal PCO2 gap in both groups throughout the study.
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To examine the current role of anesthesiologists in Canadian undergraduate medical education (UME). ⋯ A very small proportion of faculty anesthesiologists participate in Canadian UME at the pre-clerkship level. Considerable variation exists in the amount and format of teaching by anesthesiologists among the Canadian undergraduate curricula, particularly at the pre-clerkship level. However, our results indicate that anesthesiologists are assuming a more important teaching role during clerkship. Our findings may suggest that Canadian medical schools are overlooking the advantages that anesthesiologists offer to UME at the pre-clerkship level, or that many anesthesiologists are reluctant to assume pre-clerkship teaching responsibilities.
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The objectives of this study were to determine: 1) if anesthesiologists had experienced a medication error and 2) to identify causal factors. The perceived value of a Canadian reporting agency for medication errors and improved standards for labels on drug ampoules was also investigated. ⋯ Most anesthesiologists experienced at least one drug error. The commonest error was a "syringe swap" that involved a muscle relaxant. Most errors were of minor consequence, however, serious morbidity and mortality resulted from clearly preventable events. These results support the development of improved standards for drug labels and the establishment of a Canadian reporting program for medication errors.
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Case Reports Clinical Trial
Bilateral paravertebral block: a satisfactory alternative for labour analgesia.
To describe a new technique of paravertebral block for labour analgesia and to report the successful use of bilateral paravertebral block in four parturients with contraindications to conventional labour epidural analgesia. ⋯ Bilateral paravertebral block provides adequate analgesia for the first stage of labour and could be an alternative analgesic technique for some parturients with contraindications to conventional labour epidurals.
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The evaluation of services by patients is an essential component of continuous quality improvement in anesthesiology. Little is known, however, about how to achieve this objective. Our goal was to conduct a systematic review of all available studies on patient satisfaction with anesthesia services, thereby ascertaining the present level of knowledge in this field and suggesting ways of improving current measurement methodologies. ⋯ The currently available studies of patient satisfaction are of questionable value. Only rigorous methods and reliable instruments will yield valid and clinically relevant findings of this important issue in anesthesiology.