Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Acute pain management services (APMS) evolved in response to the desire for improved management of postoperative pain. The management of postoperative pain received formal support from international organizations over the past decade and by 1993 half of the Canadian university-affiliated teaching hospitals had implemented an APMS. The purpose of this survey was to describe APMSs in Canadian academic institutions, with specific emphasis on postoperative analgesics, new analgesic methods, training and research. ⋯ Since the early 1990s the percent of Canadian academic hospitals with an APMS has increased from 53% to 92%. These figures are comparable to the United States. Greater collaboration from nursing and pharmacy, mandatory training for medical and nursing students and residents, and a standardized approach to continuous quality improvement remain necessary.
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Randomized Controlled Trial Clinical Trial
Best evidence in critical care medicine: Treatment: Adrenal replacement therapy improves survival in patients with septic shock.
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Desflurane, a newer inhalation anesthetic agent, has been promoted as a superior drug because patients will awaken sooner after anesthesia. This has only been proven in operations of long duration (i.e., more than one hour). We assessed our experience using desflurane in short out-patient surgery with a retrospective analysis of a single surgeon's elective laparoscopic cholecystectomy patients. ⋯ Our results show that in short procedures the use of desflurane does not necessarily result in faster patient recovery or discharge from the PACU.
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Editorial Comment
Anesthesiology, the birth of pharmacogenetics and Werner Kalow.