Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Case Reports
Ultrasound-guided suprascapular nerve block: a correlation with fluoroscopic and cadaveric findings.
Previous work on the ultrasound-guided injection technique and the sonoanatomy of the suprascapular region relevant to the suprascapular nerve (SSN) block suggested that the ultrasound scan showed the presence of the suprascapular notch and transverse ligament. The intended target of the ultrasound-guided injection was the notch. The objective of this case report and the subsequent cadaver dissection findings is to reassess the interpretation of the ultrasound images when locating structures for SSN block. ⋯ Our fluoroscopic and cadaver dissection findings both suggest that the ultrasound image of the SSN block shown by the well-described technique is actually targeting the nerve on the floor of the suprascapular spine between the suprascapular and spinoglenoid notches rather than the suprascapular notch itself. The structure previously identified as the transverse ligament is actually the fascia layer of the supraspinatus muscle.
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Randomized Controlled Trial Comparative Study
Ketamine, but not priming, improves intubating conditions during a propofol-rocuronium induction.
Both ketamine and priming may shorten the onset time of rocuronium. This study investigates the effects of ketamine and priming as components of a propofol induction on intubating conditions and onset of neuromuscular block. ⋯ A low-dose ketamine used with a propofol-rocuronium induction improved intubating conditions and shortened onset time. Priming did not influence intubating conditions or onset time.
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Ultrasound assessment of the lumbar spine to facilitate neuraxial anesthesia has recently received much attention. The transfer of knowledge pertaining to this skill has never been studied. The purpose of this study was to determine the amount of teaching needed to achieve competence in spinal ultrasound. ⋯ Under the study conditions, 20 supervised trials plus teaching sessions were not enough for the participants to achieve competence in different aspects of ultrasound assessment of the lumbar spine. These results may well be considered when planning teaching sessions and workshops in the future.
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Routine preoperative electrocardiogram and chest x-ray prior to elective surgery in Alberta, Canada.
A study was undertaken to evaluate the utilization rates of routine preoperative electrocardiogram (ECG) and chest x-ray (CXR) by sex, age, and most frequent surgery type, and to estimate the total cost of these screening tests. ⋯ Routine preoperative testing rates and costs are relatively low in Alberta. It is possible that general evidence widely disseminated over the past number of years regarding unnecessary routines in preoperative testing has had an effect. Further interventions to reduce them would be of little value.