Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Determining epidural catheter placement and accurately depositing corticosteroids at the site of the pathology in adults with chronic back pain can be challenging. Fluoroscopy is considered the standard of care for guiding epidural catheter positioning and subsequent injection in patients receiving epidural corticosteroids, but the technique has some limitations. We hypothesized that electrophysiological stimulation using the Tsui test is feasible for determining the appropriate epidural catheter position in adults with chronic back pain receiving epidural corticosteroids. ⋯ This study demonstrated that electrophysiological stimulation using the Tsui technique is feasible for epidural catheter positioning in adults with chronic back pain. It may optimize epidural steroid injection in this population.
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Few interventions have been proven to improve outcomes in neurocritical care patients. It is unknown whether outcomes in Canada have changed over time. We performed a cohort study in Southern Alberta to determine whether survival and discharge disposition have improved. ⋯ Mortality and discharge disposition of neurocritical care patients in Southern Alberta have improved over time. Practice modifications in the region were associated with positive outcome trends. Longer ICU length of stay may imply that intensivists are increasingly delaying decisions about withdrawing life-sustaining interventions.