Canadian journal of anaesthesia = Journal canadien d'anesthésie
-
Perioperative medicine is emerging as a unique area of medical practice. Anesthesiology graduates are particularly well suited for this role given their training. The purpose of this systematic review is to summarize the various fellowships being offered in perioperative medicine and the scope of clinical perioperative practice that currently exists. The common areas of competency covered in these perioperative medicine fellowships are also identified. ⋯ There is a paucity of published literature on what perioperative care entails as well as what perioperative fellowship curricula should include. While we suggest certain areas of focus to include, the subspecialty of perioperative medicine would benefit from a cohesive and consensus-based curriculum to which academic fellowships could adhere.
-
Comparative Study
Neuraxial anesthesia improves long-term survival after total joint replacement: a retrospective nationwide population-based study in Taiwan.
This study explored the effects of general (GA) and neuraxial (NA) anesthesia on the outcomes of primary total joint replacement (TJR) in terms of postoperative mortality, length of stay (LOS), and hospital treatment costs. ⋯ Our results support the use of NA for primary TJR. The improvements in hospital costs persist even when anesthesia costs are removed. The mechanism underlying the association between NA and long-term survival is unknown.
-
Due to its anatomical complexity, a tracheal bronchus has important clinical implications for one-lung ventilation (OLV). We present a case of successful OLV in a patient with a high a type I (i.e., high take-off) tracheal bronchus. This anomaly presented unusual fibreoptic bronchoscopic (FOB) views that were difficult to discern from the normal carinal bifurcation. ⋯ Careful preoperative assessment of tracheobronchial anatomy is imperative in order to choose an appropriate method of OLV and prevent potential complications. In a type I tracheal bronchus with a narrowed distal trachea, a bronchial blocker may have advantages over the conventional DLT in achieving OLV.
-
Comment Letter
We should do more to train anesthesia technicians in Africa.