Canadian journal of anaesthesia = Journal canadien d'anesthésie
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We aimed to describe the ethical issues encountered by health care workers during the first COVID-19 outbreak in French intensive care units (ICUs), and the factors associated with their emergence. ⋯ Eight out of ten responding French ICU health care workers experienced ethical issues during the first COVID-19 outbreak. Identifying these issues is a first step towards anticipating and managing such issues, particularly in the context of potential future health crises.
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Case Reports
Perioperative cortical hand stroke syndrome mimicking peripheral neuropathy: a case report.
Timely diagnosis of perioperative stroke is challenging, and therapeutic interventions are infrequently offered. The cortical hand syndrome is a rare stroke presentation that results from infarction of the precentral gyrus leading to variable neurologic deficits mimicking peripheral nerve injuries, with no prior reports in the perioperative setting. To raise awareness of this complication among anesthesiologists, we present a case of cortical hand syndrome in a surgical patient initially suspected to have a peripheral neuropathy. ⋯ Cortical hand stroke syndrome is a rare presentation of perioperative stroke that may be misdiagnosed as a peripheral neuropathy. Our case presentation highlights that perioperative stroke should be considered for patients presenting with neurologic deficits of the hand, particularly those with deficits in multiple peripheral nerve territories and stroke risk factors.
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Review Meta Analysis
Landiolol for the prevention of postoperative atrial fibrillation after cardiac surgery: a systematic review and meta-analysis.
Postoperative atrial fibrillation (POAF) is a common complication following cardiac surgery. Although the evidence suggests that beta blockers prevent POAF, they often cause hypotension. Landiolol, an ultra-short-acting β1 blocker, may prevent POAF, without adverse hemodynamic consequences. ⋯ PROSPERO (CRD42021262703); registered 25 July 2021.
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Myocardial injury after noncardiac surgery is common and mostly asymptomatic. The ideal target population that will benefit from routine troponin measurements in low and middle income countries (LMICs) is unclear. This study aims to evaluate the clinical outcomes of a cohort of high-risk surgical patients according to high-sensitivity troponin T (hsTnT) in an LMIC setting. ⋯ ClinicalTrials.gov (NCT04187664); first submitted 5 December 2019.
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Pain catastrophizing (PC) is the tendency to magnify the threat value of pain sensations and is associated with greater postsurgical pain intensity, functional disability, and pain chronicity. Higher parental PC predicts higher chronic postsurgical pain in youth. Treating PC in caregivers and youth prior to surgery may improve recovery and surgical outcomes. We developed and evaluated a psychoeducational workshop addressing PC for presurgical youth and their parents/caregivers. We hypothesized that parent/caregiver and youth PC scores would decrease over time. We also explored preintervention levels of youth anxiety and depression as moderators of outcome. ⋯ Our results provide proof-of-concept support for a virtual SSI targeting caregivers and youth PC during the perioperative period. The present findings highlight the possible need to screen presurgical candidates for symptoms of anxiety. Replication with larger and more diverse samples, and a more robust design are warranted.