Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Postamputation pain is challenging because of complex mechanisms involving a multitude of pain pathways and psychological factors. This patient population also tends to have extensive comorbidities with or without a background of chronic pain. Electrical neuromodulation such as peripheral nerve stimulation has gained traction in the realm of chronic pain. Recently, the off-label use of hybrid perineural nerve stimulation in combination with locoregional block via the stimulating nerve block catheter has been described in single-center case reports. ⋯ Our case series supports the feasibility of using a combination of low-frequency perineural stimulation and local anesthetic infusion via a single perineural nerve block catheter to manage challenging postamputation pain.
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This study was performed to evaluate trends in and provide future direction for anesthesiology education, research, and clinical practice. ⋯ The current study provides a historical view of high-impact papers in anesthesiology in the past ten years. High-impact papers were mostly from the USA. Postoperative analgesia, chronic pain, and perioperative complications have been hot topics, and COVID-19 became a new topic in 2020. These findings provide references for education, research, and clinical practice in the field of anesthesiology.
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Observational Study
Minimum protamine dose required to neutralize heparin in cardiac surgery: a single-centre, prospective, observational cohort study.
Excess protamine contributes to coagulopathy following cardiopulmonary bypass (CPB) and may increase blood loss and transfusion requirements. The primary aim of this study was to find the least amount of protamine necessary to neutralize residual heparin following CPB using the gold standard assays of anti-IIa and anti-Xa activity. Secondary objectives were to evaluate whether the post-CPB activated clotting time could be used as a surrogate marker for quantifying heparin neutralization. ⋯ ClinicalTrials.gov (NCT03787641); registered 26 December 2018.