Canadian journal of anaesthesia = Journal canadien d'anesthésie
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Community hospitals account for 90% of hospitals in Canada, but clinical research is mainly conducted in academic hospitals. Increasing community hospital research participation can improve generalizability of study results, while also accelerating study recruitment and increasing staff engagement. We aimed to identify and describe the factors that influence community intensive care unit (ICU) research participation and the development, implementation, and sustainability of a community ICU research program. ⋯ In this qualitative descriptive study, participants identified the physical resources, skills, and relationships required to start and sustain a clinical research program in a Canadian community ICU. Our findings suggest that all levels of the Canadian health care system need to invest in strengthening community hospital research capacity to increase research participation.
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Same-day mobilization and early hospital discharge is increasingly emphasized following hip and knee arthroplasty. One challenge of spinal anesthesia in this setting is achieving adequate block height while avoiding excessively large local anesthetic doses and prolonged motor and sensory blockade. Using a hypobaric local anesthetic solution is one potential strategy, as its intrathecal distribution can be reliably manipulated by patient positioning to achieve adequate block height independent of dose. ⋯ The anesthetic profiles of low-dose hypobaric mepivacaine and bupivacaine were favorable for fast-track hip and knee arthroplasty with short and predictable operating times.
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Intraoperative facial nerve monitoring (IFNM) facilitates effective nerve preservation during ear and head and neck surgeries. Quantitative differences in the timely feasibility of IFNM during total intravenous anesthesia (TIVA) vs sevoflurane anesthesia have not been investigated. ⋯ CRIS.nih.go.kr ( KCT0006676 ); first submitted 7 October 2021.