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Published
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Volume-Issue
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Title
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Total: 47 |
11/2009 |
8-3 |
Reversal of neuromuscular blockade: current practice and future directions
BY FRANÇOIS DONATI, MD
Almost thirty years ago, residual paralysis was convincingly documented in a disconcerting
proportion of patients (30%), despite an almost systematic use of anticholinesterase agents.1 Since that time, even with the development of shorter-acting neuromuscular blockers, as well as pharmacological reversal and the more widespread use of nerve stimulation, residual paralysis is still a problem.
CME questionnaire available
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10/2009 |
8-2 |
Perioperative Management of
Patients with Coronary Artery Stents
MARIE-CHRISTINE ROSS-HUOT, MD, JOSE ARAGON, MD, AND DAVID BRACCO, MD
In the United states, approximately 2000 cardiology catheterization laboratories perform an average of one million stent procedures per year with 1.5 stents per patient. The volume of stent placements increase by 5% to 8% each year. Today stents can be deployed in native coronaries, in saphenous vein grafts, or in
internal mammary grafts.
CME questionnaire available
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03/2009 |
8-1 |
Heparin-induced thrombocytopenia: A complex clinical and laboratory paradox requiring multidisciplinary management
By ISMAIL ELALAMY, MD, PhD
For over fifty years, heparins, the true standard in antithrombotic prophylaxis and treatment, have been widely used in clinical practice. However, heparin therapy is associated with 2 types of thrombocytopenia that are described as: heparin-associated thrombocytopenia types I and II.
CME questionnaire available
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10/2008 |
7-4 |
Intravenous Lidocaine for Postoperative
Recovery After Major Abdominal Surgery
By MATHIEU SÉRIE, MD
Over the past few years, the concept of fast-track recovery in gastrointestinal (GI) surgery has gained momentum; the objectives are to improve patient comfort, decrease postoperative mortality, shorten hospital stay, and reduce financial costs.
CME questionnaire available
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08/2008 |
7-3 |
Airway Management in the Patient with Cervical Spine Instability
By ARNAUD ROBITAILLE, MD
Securing the airway of a patient with a potentially unstable cervical spine (C-spine) is a complex and challenging task. To perform this both safely and efficiently, the anesthesiologist should know C-spine anatomy, biomechanics, and the assessment of stability both clinically and radiologically.
CME questionnaire available
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05/2008 |
7-2 |
Cerebral Oximetry Monitoring in Anesthesiology
By ANDRÉ DENAULT, MD, FRCPC, ALAIN DESCHAMPS, MD, PHD, FRCPC, and JOHN MURKIN, MD, FRCPC
Cerebral oximetry is a neurological monitoring modality that was developed in the 1970s for adult and pediatric cardiac surgery; today, this type of monitoring is also applied to noncardiac surgery, cardiology, resuscitation, trauma, neurology, and neurosurgery. The technology is similar to that of pulse oximetry, but it is applied to the brain and indicates a saturation number that reflects mainly venous blood.
CME questionnaire available
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01/2008 |
7-1 |
Perioperative Cardiovascular Risk Evaluation and Care for Noncardiac Surgery – Part II
By MARIE-CLAUDE PARENT, MD, MSc, FRCPC and STÉPHANE RINFRET, MD, MSc, FRCPC
Systematic perioperative cardiovascular risk evaluation for noncardiac surgery is essential. Indeed, patients who undergo this type of surgery are at a substantial risk for cardiac events. Annually, 500,000 to 900,000 patients worldwide will experience a major perioperative cardiac complication, such as death, myocardial
infarction (MI) or nonfatal cardiac arrest.
CME questionnaire available
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12/2007 |
6-5 |
Perioperative Cardiovascular Risk Evaluation and Care for Noncardiac Surgery – Part I
By MARIE-CLAUDE PARENT, MD, MSc, FRCPC and STÉPHANE RINFRET, MD, MSc, FRCPC
Systematic perioperative cardiovascular risk evaluation for noncardiac surgery is essential. Indeed, patients who undergo this type of surgery are at a substantial risk for cardiac events. Annually, 500,000 to 900,000 patients worldwide will experience a major perioperative cardiac complication, such as death, myocardial infarction (MI) or nonfatal cardiac arrest.
CME questionnaire available
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11/2007 |
6-4 |
Postoperative Cognitive Dysfunction (POCD)
By GILBERT BLAISE, MD; RAME TAHA, MD; ANDand
A few decades ago, surgical procedures performed under anesthesia were considered very dangerous events due to the very high mortality and morbidity that followed. Today, perioperative mortality due to anesthesia has almost disappeared and, when it does occur, it is front-page news.
CME questionnaire available
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08/2007 |
6-3 |
Managing the Pain of Sickle Cell Anemia
By MARGARET HAIG, MD
The life expectancy of an individual with sickle cell disease (SCD) has increased dramatically in the last 30 years, from an average of 14 years in 1973 to a current estimate of about 50 years. Therefore, clinicians will be confronted with new management challenges from infrequently observed disease sequelae as the current cohort of SCD patients reaches adulthood.
CME questionnaire available
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06/2007 |
6-2 |
Analysis of heart rate and blood pressure
variability to assess autonomic reserves:
its role in anesthesiology
By ALAIN DESCHAMPS, MD and ANDRÉ DENAULT, MD
The discovery of general anesthesia was one of the most important advancements in medicine during the last century; however, this advancement came at a price. General anesthesia inhibits pain, but it also results in the inhibition of the autonomic nervous system (ANS), such that, in certain conditions it can be
life-threatening.
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05/2007 |
6-1 |
Thoracic surgery as a model for
postoperative acute and chronic pain
By CLÉMENT CHASSERY, MD
Pain after thoracotomy is considered particularly intense and prolonged, compared with other types of surgery.1 The pain is complex because it originates from many different stimuli; there is nociceptive excess carried by somatic and visceral fibres, and a major neuropathic component is added as in all postoperative pain.
CME questionnaire available
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12/2006 |
5-5 |
The use of muscle relaxants in patients with neuromuscular diseases
By LOUIS-PHILIPPE FORTIER, MD
Therapeutic choices concerning muscle relaxants used in patients with neuromuscular diseases (NMD) should not be regarded as just a curiosity during an oral exam, but rather a part of a clinicians efficient and synthesized knowledge.
CME questionnaire available
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12/2006 |
5-4 |
Analgesia for total knee arthroplasty
By ARNAUD CHAUMERON, MD
Total knee arthroplasty (TKA) is a surgery that provokes intense postoperative pain and requires specialized care. Delays in postoperative mobilization induce tissue retraction, adherences, and atrophy.2 As a result, the return to successful function after a TKA requires sufficient analgesia to allow early rehabilitation.
CME questionnaire available
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10/2006 |
5-3 |
Oxygenation before anesthesia
(preoxygenation) in adults
By Issam Tanoubi, MD
Preoxygenation has been a recognized technique since 1955. Its purpose is to increase the oxygen reserves in the body and thus prolong the safe period of apnea between induction of anesthesia and the moment the airway is secured.
CME questionnaire available
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05/2006 |
5-2 |
Muscle Relaxation for Induction in Patients with a Full Stomach
By FRANÇOIS DONATI, MD
When a patient is suspected of having a full stomach, specific considerations must be included when planning the induction of anesthesia. Vomiting and regurgitation, sometimes leading to pulmonary aspiration, may occur when a patient has depressed reflexes and an unprotected airway.
CME questionnaire available
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02/2006 |
5-1 |
Perioperative Antiplatelet Therapy:
A New Approach
By CHARLES-MARC SAMAMA, MD
Antiplatelet agents (APA) are familiar to anesthesiologists, but their perioperative management is a subject of controversy. The advent of drug-eluting coronary stents requiring extended antiplatelet therapy makes this issue more complicated. However, a number of simple recommendations can be made.
CME questionnaire available
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05/2005 |
4-5 |
Obstructive Sleep Apnea Syndrome (OSAS) in Children
BY KAREN A. BROWN, MD
Obstructive sleep apnea syndrome (OSAS) is a sleep-disordered pattern of breathing characterized by periodic, partial, or complete obstruction of the upper airway during sleep.
CME questionnaire available
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04/2005 |
4-4 |
Anesthesia and Hepatic Resection
BY ANDRÉE CHEVALIER, MD, FRCPC
The emergence of partial hepatectomy as a safe and effective treatment for both benign and malignant liver disease is relatively recent due to the high mortality rate traditionally associated with the surgery.
CME questionnaire available
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03/2005 |
4-3 |
Automated Implantable
Cardioverter Defibrillators
By SUSAN KAPRELIAN, MD; FRANCOIS HADDAD, MD; ANDRÉ DENAULT, MD; MARC DUBUC, MD; and PIERRE COUTURE, MD.
Automated implantable cardioverter defibrillators (ICDs) were introduced in the early 1980s after a report by Mirowski et al described the first successful defibrillation with an ICD in humans. Since then, multiple randomized clinical trials have proven the efficacy and superiority of ICD therapy for both the secondary and primary prevention of sudden cardiac death.
CME questionnaire available
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02/2005 |
4-2 |
Anesthetic Considerations in Non-AIDS HIV-Positive Patients
By MARTIN GIRARD, M.D.
Amid the proliferation of literature about acquired immunodeficiency syndrome (AIDS) patients, few authors have looked at the specific problem of anesthetic considerations in patients infected by the human immunodeficiency virus (HIV) who have not developed AIDS.
CME questionnaire available
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01/2005 |
4-1 |
Ultrasound-guided Brachial Plexus Anesthesia
By STEPHAN WILLIAMS, MD, FRCPC
Interest in regional anesthesia has waxed and waned since its introduction into clinical practice over a century ago. The elegance, safety, and comfort of a successful peripheral nerve block are undeniable.
CME questionnaire available
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12/2004 |
3-9 |
Cannabis (marijuana) and anesthesia
By HUU TRAM ANH NGUYEN, MD, FRCPC
Cannabis (marijuana) has been used for a long time. In 2700 BC, the use of cannabis for malaria, constipation, and the pain of rheumatism was described. In 1839, the analgesic, antispasmodic, and anti-inflammatory properties of cannabis as a medicinal substance were promoted.
CME questionnaire available
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10/2004 |
3-8 |
Physiology of Acute Isovolemic Anemia: Practical Concerns
By PHILIPPE VAN DER LINDEN MD, PhD (Guest Author)
The adequacy of a hemoglobin concentration in a given clinical situation depends on whether a sufficient amount of oxygen is carried to the tissues to meet metabolic requirements. Therefore, the decision to transfuse a given patient cannot be based only on the hemoglobin level.
CME questionnaire available
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09/2004 |
3-7 |
Anesthesia for off-pump coronary artery bypass graft (OPCABG) surgery: Experience at the Montreal Heart Institute
By PIERRE COUTURE, MD, ANDRÉ DENAULT, MD, ROBERT BLAIN, MD, PATRICK LIMOGES, MD, and RAYMOND CARTIER, MD
Since the recent development of effective devices for target vessel exposure and stabilization, off-pump coronary artery bypass graft (OPCABG) surgery has gained widespread use as an alternative to conventional on-pump CABG.
CME questionnaire available
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08/2004 |
3-6 |
Postoperative shivering
By JEAN-DENIS ROY, M.D.
Postanesthesia shivering was first described over fifty years ago. Although initially believed to be associated with hypothermia alone, postoperative shivering has since been observed on many occasions in normothermic patients.
CME questionnaire available
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06/2004 |
3-5 |
Cardioprotection with Anesthetic Agents:
Myth or Reality?
BY STEFAN G. DE HERT, MD, PHD
With the aging of the population, anesthesiologists are increasingly treating patients with ischemic heart disease. The presence or development of myocardial ischemia may be an important cause of perioperative complications.
CME questionnaire available
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04/2004 |
3-4 |
Neuromuscular Monitoring
Part 2: A Review and Update
THOMAS M HEMMERLING, MD, DEAA
All of the objective neuromuscular monitoring methods are based on monitoring an evoked response after different patterns of stimulation have been applied to a motor nerve.
CME questionnaire available
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03/2004 |
3-3 |
Neuromuscular Monitoring
Part 1: A Review and Update
THOMAS M HEMMERLING, MD, DEAA
Monitoring the action of neuromuscular blocking drugs is one of the essential components in the practice of anesthesiology.
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02/2004 |
3-2 |
Physiopathology and Clinical Management of Massive Transfusion and Hemostatic Dysfunction
JEAN-FRANÇOIS HARDY, MD, FRCPS and the members of the Groupe dIntérêt en Hémostase Périopératoire (GIHP)
Although the need for massive transfusions occurs relatively frequently in clinical practice, optimal management of hemorrhagic complications remains problematic.
CME questionnaire available
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01/2004 |
3-1 |
Opioid Dependence and Tolerance:
Important Clinical Issues?
DOMINIQUE DION, MD, MSC and MANON CHOINIÈRE, PhD
Have the risks of opioid dependence or tolerance following therapeutic exposure to these agents been overestimated or underestimated? Since contemporary literature provides no definitive answer to this question, further study is required to more accurately define the problems.
CME questionnaire available
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12/2003 |
2-10 |
Biochemical Terrorism: What the Anesthesiologist Should Know
MAJOR DANIEL AUDY, MD, FRCPS, B.SC. BIOCHEMISTRY, CD
Although the chances of a biological or chemical attack occurring in Canada are slim, the consequences of such an attack could be devastating.
CME questionnaire available
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11/2003 |
2-9 |
Pulmonary artery catheters: Do we still use them?
JEAN GÉLINAS MD, FRCPC
The pulmonary artery catheter (PAC) has long been considered an important component of medical therapy for critically ill patients and for patients undergoing major surgery.
CME questionnaire available
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10/2003 |
2-8 |
Patient-controlled analgesia (PCA): Additions or Alternatives to Morphine
FRANÇOIS FUGÈRE MD, FRCPC
Intravenous patient-controlled analgesia (PCA) is frequently used as a means of easing postoperative pain. Morphine is the most commonly used opiate, but some patients have allergies or experience side effects, requiring the use of alternatives.
CME questionnaire available
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08/2003 |
2-7 |
Transesophageal echocardiography in the ICU and during noncardiac surgery: Part 2
ANDRÉ DENAULT, MD, FRCPC and PIERRE COUTURE, MD, FRCPC
As presented in the previous issue of Anesthesiology Rounds, the indications for transesophageal echocardiography (TEE) fall into three categories.
CME questionnaire available
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07/2003 |
2-6 |
Transesophageal echocardiography in the ICU and during noncardiac surgery: Part 1
ANDRÉ DENAULT, MD, FRCPC, and PIERRE COUTURE, MD, FRCPC
Perioperative echocardiography primarily involves the use of transesophageal echocardiography (TEE), but also includes all echocardiographic techniques that play diagnostic, monitoring, and supportive roles for various medical and surgical procedures.
CME questionnaire available
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05/2003 |
2-5 |
The epidural test dose in obstetric anesthesia
NICOLE LESSARD MD, FRCPC
Complications related to anesthesia represent the 6th leading cause of pregnancy-related mortality. In 82% of cases, death occurs during a caesarean section.
CME questionnaire available
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04/2003 |
2-4 |
Intracranial Hypertension in the Perioperative Period
FRANÇOIS GIRARD, MD, FRCPC
Control of intracranial hypertension (ICHT) is crucial when treating patients with head trauma and treatment in these cases has already been extensively described in the literature.
CME questionnaire available
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03/2003 |
2-3 |
When to transfuse red cell concentrate perioperatively
SYLVAIN BÉLISLE, M.D., FRCPC
The anesthesiologist assumes an important role when administering a blood transfusion. The indication for transfusing packed red blood cells in the perioperative phase has been the subject of many published articles.
CME questionnaire available
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02/2003 |
2-2 |
Intrathecal opioids
YVES VEILLETTE, MD, FRCPC
Opioid receptors were identified in the central nervous system in 1971. Later, in 1977, these receptors were precisely localized in the posterior horn of the spinal cord.
CME questionnaire available
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01/2003 |
2-1 |
Preventing perioperative myocardial ischemia
TUDOR COSTACHESCU, MD, FRCPC
Perioperative myocardial ischemia is associated with significant morbidity and mortality. Underlying heart disease, the type of surgical procedure, and postoperative physiological stress all play a role in its physiopathology.
CME questionnaire available
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12/2002 |
1-6 |
Neuromuscular blocking agents and pregnancy
EMMANUEL NOUVELLON, MD
Up to 2% of pregnant women have surgery during their pregnancy. The anesthetic technique must take into account the physiological and anatomical changes associated with pregnancy and attempt to limit any disturbances in fetal- maternal homeostasis.
CME questionnaire available
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11/2002 |
1-5 |
Nonsteroidal anti-inflammatory drugs in postoperative pain management
PIERRE BEAULIEU MD, PhD, FRCA
Management of acute postoperative pain remains suboptimal; nearly 80% of patients report moderate to extreme pain following surgery.
CME questionnaire available
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10/2002 |
1-4 |
Ropivacaine and levobupivacaine: A review of the adult and nonobstetrical literature I remember
MICHEL GIRARD, MD, MHPE, FRCPC
Every comprehensive article on the use of ropivacaine or levobupivacaine includes a sentence about their lesser toxicity in relation to bupivacaine.
CME questionnaire available
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08/2002 |
1-3 |
Opiates and Rigidity
LOUIS-PHILIPPE FORTIER, MSC, MD, FRCPC
Potent synthetic opiates such as fentanyl, sufentanil, and alfentanil are used on a daily basis because they have little effect on hemodynamic stability in an aging population known for its cardiovascular comorbidity.
CME questionnaire available
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07/2002 |
1-2 |
Succinylcholine in modern anesthesia
FRANÇOIS DONATI, PHD, MD, FRCPC
Since entering the market over 50 years ago, succinylcholine has continued to fuel controversy, but its usefulness was never doubted.
CME questionnaire available
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05/2002 |
1-1 |
Antiplatelet agents and perioperative bleeding
JEAN-FRANÇOIS HARDY, MD, FRCPC
Intravascular thrombosis begins with an endothelial lesion, either spontaneous or mechanical that exposes the underlying subendothelium, provoking the adhesion of platelets.
CME questionnaire available
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Total: 47 |
