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1. Clinical relevance of transcranial Doppler in a cardiac surgery setting: embolic load predicts difficult separation from cardiopulmonary bypass

Author

Jarry, Stéphanie, primary, Couture, Etienne J., additional, Beaubien-Souligny, William, additional, Fernandes, Armindo, additional, Fortier, Annik, additional, Ben-Ali, Walid, additional, Desjardins, Georges, additional, Huard, Karel, additional, Mailhot, Tanya, additional, and Denault, André Y., additional

Published
2024
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2. Intrapandemic regional anesthesia as practice: a historical cohort study in patients undergoing breast cancer surgery

Author

Clairoux, Ariane, Soucy-Proulx, Maxim, Pretto, François, Courgeon, Victoria, Caron-Goudreau, Maxime, Issa, Rami, Bélanger, Marie-Ève, Brulotte, Véronique, Verdonck, Olivier, Idrissi, Moulay, Fortier, Annik, and Richebé, Philippe

Subjects
Pain, Postoperative, pandemic, COVID-19, Breast Neoplasms, General Medicine, Anesthesia, General, Reports of Original Investigations, Cohort Studies, Anesthesiology and Pain Medicine, breast cancer surgery, Anesthesia, Conduction, Recovery, Humans, Female, Pandemics, paravertebral block, Retrospective Studies
Abstract

The COVID-19 pandemic has markedly increased delays in oncologic surgeries because of the virus's impact on traditional anesthetic management. Novel protocols, developed to protect patients and medical professionals, have altered the ways and instances in which general anesthesia (GA) can be safely performed. To reduce virus exposure related to aerosol-generating procedures, it is now recommended to avoid GA when feasible and promote regional anesthesia instead. At our institution, we observed faster postoperative recovery in patients who received paravertebral blocks for breast cancer surgery instead of GA. This led us to formally evaluate whether regional anesthesia instead of GA helped improve time to hospital discharge.We conducted a historical cohort study to retrospectively analyze two cohorts of patients: prepandemic vs intrapandemic. We obtained approval from our institutional ethics committee to review files of consecutive patients who underwent breast cancer surgery between 30 March 2020 and 30 June 2020 (intrapandemic group; N = 106) and consecutive patients-moving backwards-from 28 February 2020 to 6 December 2019 (prepandemic group; N = 104). The primary outcome was the length of time between the end of surgery to readiness for hospital discharge. Secondary outcomes included the incidence of postoperative nausea and vomiting (PONV), the need for postoperative analgesia, and the duration of stay in the postanesthesia care unit (PACU).The median [interquartile range (IQR)] time to readiness for hospital discharge was significantly lower in patients who received paravertebral blocks for breast cancer surgery compared with GA (intrapandemic group, 119 [99-170] min vs prepandemic group, 191 [164-234] min; P0.001) as was the incidence of PONV (3% vs 11%; P = 0.03) and median [IQR] PACU durations of stay (29 [21-39] min vs 46 [37-63] min; P0.001).Patients who received paravertebral blocks for breast cancer surgery in the intrapandemic group were ready for hospital discharge earlier, spent less time in the PACU, and experienced less PONV than those who received GA in the prepandemic group. With growing surgical wait times, concerns related to aerosol-generating procedures, and recommendations to avoid GA when feasible, paravertebral blocks as the principal anesthetic modality for breast cancer surgery offered benefits for patients and medical teams.RéSUMé: CONTEXTE: La pandémie de COVID-19 a considérablement augmenté les retards dans les chirurgies oncologiques en raison de l’impact du virus sur la prise en charge anesthésique traditionnelle. De nouveaux protocoles, mis au point pour protéger les patients et les professionnels de la santé, ont modifié les façons et les cas dans lesquels une anesthésie générale (AG) peut être réalisée en toute sécurité. Afin de réduire l’exposition au virus liée aux interventions génératrices d’aérosols, il est maintenant recommandé d’éviter l’AG lorsque possible et de privilégier l’anesthésie régionale. Dans notre établissement, nous avons observé une récupération postopératoire plus rapide chez les patientes ayant reçu des blocs paravertébraux pour une chirurgie de cancer du sein au lieu d’une AG. Cela nous a menés à évaluer de façon formelle si l’anesthésie régionale au lieu de l’AG avait contribué à réduire les délais jusqu’au congé de l’hôpital. MéTHODE: Nous avons réalisé une étude de cohorte historique afin d’analyser rétrospectivement deux cohortes de patientes : prépandémie vs intrapandémie. Nous avons obtenu l’approbation de notre comité d’éthique institutionnel pour examiner les dossiers de patientes consécutives ayant bénéficié d’une chirurgie de cancer du sein entre le 30 mars 2020 et le 30 juin 2020 (groupe intrapandémie; n = 106) et des patientes consécutives – en reculant – du 28 février 2020 au 6 décembre 2019 (groupe prépandémie; n = 104). Le critère d’évaluation principal était le délai entre la fin de la chirurgie et le moment où les patientes étaient prêtes à recevoir leur congé de l’hôpital. Les critères d’évaluation secondaires comprenaient l’incidence de nausées et vomissements postopératoires (NVPO), la nécessité d’une analgésie postopératoire et la durée de séjour en salle de réveil (SDR). RéSULTATS: Le délai médian [écart interquartile (ÉIQ)] jusqu’à la disposition au congé de l’hôpital était significativement plus court chez les patientes ayant reçu des blocs paravertébraux pour une chirurgie de cancer du sein plutôt qu’une AG (groupe intrapandémie, 119 [99-170] min vs groupe prépandémie, 191 [164–234] min; P0,001), tout comme l’incidence de NVPO (3 % vs 11 %; P = 0,03) et les durées médianes [ÉIQ] de séjour en salle de réveil (29 [21–39] min vs 46 [37–63] min; P0,001). CONCLUSION: Les patientes qui ont reçu des blocs paravertébraux pour une chirurgie de cancer du sein dans le groupe intrapandémie étaient prêtes à quitter l’hôpital plus tôt, ont passé moins de temps en salle de réveil et ont ressenti moins de NVPO que celles qui ont reçu une AG dans le groupe prépandémie. Avec des temps d’attente pour accès à la chirurgie de plus en plus longs, des préoccupations liées aux interventions génératrices d’aérosols et les recommandations d’éviter l’AG lorsque possible, les blocs paravertébraux ont offert des avantages aux patientes et aux équipes médicales en tant que principale modalité anesthésique pour la chirurgie de cancer du sein.

Published
2022
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3. Correction: Intrapandemic regional anesthesia as practice: a historical cohort study in patients undergoing breast cancer surgery

Author

Clairoux, Ariane, primary, Soucy-Proulx, Maxim, additional, Pretto, François, additional, Courgeon, Victoria, additional, Caron-Goudreau, Maxime, additional, Issa, Rami, additional, Bélanger, Marie-Ève, additional, Brulotte, Véronique, additional, Verdonck, Olivier, additional, Idrissi, Moulay, additional, Fortier, Annik, additional, and Richebé, Philippe, additional

Published
2022
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5. Correction to: Intrapandemic regional anesthesia as practice: a historical cohort study in patients undergoing breast cancer surgery

Author

Clairoux, Ariane, primary, Soucy-Proulx, Maxim, additional, Pretto, François, additional, Courgeon, Victoria, additional, Caron-Goudreau, Maxime, additional, Issa, Rami, additional, Bélanger, Marie-Ève, additional, Brulotte, Véronique, additional, Verdonck, Olivier, additional, Idrissi, Moulay, additional, Fortier, Annik, additional, and Richebé, Philippe, additional

Published
2022
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7. A randomized controlled trial comparing nociception level (NOL) index, blood pressure, and heart rate responses to direct laryngoscopy versus videolaryngoscopy for intubation: the NOLint project

Author

Sbeghen, Virginie, primary, Verdonck, Olivier, additional, McDevitt, Jason, additional, Zaphiratos, Valérie, additional, Brulotte, Véronique, additional, Loubert, Christian, additional, Tanoubi, Issam, additional, Drolet, Pierre, additional, Belanger, Marie-Eve, additional, Fortier, Louis-Philippe, additional, Godin, Nadia, additional, Guertin, Marie-Claude, additional, Fortier, Annik, additional, and Richebé, Philippe, additional

Published
2021
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8. Impact of chronic treatment by β1-adrenergic antagonists on Nociceptive-Level (NOL) index variation after a standardized noxious stimulus under general anesthesia: a cohort study

Author

Bergeron, Catherine, primary, Brulotte, Véronique, additional, Pelen, Felix, additional, Clairoux, Ariane, additional, Bélanger, Marie-Eve, additional, Issa, Rami, additional, Urbanowicz, Robert, additional, Tanoubi, Issam, additional, Drolet, Pierre, additional, Fortier, Louis-Philippe, additional, Verdonck, Olivier, additional, Fortier, Annik, additional, Espitalier, Fabien, additional, and Richebé, Philippe, additional

Published
2021
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10. A multicentre randomized-controlled trial of inhaled milrinone in high-risk cardiac surgical patients

Author

Denault, André Y., primary, Bussières, Jean S., additional, Arellano, Ramiro, additional, Finegan, Barry, additional, Gavra, Paul, additional, Haddad, François, additional, Nguyen, Anne Q. N., additional, Varin, France, additional, Fortier, Annik, additional, Levesque, Sylvie, additional, Shi, Yanfen, additional, Elmi-Sarabi, Mahsa, additional, Tardif, Jean-Claude, additional, Perrault, Louis P., additional, and Lambert, Jean, additional

Published
2016
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12. Abstract

Author

Rasic, Nivez F., primary, Friesen, Robert M., additional, Anderson, Bruce, additional, Hoban, Shirley A., additional, Olson, Nancy, additional, Kress, Jacob, additional, Lévesque, Simon, additional, Lessard, Martin R., additional, Nicole, Pierre, additional, Langevin, Stéphan, additional, Langevin, Jacques, additional, LeBlanc, François, additional, Brochu, Jacques, additional, Turgeon, Alexis, additional, Nicole, Pierre C., additional, Trépanier, Claude A., additional, Marcoux, Sylvie, additional, Lash, Vynka C., additional, Anderson, Keith, additional, Asenjo, J. Francisco, additional, Carli, Francesco, additional, Engen, Dale A., additional, Morewood, Gordon H., additional, Ghazar, Nancy, additional, Ashbury, Ted, additional, VanDenKerkhof, Elizabeth G., additional, Wang, Louie, additional, Blight, Katherine R., additional, Mazer, C. David, additional, Hare, Gregory M. T., additional, Wang, Zhilan, additional, Coackley, Carla, additional, Qu, Rong, additional, Robb, Malcolm, additional, Stewart, Duncan J., additional, Schricker, Thomas, additional, Meterissian, Sarkis, additional, Lattermann, Ralph, additional, Carli, Franco, additional, Dupuis, Jean-Yves, additional, Wang, Feng, additional, Nathan, Howard, additional, Williams, Kathryn, additional, Robblee, James A., additional, Nathan, Howard J., additional, Ko, Raynauld, additional, Kruger, Marelise, additional, McRae, Karen, additional, Darling, Gail, additional, Waddell, Thomas, additional, Morrice, David, additional, McGlade, Desmond, additional, Cheung, Ken, additional, Katz, Joel, additional, Slinger, Peter, additional, Baker, Andrew J., additional, Hum, Kathryn M., additional, Kim, Steve Y., additional, Barr, Aiala, additional, Friedman, Zeev, additional, Wong, David T., additional, Chung, Frances, additional, Goldstein, David H., additional, Blaine, William C., additional, Rimmer, Michael J., additional, Kolman, Jacelyn M., additional, Hung, Orlando R., additional, Beauprie, Ian G., additional, Vandorpe, Robert, additional, Baker, Chandran J., additional, Rennie, William, additional, Brown, Robert, additional, Kenny, Susan, additional, Kamming, Damon, additional, McGrath, Brid, additional, Curti, Bruna, additional, King, Shirley, additional, Lau, Brenda W., additional, Ries, Craig R., additional, Schmid, Josie, additional, Kraima, Richard N., additional, Arai, Toshimi, additional, Yamashita, Masao, additional, Splinter, William, additional, Parekh, Uma R., additional, Valois-Gomez, Teresa, additional, Muir, John G., additional, Usher, Andrew G., additional, Kearney, Ramona A., additional, Tsui, Ban C. H., additional, Shende, D., additional, Darlong, V., additional, Asit, N., additional, Richards, Justin, additional, Van Aerde, John, additional, Wagner, Alese, additional, Cave, Dominic, additional, Kearney, Ramona, additional, Philips, Leeanne, additional, Reid, Kathy, additional, Chowdary, Khalid, additional, Brooks, Peter, additional, Ree, Ron, additional, Ansermino, Mark, additional, Rosen, David, additional, Manninen, Pirjo H., additional, Ghazaime, Ghazali, additional, Louissi, Soad, additional, Odukoya, Bisi, additional, Rodriguez, Rosendo A., additional, Parlea, Luciana, additional, Rubens, Fraser D., additional, Hendry, Paul, additional, Lee, Il-Ok, additional, Lee, In Ho, additional, Audu, Paul, additional, Mak, Peter H. K., additional, Manninen, Pirijo H., additional, Sundar, Shanti, additional, Schwarz, Stephan K. W., additional, Puil, Ernest, additional, Hybarger, Steven E., additional, Sloan, Tod B., additional, Brull, Richard, additional, McCartney, Colin J. L., additional, Rawson, Regan, additional, Abbas, Sherif, additional, Chan, Vincent W. S., additional, Ong, D., additional, Ha, D., additional, Ha, H., additional, McKay, W. P. S., additional, Kong, Myung-Hoon, additional, Lee, Mi-Kyung, additional, Lim, Sang-Ho, additional, Choi, Young-Seok, additional, Kim, Nan-Sook, additional, Lennox, P. H., additional, Umedaly, H. S., additional, Keogh, C. F., additional, Setton, D., additional, Grant, R. P., additional, Fitzmaurice, B. G., additional, Evans, K., additional, White, S. A., additional, Watt-Watson, Judy, additional, McGillion, Michael, additional, Daley, M. Denise, additional, Normanaf], Peter H., additional, Hogervorst, Sarah, additional, Kowalski, Alicia, additional, Arens, James, additional, Kennamer, Debra, additional, Curley, Steven, additional, Vauthey, Jean, additional, Finucaneaf], Brendan, additional, Beattie, W. Scott, additional, Choi, Peter, additional, Donais, Phillip E., additional, McKay, William P. S., additional, Banner, Robert, additional, Kennedy, Renee, additional, Konok, George, additional, Guglielmin, Darryl R., additional, King, Francis G., additional, Hwang, Kyungil, additional, Kim, Hoondo, additional, Lee, Sangho, additional, Cardinal, Valérie, additional, Martin, René, additional, Tétreault, Jean-Pierre, additional, Colas, Marie-José, additional, Gagnon, Linda, additional, Claprood, Yves, additional, Wykes, Linda, additional, Luo, Tao, additional, Xia, Zhengyuan, additional, Ansley, David M., additional, Ouyang, Jingping, additional, Xia, Zhong-Yuan, additional, Brousseau, Paul, additional, Dobson, Greg, additional, Lummis, Heather, additional, Arellano, Ramiro, additional, Steinberg, David, additional, Trigazis, Leo, additional, Devito, Isabella, additional, Downey, Kristi, additional, Minogue, Sean, additional, Ralph, James, additional, Lampa, Martin, additional, Roscoe, Andrew J., additional, Sawchuk, Corey W., additional, Fayad, Ashraf, additional, Healey, Jeff, additional, Crystal, Eugene, additional, Teoh, Kevin, additional, Lonn, Eva, additional, Carroll, Sandra, additional, Hohnloser, Stephan, additional, Connolly, Stuart, additional, Lavallee, Gilbert, additional, Rubens, Fraser, additional, Rodriguez, Carlos D., additional, Robitaille, Arnaud, additional, Denault, André Y., additional, Couture, Pierre, additional, Bélisle, Sylvain, additional, Fortier, Annik, additional, Guertin, Marie-Claude, additional, Carrier, Michel, additional, Martineau, Raymond, additional, Basran, Sukhjeewan, additional, Frumento, Robert, additional, O’Malley, Catherine, additional, Mongero, Linda, additional, Beck, James, additional, Bennett-Guerrero, Elliott, additional, Hemmerling, Thomas M., additional, Choinière, Jen-Luc, additional, Basile, Fadi, additional, Prieto, Ignatio, additional, Fortier, Joanne D., additional, MacAdams, Charles, additional, Fan, Lawrence, additional, Seal, Douglas, additional, Maier, Karen, additional, Kowalewski, Richard, additional, Tang, Tim, additional, Haigh, John, additional, Tofflemire, Karen, additional, Norris, James Q., additional, Howells, Steven, additional, Browne, Joseph, additional, Beney, Andrew, additional, Pynn, Todd, additional, Taylor, Steven, additional, Mong, Kam, additional, Djaiani, George, additional, Fedorko, Ludwik, additional, Carroll, Jo, additional, Ali, Mohamed, additional, Cheng, Davy, additional, Klein, Andrew, additional, Rakowski, Harry, additional, Woo, Anna, additional, Heinrich, Lee, additional, Mikulis, David, additional, Karski, Jacek, additional, Sia, Alex, additional, Chua, Sebastian, additional, Hong, Xi, additional, Gvozdic, Branka, additional, Morgan, Pamela J., additional, Tarshis, Jordan, additional, Macarthur, Alison J., additional, Brant, Rollin, additional, Pollard, Jeffrey, additional, Cook, Linda, additional, Yoon, Hea Jo, additional, Lee, Youn Woo, additional, Hong, Jeong-Yeon, additional, Kim, Soo Mie, additional, Parkhurst, Sherry, additional, Biehl, Diane, additional, Ong, Bill, additional, Brochuaf], Jacques, additional, Croft, Dary, additional, Ho, Anthony M. -H., additional, Lee, Tak Wai, additional, Karmakar, Manoj K., additional, Lam, Wynnie M., additional, Chung, David C., additional, Massicotte, Luc, additional, Wilkes, Peter R. H., additional, Legault, Stephan, additional, Gupta, Sanjiv, additional, Baxter, Alan D., additional, Allan, J. E., additional, Malherbe, Stephan, additional, Allan, J., additional, Bedard, J., additional, Malone-Tucker, S., additional, Slivar, S., additional, Langil, M., additional, Perrault, M., additional, Janseo, O., additional, Carvalho, George, additional, Moore, Anne, additional, Lachapelle, Kevin, additional, Quizilbash, Baqir, additional, Salem, Reda, additional, Klein, Andrew A., additional, Shayan, Charles, additional, Chamchad, Dmitri, additional, Keyvan, Karkouti, additional, Bird, Sally J., additional, Feldman, Liane S., additional, Anidjar, Maurice, additional, Stanbridge, Donna, additional, Karkouti, Keyvan, additional, Abdelnaem, Esam, additional, Wijeysundera, Duminda, additional, Beattie, Scott, additional, Yau, Terry, additional, Sutton, David, additional, Varadarajan, Bharathi, additional, Jose, Geraldine, additional, Kakizawa, Karen, additional, McCluskey, Stuart A., additional, Ghannam, Mohammed, additional, Smith, Robert, additional, Goldman, Adam, additional, Hsu, Janet, additional, Duviner, Geoff, additional, Grant, David, additional, Levy, Gary, additional, Chang, Alvin, additional, Borger, Michael, additional, Cleave-Hogg, Doreen, additional, DeSousa, Susan, additional, Radwan, Omar, additional, Fried, Gerald, additional, Backman, Steven, additional, Christou, Nicolas, additional, Engen, Dale, additional, Brown, Russell, additional, Iglesias, Stuart, additional, Kohlhammer, Monica, additional, Tanzola, Rob C., additional, Milne, Brian, additional, Doyle, D. John, additional, Joo, Hwan, additional, Frazer, Cassandra, additional, Iacolucci, Anthony, additional, Bagrin, Andrew, additional, Small, Orville, additional, Lewin, Warren, additional, Chowet, Anne L., additional, Lopez, Jaime R., additional, Brock-Utne, John, additional, Jaffe, Richard A., additional, Milne, Andrew D., additional, Lee, J. Michael, additional, English, Michael J. M., additional, Hung, O. R., additional, and Finucane, Brendan, additional

Published
2003
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