Improving Access to Safe Anesthetic Care in Rural and Remote Communities in Affluent Countries.

Inadequate access to anesthesia and surgical services is often considered to be a problem of low- and middle-income countries. However, affluent nations, including Canada, Australia, and the United States, also face shortages of anesthesia and surgical care in rural and remote communities. Inadequate services often disproportionately affect indigenous populations.

A randomized control trial using intraoperative dexmedetomidine during Roux-en-Y gastric bypass surgery to reduce postoperative pain and narcotic use.

Background: Dexmedetomidine (DMET), a selective a2-adrenergic agonist, is an opioid-sparing adjuvant sedative that avoids respiratory depression and has been shown to be beneficial in bariatric surgery patients. Although benefit has been shown, prior studies have not evaluated the pain control effects of a single intraoperative bolus.

Objectives: To evaluate the postoperative effects of a single intraoperative dose of DMET.

Ultrasound-Guided Greater Auricular Nerve Block as Sole Anesthetic for Ear Surgery.

A greater auricular nerve (GAN) block was used as the sole anesthetic for facial surgery in an 80-year-old male patient with multiple comorbidities which would have made general anesthesia challenging. The GAN provides sensation to the ear, mastoid process, parotid gland, and angle of the mandible. In addition to anesthesia for operating room surgery, the GAN block can be used for outpatient or emergency department procedures without the need for a separate anesthesia team.

Chronic headache and backache are long-term sequelae of unintentional dural puncture in the obstetric population.

Introduction: Unintentional dural puncture (UDP) and postdural puncture headache (PDPH) occur during the course of epidural catheter placement for labor analgesia with a reported incidence of 1%-5%. After UDP with an epidural needle, 80%-86% of patients develop PDPH. Acute symptoms after UDP are well known.

Tracheal tube cuff perforation during ventriculoatrial shunt procedure.

We report a case of tracheal and endotracheal tube cuff perforation that occurred intraoperatively during a ventriculoatrial shunting procedure for a patient with normal pressure hydrocephalus. Unusual tracheal anatomy and technique were contributory factors. Use of noninvasive imaging devices to guide the intraoperative placement of catheters may avoid many of the complications related to anatomy, skill, and technique.

Comparative study on density gradients and swim-up preparation techniques utilizing neat and cryopreserved spermatozoa.

Aim: To 1) compare post-wash and post-thaw parameters of sperm processed with PureSperm density gradient technique and swim-up method; and 2) test the efficacy of two commonly available density gradient media PureSperm and ISolate.

Methods: This prospective study used semen specimens from 22 patients. Specimens from nine patients were processed by both PureSperm density gradient and swim-up method.

Fertility after cancer: a prospective review of assisted reproductive outcome with banked semen specimens.

Objective: To examine the outcome of assisted reproduction techniques (ART) using cryopreserved semen from patients with cancer.

Design: Prospective.

Setting: Therapeutic semen banking program at a tertiary healthcare center.

Sperm cryopreservation for men with nonmalignant, systemic diseases: a descriptive study.

Cytotoxic drugs and immunosuppressive therapies are used to treat patients with nonmalignant, nontesticular systemic diseases. These therapies can permanently suppress spermatogenesis. Sperm cryopreservation before treatment theoretically could give these men the opportunity to achieve a pregnancy with a woman later in life when the couple decides to do so.