Guidelines to the Practice of Anesthesia: Revised Edition 2023

Dobson, Gregory; Chau, Anthony; Denomme, Justine; Fuda, Giuseppe; McDonnell, Conor; McIntyre, Ian; Milne, Andrew D.; Milkovich, Robert; Sparrow, Kathryn; Wang, Yongjun; Young, Christopher

doi:10.1007/s12630-022-02368-0

Cited by 24 publications

(4 citation statements)

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“…This study design is consistent with how other effective perioperative practices such as preoperative surgical safety checklists, perioperative use of antibiotics and surgical sponge counts have been studied, standardised and introduced as hospital-level policies. [25][26][27] When administered to highly selected groups of patients undergoing major non-cardiac surgery, and in the context of explanatory (vs pragmatic) trials, TXA consistently reduces transfusion without evidence of increased thrombotic risk. 7 9 Given the large numbers of patients undergoing major non-cardiac surgery, generalisable evidence that TXA is safe and effective is required.…”

Section: Discussionmentioning

confidence: 99%

Hospital policy of tranexamic acid to reduce transfusion in major non-cardiac surgery (TRACTION): protocol for a phase IV randomised controlled trial

Houston,

McIsaac,

Breau

et al. 2024

BMJ Open

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IntroductionTranexamic acid (TXA) is an inexpensive and widely available medication that reduces blood loss and red blood cell (RBC) transfusion in cardiac and orthopaedic surgeries. While the use of TXA in these surgeries is routine, its efficacy and safety in other surgeries, including oncologic surgeries, with comparable rates of transfusion are uncertain. Our primary objective is to evaluate whether a hospital-level policy implementation of routine TXA use in patients undergoing major non-cardiac surgery reduces RBC transfusion without increasing thrombotic risk.Methods and analysisA pragmatic, registry-based, blinded, cluster-crossover randomised controlled trial at 10 Canadian sites, enrolling patients undergoing non-cardiac surgeries at high risk for RBC transfusion. Sites are randomised in 4-week intervals to a hospital policy of intraoperative TXA or matching placebo. TXA is administered as 1 g at skin incision, followed by an additional 1 g prior to skin closure. Coprimary outcomes are (1) effectiveness, evaluated as the proportion of patients transfused RBCs during hospital admission and (2) safety, evaluated as the proportion of patients diagnosed with venous thromboembolism within 90 days. Secondary outcomes include: (1) transfusion: number of RBC units transfused (both at a hospital and patient level); (2) safety: in-hospital diagnoses of myocardial infarction, stroke, deep vein thrombosis or pulmonary embolism; (3) clinical: hospital length of stay, intensive care unit admission, hospital survival, 90-day survival and the number of days alive and out of hospital to day 30; and (4) compliance: the proportion of enrolled patients who receive a minimum of one dose of the study intervention.Ethics and disseminationInstitutional research ethics board approval has been obtained at all sites. At the completion of the trial, a plain language summary of the results will be posted on the trial website and distributed in the lay press. Our trial results will be published in a peer-reviewed scientific journal.Trial registration numberNCT04803747.

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Section: Discussionmentioning

confidence: 99%

Hospital policy of tranexamic acid to reduce transfusion in major non-cardiac surgery (TRACTION): protocol for a phase IV randomised controlled trial

Houston,

McIsaac,

Breau

et al. 2024

BMJ Open

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“…Dans ce nume ´ro du Journal, vous trouverez l'e ´dition re ´vise ´e du Guide d'exercice de l'anesthe´sie. 1 Mis au point a `l'origine et de ´sormais mis a `jour annuellement par le Comite ´des normes de la Socie ´te ´canadienne des anesthe ´siologistes (SCA), ce Guide est approuve ´par le Conseil d'administration de la SCA. Le Guide a e ´te ´cre ´e ´en 1977, alors que les lignes directrices de pratique clinique n'e ´taient pas aussi re ´pandues qu'aujourd'hui.…”

Section: Communique ´Spe ´Cial -Guide D'exercice De L'anesthe ´Sie -E...unclassified

“…This issue of the Journal features the 2023 Revised Edition of the Guidelines to the Practice of Anesthesia. 1 These Guidelines were originally developed, and now updated annually, by the Canadian Anesthesiologists' Society (CAS) Committee on Standards and are approved by the CAS Board of Directors. They were initially created in 1977 when clinical practice guidelines were not as prevalent as they are today.…”

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confidence: 99%

Special Announcement: Guidelines to the Practice of Anesthesia—Revised Edition 2023

Dobson¹

2023

Can J Anesth/J Can Anesth

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“… 1 , 2 Therefore, capnography monitoring is deemed mandatory for all patients undergoing general anesthesia or procedural sedation by many renowned anesthesiology societies worldwide. 3 , 4 , 5 , 6 Hence, nasal cannulae with combined side-stream sampling ports for waveform capnography monitoring are commonly used by anesthesiologists.…”

mentioning

confidence: 99%

Separate circuit nasal cannulae for end-tidal CO2 monitoring may lead to hypoxia in patients with unilateral nasal airway obstruction

Cohen

O'Reilly

et al. 2023

Brazilian Journal of Anesthesiology (English Edition)

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Guidelines to the Practice of Anesthesia: Revised Edition 2023

Cited by 24 publications

References 0 publications

Hospital policy of tranexamic acid to reduce transfusion in major non-cardiac surgery (TRACTION): protocol for a phase IV randomised controlled trial

Hospital policy of tranexamic acid to reduce transfusion in major non-cardiac surgery (TRACTION): protocol for a phase IV randomised controlled trial

Special Announcement: Guidelines to the Practice of Anesthesia—Revised Edition 2023

Separate circuit nasal cannulae for end-tidal CO2 monitoring may lead to hypoxia in patients with unilateral nasal airway obstruction

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