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ASRA pain medicine narrative review and expert practice recommendations for gastric point-of-care ultrasound to assess aspiration risk in medically complex patients undergoing regional anesthesia and pain procedures.
Haskins SC, Bronshteyn YS, Ledbetter L, Arzola C, Kalagara H, Hardman D, Panzer O, Weber MM, Heinz ER, Boublik J, Cubillos J, Hernandez N, Zimmerman J, Perlas A. Haskins SC, et al. Among authors: arzola c. Reg Anesth Pain Med. 2025 Apr 18:rapm-2024-106346. doi: 10.1136/rapm-2024-106346. Online ahead of print. Reg Anesth Pain Med. 2025. PMID: 40250977
Gastric point-of-care ultrasound (POCUS) may offer clinical value in assessing aspiration risk among medically complex patients undergoing regional anesthesia and pain procedures. While the American Society of Anesthesiologists (ASA) preoperative fasting guidelines primari …
Gastric point-of-care ultrasound (POCUS) may offer clinical value in assessing aspiration risk among medically complex patients undergoing r …
Prevention of hypotension after induction of general anesthesia using point-of-care ultrasound to guide fluid management: a randomized controlled trial.
Dana E, Arzola C, Khan JS. Dana E, et al. Among authors: arzola c. Can J Anaesth. 2024 Sep;71(9):1219-1228. doi: 10.1007/s12630-024-02748-8. Epub 2024 Mar 13. Can J Anaesth. 2024. PMID: 38480632 Clinical Trial. English.
PURPOSE: Hypotension after induction of general anesthesia (GAIH) is common and is associated with postoperative complications including increased mortality. ...METHODS: We conducted a single-centre randomized controlled trial with adult patients scheduled to undergo elect …
PURPOSE: Hypotension after induction of general anesthesia (GAIH) is common and is associated with postoperative complications includ …
The Effect of Prolonged Face Mask Ventilation on Gastric Insufflation: A Prospective Observational Study.
Azem K, Fein S, Matatov Y, Heesen P, Eidelman LA, Stav MY, Shufaro Y, Orbach-Zinger S, Arzola C. Azem K, et al. Among authors: arzola c. Isr Med Assoc J. 2024 Jan;26(1):24-29. Isr Med Assoc J. 2024. PMID: 38420638 Free article.
METHODS: We conducted a prospective observational study at a tertiary medical center with female patients who underwent oocyte retrieval surgery under general anesthesia FMV. Pre- and postoperative gastric ultrasound examinations measured the gastric antral cross-sectional …
METHODS: We conducted a prospective observational study at a tertiary medical center with female patients who underwent oocyte retrieval sur …
Use of a Novel Three-Dimensional Model to Teach Ultrasound-guided Subclavian Vein Cannulation.
Tanwani J, Nabecker S, Hiansen JQ, Mashari A, Siddiqui N, Arzola C, Goffi A, Peacock S. Tanwani J, et al. Among authors: arzola c. ATS Sch. 2023 Jul 25;4(3):344-353. doi: 10.34197/ats-scholar.2022-0104IN. eCollection 2023 Sep. ATS Sch. 2023. PMID: 37795109 Free PMC article.
A qualitative usability test design was used to assess the validity of the curriculum in trainees with advanced vascular access skills (anesthesiologists). Participants were second-year anesthesia residents, anesthesia fellows, and staff physicians. Focus groups con …
A qualitative usability test design was used to assess the validity of the curriculum in trainees with advanced vascular access skills (anes …
Validation of a novel patient satisfaction questionnaire for preoperative fasting in cataract surgery: a discrimination analysis.
Kabanovski A, Popovic MM, Kalaichandran S, Arzola C, Rai A, Ramwani J, Minotti SC, Ma J, Chandrakumar M, El-Defrawy S, Schlenker MB. Kabanovski A, et al. Among authors: arzola c. Can J Ophthalmol. 2023 Oct;58(5):401-407. doi: 10.1016/j.jcjo.2022.06.001. Epub 2022 Jul 1. Can J Ophthalmol. 2023. PMID: 35780859
OBJECTIVE: Preoperative fasting is routinely performed to prevent anaesthesia-related pulmonary aspiration. To capture patients' experiences with preoperative fasting, a 13-item questionnaire was developed and validated using Rasch analysis and shortened to 6 items. ...
OBJECTIVE: Preoperative fasting is routinely performed to prevent anaesthesia-related pulmonary aspiration. To capture patients' expe …
What are we missing? The quality of intraoperative handover before and after introduction of a checklist.
Lane S, Gross M, Arzola C, Malavade A, Szadkowski L, Huszti E, Friedman Z. Lane S, et al. Among authors: arzola c. Can J Anaesth. 2022 Jul;69(7):832-840. doi: 10.1007/s12630-022-02238-9. Epub 2022 Mar 22. Can J Anaesth. 2022. PMID: 35314994 English.
METHODS: From February to August 2016, anesthesia providers (residents, fellows, and consultants) at a single tertiary academic center participated in a handover study. Baseline handovers between anesthesia care providers were videotaped, analyzed, and compared with …
METHODS: From February to August 2016, anesthesia providers (residents, fellows, and consultants) at a single tertiary academic cente …
Adapting obstetric and neonatal services during the COVID-19 pandemic: a scoping review.
Gold S, Clarfield L, Johnstone J, Diambomba Y, Shah PS, Whittle W, Abbasi N, Arzola C, Ashraf R, Biringer A, Chitayat D, Czikk M, Forte M, Franklin T, Jacobson M, Keunen J, Kingdom J, Lapinsky S, MacKenzie J, Maxwell C, Preisman M, Ryan G, Selk A, Sermer M, Silversides C, Snelgrove J, Watts N, Young B, De Castro C, D'Souza R. Gold S, et al. Among authors: arzola c. BMC Pregnancy Childbirth. 2022 Feb 11;22(1):119. doi: 10.1186/s12884-022-04409-4. BMC Pregnancy Childbirth. 2022. PMID: 35148698 Free PMC article.
Predicting pain after Cesarean delivery: pressure algometry, temporal summation, three-item questionnaire.
Guevara J, Carvalho JCA, Downey K, Ye XY, Sharkey AM, Arzola C. Guevara J, et al. Among authors: arzola c. Can J Anaesth. 2021 Dec;68(12):1802-1810. doi: 10.1007/s12630-021-02105-z. Epub 2021 Sep 28. Can J Anaesth. 2021. PMID: 34585366 English.
We hypothesized that the addition of psychophysical pain tests to the existing 3-IQ would improve the ability to predict severe pain in women undergoing elective CD under spinal anesthesia METHODS: This was a prospective cohort study on women undergoing elective CD under s …
We hypothesized that the addition of psychophysical pain tests to the existing 3-IQ would improve the ability to predict severe pain in wome …
Programmed intermittent epidural bolus for labour analgesia during first stage of labour: a sequential allocation trial to determine the effective interval time between boluses of a fixed volume of 2.5 mL of bupivacaine 0.25% plus fentanyl 8 µg·mL-1.
Shatalin D, Arzola C, Downey K, Ye XY, Carvalho JCA. Shatalin D, et al. Among authors: arzola c. Can J Anaesth. 2021 May;68(5):653-660. doi: 10.1007/s12630-021-01922-6. Epub 2021 Feb 2. Can J Anaesth. 2021. PMID: 33532993 Clinical Trial. English.
Canadian recommendations for training and performance in basic perioperative point-of-care ultrasound: recommendations from a consensus of Canadian anesthesiology academic centres.
Meineri M, Arellano R, Bryson G, Arzola C, Chen R, Collins P, Denault A, Desjardins G, Fayad A, Funk D, Hegazy AF, Kim H, Kruger M, Kruisselbrink R, Perlas A, Prabhakar C, Syed S, Sidhu S, Tanzola R, Van Rensburg A, Talab H, Vegas A, Bainbridge D. Meineri M, et al. Among authors: arzola c. Can J Anaesth. 2021 Mar;68(3):376-386. doi: 10.1007/s12630-020-01867-2. Epub 2020 Nov 24. Can J Anaesth. 2021. PMID: 33236278 English.
The increased use of ultrasound for regional anesthesia and vascular cannulation, together with more anesthesiologists trained in transesophageal echocardiography have contributed to the widespread use of POCUS in perioperative care. ...
The increased use of ultrasound for regional anesthesia and vascular cannulation, together with more anesthesiologists trained in tra …
Pregnancy and COVID-19: pharmacologic considerations.
D'Souza R, Ashraf R, Rowe H, Zipursky J, Clarfield L, Maxwell C, Arzola C, Lapinsky S, Paquette K, Murthy S, Cheng MP, Malhamé I. D'Souza R, et al. Among authors: arzola c. Ultrasound Obstet Gynecol. 2021 Feb;57(2):195-203. doi: 10.1002/uog.23116. Ultrasound Obstet Gynecol. 2021. PMID: 32959455 Free PMC article. Review.
Liberal use of neuraxial labor analgesia may reduce the need for emergency general anesthesia which results in aerosolization. Short courses of non-steroidal anti-inflammatory drugs can be administered for postpartum analgesia, but opioids should be used with caution due t …
Liberal use of neuraxial labor analgesia may reduce the need for emergency general anesthesia which results in aerosolization. Short …
A biased coin up-and-down sequential allocation trial to determine the optimum programmed intermittent epidural bolus time interval between 5 mL boluses of bupivacaine 0.125% with fentanyl 2 µg·mL-1.
Bittencourt R, Arzola C, Zakus P, Downey K, Ye XY, Carvalho JCA. Bittencourt R, et al. Among authors: arzola c. Can J Anaesth. 2019 Sep;66(9):1075-1081. doi: 10.1007/s12630-019-01407-7. Epub 2019 May 31. Can J Anaesth. 2019. PMID: 31152372 Clinical Trial. English.
Practice of Ultrasound-Guided Palpation of Neck Landmarks Improves Accuracy of External Palpation of the Cricothyroid Membrane.
You-Ten KE, Wong DT, Ye XY, Arzola C, Zand A, Siddiqui N. You-Ten KE, et al. Among authors: arzola c. Anesth Analg. 2018 Dec;127(6):1377-1382. doi: 10.1213/ANE.0000000000003604. Anesth Analg. 2018. PMID: 29958219
In this study, we tested the ability of anesthesia participants to identify the midpoint of the cricothyroid membrane using external palpation with and without ultrasound (US)-guided practice. METHODS: Following institutional ethics approval and informed consent, anesth …
In this study, we tested the ability of anesthesia participants to identify the midpoint of the cricothyroid membrane using external …
Determination of the optimal programmed intermittent epidural bolus volume of bupivacaine 0.0625% with fentanyl 2 μg.ml-1 at a fixed interval of forty minutes: a biased coin up-and-down sequential allocation trial.
Zakus P, Arzola C, Bittencourt R, Downey K, Ye XY, Carvalho JC. Zakus P, et al. Among authors: arzola c. Anaesthesia. 2018 Apr;73(4):459-465. doi: 10.1111/anae.14159. Epub 2017 Dec 2. Anaesthesia. 2018. PMID: 29197080 Free article. Clinical Trial.
In Response.
Arzola C. Arzola C. Anesth Analg. 2017 Aug;125(2):705. doi: 10.1213/ANE.0000000000002220. Anesth Analg. 2017. PMID: 28654434 No abstract available.
Determining the amount of training needed for competency of anesthesia trainees in ultrasonographic identification of the cricothyroid membrane.
Oliveira KF, Arzola C, Ye XY, Clivatti J, Siddiqui N, You-Ten KE. Oliveira KF, et al. Among authors: arzola c. BMC Anesthesiol. 2017 Jun 2;17(1):74. doi: 10.1186/s12871-017-0366-7. BMC Anesthesiol. 2017. PMID: 28577552 Free PMC article.
In this study, we aimed to determine the amount of training anesthesia trainees would need to achieve competence in bedside ultrasound to identify the cricothyroid membrane. METHODS: This is a prospective non-randomized cohort study in the Department of Anesthesia a …
In this study, we aimed to determine the amount of training anesthesia trainees would need to achieve competence in bedside ultrasoun …
In Response.
Patel R, Arzola C, Petrounevitch V, Balki M, Downey K, Tsui BC, Carvalho JC. Patel R, et al. Among authors: arzola c. Anesth Analg. 2017 Mar;124(3):1010-1011. doi: 10.1213/ANE.0000000000001828. Anesth Analg. 2017. PMID: 28207451 No abstract available.
The Use of Ultrasonography in Obstetric Anesthesia.
Talati C, Arzola C, Carvalho JC. Talati C, et al. Among authors: arzola c. Anesthesiol Clin. 2017 Mar;35(1):35-58. doi: 10.1016/j.anclin.2016.09.005. Anesthesiol Clin. 2017. PMID: 28131119 Review.
This article provides an overview of the use of ultrasonography in obstetric anesthesia. It discusses the indications, benefits, and techniques of using ultrasonography to optimize the delivery of anesthesia and provide safe and efficacious clinical care. More speci …
This article provides an overview of the use of ultrasonography in obstetric anesthesia. It discusses the indications, benefits, and …
Programmed Intermittent Epidural Bolus for Labor Analgesia During First Stage of Labor: A Biased-Coin Up-and-Down Sequential Allocation Trial to Determine the Optimum Interval Time Between Boluses of a Fixed Volume of 10 mL of Bupivacaine 0.0625% With Fentanyl 2 μg/mL.
Epsztein Kanczuk M, Barrett NM, Arzola C, Downey K, Ye XY, Carvalho JC. Epsztein Kanczuk M, et al. Among authors: arzola c. Anesth Analg. 2017 Feb;124(2):537-541. doi: 10.1213/ANE.0000000000001655. Anesth Analg. 2017. PMID: 27755057 Clinical Trial.
Role of contextualizing a crisis scenario on the performance of a cricothyrotomy procedural task.
You-Ten KE, Wong C, Arzola C, Cheung J, Friedman Z, Perelman S, Siddiqui N. You-Ten KE, et al. Among authors: arzola c. Can J Anaesth. 2015 Oct;62(10):1104-13. doi: 10.1007/s12630-015-0430-z. Epub 2015 Jul 8. Can J Anaesth. 2015. PMID: 26153485 Clinical Trial.
This crossover study aimed to determine whether contextualization of a crisis scenario would impact the performance of a cricothyrotomy procedural task. METHODS: Sixty-five anesthesia assistants and emergency medicine and anesthesia residents underwent a teaching se …
This crossover study aimed to determine whether contextualization of a crisis scenario would impact the performance of a cricothyrotomy proc …
Interrater reliability of qualitative ultrasound assessment of gastric content in the third trimester of pregnancy.
Arzola C, Cubillos J, Perlas A, Downey K, Carvalho JC. Arzola C, et al. Br J Anaesth. 2014 Dec;113(6):1018-23. doi: 10.1093/bja/aeu257. Epub 2014 Jul 30. Br J Anaesth. 2014. PMID: 25080428 Free article.
BACKGROUND: Pulmonary aspiration of gastric contents in pregnant women undergoing general anaesthesia is one of the most feared complications in obstetric anaesthesia. Bedside gastric ultrasonography is a feasible imaging tool to assess the gastric content. ...
BACKGROUND: Pulmonary aspiration of gastric contents in pregnant women undergoing general anaesthesia is one of the most feared compl …
Spinal ultrasound versus palpation for epidural catheter insertion in labour: A randomised controlled trial.
Arzola C, Mikhael R, Margarido C, Carvalho JC. Arzola C, et al. Eur J Anaesthesiol. 2015 Jul;32(7):499-505. doi: 10.1097/EJA.0000000000000119. Eur J Anaesthesiol. 2015. PMID: 25036283 Clinical Trial.
PARTICIPANTS AND INTERVENTION: A group of 17 second-year anaesthesia residents and five anaesthesia fellows underwent a training programme in ultrasound assessment of the spine. ...CONCLUSION: The use of preprocedural spinal ultrasound by a cohort of anaesthesia …
PARTICIPANTS AND INTERVENTION: A group of 17 second-year anaesthesia residents and five anaesthesia fellows underwent a traini …
Predictors of desaturation in the postoperative anesthesia care unit: an observational study.
Siddiqui N, Arzola C, Teresi J, Fox G, Guerina L, Friedman Z. Siddiqui N, et al. Among authors: arzola c. J Clin Anesth. 2013 Dec;25(8):612-7. doi: 10.1016/j.jclinane.2013.04.018. Epub 2013 Oct 4. J Clin Anesth. 2013. PMID: 24095886
PATIENTS: All adult postsurgical patients who received general anesthesia and who were admitted to the PACU. MEASUREMENTS: Patients were observed over a three-month study period during transfer to the PACU with or without oxygen supplementation. ...Significant predictors o …
PATIENTS: All adult postsurgical patients who received general anesthesia and who were admitted to the PACU. MEASUREMENTS: Patients w …
Ultrasound estimates for midline epidural punctures in the obese parturient: paramedian sagittal oblique is comparable to transverse median plane.
Sahota JS, Carvalho JC, Balki M, Fanning N, Arzola C. Sahota JS, et al. Among authors: arzola c. Anesth Analg. 2013 Apr;116(4):829-35. doi: 10.1213/ANE.0b013e31827f55f0. Epub 2013 Feb 5. Anesth Analg. 2013. PMID: 23385058
METHODS: We recruited obese (World Health Organization classes I, II, and III) pregnant women at term requesting labor epidural analgesia or combined spinal-epidural anesthesia for cesarean delivery. US imaging was performed with a 5-2 MHz curved array probe to identify th …
METHODS: We recruited obese (World Health Organization classes I, II, and III) pregnant women at term requesting labor epidural analgesia or …
Challenging authority during a life-threatening crisis: the effect of operating theatre hierarchy.
Sydor DT, Bould MD, Naik VN, Burjorjee J, Arzola C, Hayter M, Friedman Z. Sydor DT, et al. Among authors: arzola c. Br J Anaesth. 2013 Mar;110(3):463-71. doi: 10.1093/bja/aes396. Epub 2012 Nov 27. Br J Anaesth. 2013. PMID: 23188096 Free article. Clinical Trial.
We investigated how hierarchy in the OT team influences an anaesthesia trainee's ability to challenge an unethical decision by a consultant anaesthetist in a simulated crisis scenario. METHODS: We prospectively randomized 49 postgraduate year (PGY) 2-5 anaesthesia t …
We investigated how hierarchy in the OT team influences an anaesthesia trainee's ability to challenge an unethical decision by a cons …
The utility of ultrasound imaging in predicting ease of performance of spinal anesthesia in an orthopedic patient population.
Chin KJ, Ramlogan R, Arzola C, Singh M, Chan V. Chin KJ, et al. Among authors: arzola c. Reg Anesth Pain Med. 2013 Jan-Feb;38(1):34-8. doi: 10.1097/AAP.0b013e3182734927. Reg Anesth Pain Med. 2013. PMID: 23143015
An operator, blinded to the ultrasound scan, performed surface landmark-guided spinal anesthesia using a midline approach. Absence of technical difficulty was defined as successful dural puncture within 2 skin punctures or 10 needle passes. ...CONCLUSIONS: Ultrasound can b …
An operator, blinded to the ultrasound scan, performed surface landmark-guided spinal anesthesia using a midline approach. Absence of …
Deficits in information transfer between anaesthesiologist and postanaesthesia care unit staff: an analysis of patient handover.
Siddiqui N, Arzola C, Iqbal M, Sritharan K, Guerina L, Chung F, Friedman Z. Siddiqui N, et al. Among authors: arzola c. Eur J Anaesthesiol. 2012 Sep;29(9):438-45. doi: 10.1097/EJA.0b013e3283543e43. Eur J Anaesthesiol. 2012. PMID: 22569028
BACKGROUND: The immediate postoperative period is important, as the patient recovers from the acute derangements resulting from the surgical insult and anaesthesia. Incomplete or incorrect communication between the anaesthesiologist and the postanaesthesia care unit nurse …
BACKGROUND: The immediate postoperative period is important, as the patient recovers from the acute derangements resulting from the surgical …
Sonoanatomy of the thoracic spine in adult volunteers.
Avramescu S, Arzola C, Tharmaratnam U, Chin KJ, Balki M. Avramescu S, et al. Among authors: arzola c. Reg Anesth Pain Med. 2012 May-Jun;37(3):349-53. doi: 10.1097/AAP.0b013e3182464be2. Reg Anesth Pain Med. 2012. PMID: 22354105
BACKGROUND AND OBJECTIVES: Ultrasonography of the lumbar spine provides information to facilitate the placement of neuraxial anesthesia. Likewise, thoracic spine ultrasound (US) might conceivably improve the quality and safety of thoracic epidural anesthesia. ...
BACKGROUND AND OBJECTIVES: Ultrasonography of the lumbar spine provides information to facilitate the placement of neuraxial anesthesia …
Efficacy of low-dose bupivacaine in spinal anaesthesia for Caesarean delivery: systematic review and meta-analysis.
Arzola C, Wieczorek PM. Arzola C, et al. Br J Anaesth. 2011 Sep;107(3):308-18. doi: 10.1093/bja/aer200. Epub 2011 Jul 14. Br J Anaesth. 2011. PMID: 21764820 Free article. Review.
Spinal anaesthesia is the preferred anaesthetic technique for elective Caesarean deliveries. Hypotension is the most common side-effect and has both maternal and neonatal consequences. ...This meta-analysis demonstrates that low-dose bupivacaine in spinal anaesthesia …
Spinal anaesthesia is the preferred anaesthetic technique for elective Caesarean deliveries. Hypotension is the most common side-effe …
Anesthesiologists' learning curves for ultrasound assessment of the lumbar spine.
Margarido CB, Arzola C, Balki M, Carvalho JC. Margarido CB, et al. Among authors: arzola c. Can J Anaesth. 2010 Feb;57(2):120-6. doi: 10.1007/s12630-009-9219-2. Epub 2009 Dec 30. Can J Anaesth. 2010. PMID: 20041358
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine to facilitate neuraxial anesthesia has recently received much attention. The transfer of knowledge pertaining to this skill has never been studied. ...
BACKGROUND AND OBJECTIVES: Ultrasound assessment of the lumbar spine to facilitate neuraxial anesthesia has recently received much at …
An ultrasound-assisted approach facilitates spinal anesthesia for total joint arthroplasty.
Chin KJ, Perlas A, Singh M, Arzola C, Prasad A, Chan V, Brull R. Chin KJ, et al. Among authors: arzola c. Can J Anaesth. 2009 Sep;56(9):643-50. doi: 10.1007/s12630-009-9132-8. Epub 2009 Jun 23. Can J Anaesth. 2009. PMID: 19548051
PURPOSE: Spinal anesthesia can be challenging in patients undergoing total joint arthroplasty because of poorly palpable surface landmarks and age-related changes in the lumbar spine. ...CONCLUSIONS: Ultrasound imaging of the lumbar spine provides clinically useful informa …
PURPOSE: Spinal anesthesia can be challenging in patients undergoing total joint arthroplasty because of poorly palpable surface land …
The antero-posterior diameter of the lumbar dural sac does not predict sensory levels of spinal anesthesia for Cesarean delivery.
Arzola C, Balki M, Carvalho JC. Arzola C, et al. Can J Anaesth. 2007 Aug;54(8):620-5. doi: 10.1007/BF03022955. Can J Anaesth. 2007. PMID: 17666714
The purpose of this study was to investigate whether the dural sac antero-posterior diameter correlates with sensory levels of spinal anesthesia during elective Cesarean delivery (CD). METHODS: After Research Ethics Board approval and informed consent, a prospective observ …
The purpose of this study was to investigate whether the dural sac antero-posterior diameter correlates with sensory levels of spinal ane …