Current opinion in anaesthesiology
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Curr Opin Anaesthesiol · Oct 2019
ReviewPatient-reported outcome measures for acute and chronic pain: current knowledge and future directions.
During the past years, patient-reported outcomes (PROs) and patient-reported outcome measures (PROMs) have become of growing awareness and importance in medical research and practice. This review summarizes recent developments concerning PROs and PROMs related to pain in the acute postoperative as well as chronic settings and indicates gaps and challenges relevant for future research and clinical applications. ⋯ COSs of PRO and PROMs are crucial in the field of research to enhance the comparability of results and reducing outcome reporting bias. In clinical practice PROs and PROMs are important for allocation of treatment. Concerning the development and implementation of PROs and PROMs patients' perspective should be thoroughly considered. Relating to acute as well as chronic pain there are some attempts to create COSs of PROs and PROMs but validity and reliability for both are still missing.
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Curr Opin Anaesthesiol · Oct 2019
ReviewAnesthetic management of complex spine surgery in adult patients: a review based on outcome evidence.
The aim of this article is to review the evidence regarding the anesthetic management of blood loss, pain control, and position-related complications of adult patients undergoing complex spine procedures. ⋯ As the number and complexity of spine procedures are being performed worldwide is increasing, we suggested to bundle the aforementioned effective interventions as part of an ERAS spine protocol to improve the patient outcome of spine surgery.
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Curr Opin Anaesthesiol · Oct 2019
ReviewPrimer on machine learning: utilization of large data set analyses to individualize pain management.
Pain researchers and clinicians increasingly encounter machine learning algorithms in both research methods and clinical practice. This review provides a summary of key machine learning principles, as well as applications to both structured and unstructured datasets. ⋯ In the coming years, machine learning is likely to become a key component of evidence-based medicine, yet will require additional skills and perspectives for its successful and ethical use in research and clinical settings.
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Curr Opin Anaesthesiol · Oct 2019
ReviewNeuroanesthesia and outcomes: evidence, opinions, and speculations on clinically relevant topics.
The objective of this review is to identify outstanding topics most relevant to neuroanesthesia practice and patient outcomes. We discuss the role of awake craniotomy, choice of general anesthetic agents, monitoring of anesthetic 'depth', mannitol-induced diuresis, neurophysiological monitoring, hyperventilation, and cerebral hypoperfusion. ⋯ We provide an overview of several topics that are relevant to neuroanesthesia practice and patient outcomes based on evidence, opinions, and speculations. Our review highlights the need for further outcome-oriented studies to specifically address these clinically relevant issues.
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Curr Opin Anaesthesiol · Oct 2019
ReviewRegional anesthesia for vascular surgery: does the anesthetic choice influence outcome?
Outcomes following surgery are of major importance to clinicians, institutions and most importantly patients. This review examines whether regional anesthesia and analgesia influence outcome after vascular surgery. ⋯ Patients undergoing vascular surgery often have multiple comorbidities and it is important to be able to outline both benefits and risks of regional anesthesia techniques. Regional anesthesia in vascular surgery allows avoidance of general anesthesia and does provide short-term benefits beyond superior analgesia. Evidence of long-term benefits is lacking in most procedures. Further work is required on newer patient centered outcomes.