Current opinion in anaesthesiology
-
Measuring clinically relevant and patient-centered perioperative outcomes provides the knowledge that enables clinicians to optimize their practice and guide shared decision-making, researchers to set a future agenda and policymakers to prioritize healthcare spending. ⋯ Future clinical trials in perioperative medicine should utilize clearly defined, validated and standardized patient-centered outcome measures.
-
The purpose of this article is to provide a structural and functional understanding of the systems used for the regulation of medical devices in the USA and European Union (EU). ⋯ The US and EU medical device regulatory systems are similar in many ways, but differ in important ways too, which impacts the afforded level of safety and effectiveness assurance. In both systems, medical devices are classified and regulated on a risk basis, which fundamentally differs from drug regulation, where uniform requirements are imposed. Anesthesia providers must gain knowledge of these systems and be active players in both premarket and postmarket activities, particularly with regard to vigilance and adverse event/device failure reporting.
-
Curr Opin Anaesthesiol · Dec 2016
ReviewAnaesthesia in outer space: the ultimate ambulatory setting?
Missions to the Moon or more distant planets are planned in the next future, and will push back the limits of our experience in providing medical support in remote environments. Medical preparedness is ongoing, and involves planning for emergency surgical interventions and anaesthetic procedures. This review will summarize what principles of ambulatory anaesthesia on Earth could benefit the environment of a space mission with its unique constraints. ⋯ The application of some of the key principles of ambulatory anaesthesia, as well as recent advances in anaesthetic techniques and better understanding of human adaptation to the space environment might allow nonanaesthesiologist physicians to perform common anaesthetic procedures, whilst maximizing crew safety and minimizing the impact of medical events on the mission.
-
Curr Opin Anaesthesiol · Dec 2016
ReviewAn update on pain management for elderly patients undergoing ambulatory surgery.
The aim of this review is to provide an overview of the drugs and techniques used for multimodal postoperative pain management in the older population undergoing surgery in the ambulatory setting. ⋯ The nonopioid analgesic therapies will likely assume an increasingly important role in facilitating the recovery process and improving the satisfaction for elderly ambulatory surgery patients. Strategies to avoid the use of opioids and minimize opioid-related side-effects is an important advance as we expand on the use of ambulatory surgery for the aging population.