Chapter
5 Critical appraisal and presentation of study details
Internal and external validity
Choice of quality assessment tool
Performing quality assessment
Conflicts of interest and fraud
Clinical trial registration
Presentation of study details
Clinically relevant outcomes
Other anaesthesia related clinical outcomes
The randomised controlled trial
The cohort study (epidemiological research/regression analysis)
7 The meta-analysis of a systematic review
SR data: study characteristics
SR data: observed study outcomes
Summary effect measures and heterogeneity
Resources, problems, and promises
8 Bias in systematic reviews: considerations when updating your knowledge
Within-study biases/trial quality
Bias and quality assessment in randomised controlled trials
Selection bias: biased allocation to intervention or control group
Performance bias: unequal care for the intervention and control group
Information (Detection) bias: different outcome assessment in the comparison groups
Attrition bias: differential loss to follow-up or handling of protocol deviations
Realisation versus reporting
Assessing trial quality of RCTs
Omission of low-quality studies
Quality assessment of abstracts
Bias and quality assessment in diagnostic studies
Selection bias in case–control studies
Prevention of publication bias
Registries of clinical trials
Medical editors’ trial amnesty
Peer-reviewed electronic journals
Biased inclusion criteria
Multiple publication bias
Citation bias and reference bias
“Place of publication” bias
9 The Cochrane Collaboration and the Cochrane Anaesthesia Review Group
What is The Cochrane Collaboration?
Structure of the Collaboration
The Cochrane Database of Systematic Reviews
10 Integrating clinical practice and evidence: how to learn and teach evidence-based medicine
What prevents clinicians from using evidence more often?
Lack of awareness of a gap in personal knowledge
Lack of ability to formulate a clinical question
Lack of access to information resources
Lack of skills in retrieving and interpreting information from available resources
Difficulty in changing clinical practice in the light of evidence
Strategies for learning and teaching evidence-based practice
Practical techniques for learning and teaching EBM
Generating and formulating questions
Information access in the workplace
Critically appraised topics
Teaching critical appraisal skills using the journal club format
Level 1: Basic principles of critical appraisal
Level 2: Increasing relevance to practice
Level 3: The anatomy of the anaesthesia journal
Level 4: The nature and limits of evidence
Integrating evidence into practice
Using pre-appraised evidence
Strategies to change behaviour
Educational interventions
Clinical decision support systems
11 Involving patients and consumers in health care and decision-making processes: nothing about us without us
The informed patient and shared decision-making
Communication and information
The individual patient: health care provider role in anaesthesia
The preanaesthetic consultation
The immediate preanaesthesia period
The intraoperative period
The immediate postoperative period
Return to normal daily function and optimising recovery
What consumers want to know about anaesthesia
Outcomes measured in Cochrane anaesthesia protocols
Anaesthesia and medical diseases
12 Evidence-based medicine in the Third World
Teaching evidence-based medicine
Research in Third World countries
Prevention of mother to child HIV infection
13 Preoperative anaesthesia evaluation
When should it be performed?
14 Regional anaesthesia versus general anaesthesia
Neuraxial versus general anaesthesia
Heterogeneity of the trials that compared regional versus general anaesthesia
The discrepancy between recent and old trials
Regional anaesthesia versus general anaesthesia for hip fracture surgery
Regional anaesthesia versus general anaesthesia for carotid endarterectomy
Regional anaesthesia versus general anaesthesia for Caesarean section
Regional versus general anaesthesia for ambulatory orthopaedic surgery
Regional versus general anaesthesia: postoperative cognitive dysfunction in elderly patients after non-cardiac surgery
Does the choice of IV fluid affect clinical outcomes?
Isotonic crystalloids versus colloids
Hypertonic crystalloids versus isotonic crystalloids
Hypertonic crystalloids versus colloids
Albumin or plasma protein fraction
Does the amount of IV fluid make a difference to clinical outcomes?
Does the timing of IV fluid administration make a difference to clinical outcomes?
Paediatric IV fluid resuscitation
Current limitations and future research
Fasting and nasogastric tubes
General anaesthetic agents
Cholinesterase inhibitors (with or without antimuscarinic agents)
Counteracting emetic symptoms: prevention of PONV
Dexamethasone [36,39,45–47]
Droperidol versus metoclopramide
Droperidol versus ondansetron
Metoclopramide versus ondansetron
Counteracting emetic symptoms: treatment of PONV
17 Anaesthesia for day-case surgery
Preoperative fasting and premedication
Postoperative nausea and vomiting
18 Obstetrical anaesthesia
Instrumental vaginal delivery
Results from RCTs comparing neuraxial analgesia to opioid
Instrumental vaginal delivery: the effect of local anaesthetic concentration
19 Anaesthesia for major abdominal and urological surgery
Supplemental oxygen therapy
Induction of anaesthesia in obese patients
Avoidance of nitrous oxide
Maintenance of normothermia
Wound infection and wound healing
Blood loss and blood transfusion
Myocardial ischaemia and infarction
Recovery from anaesthesia
Benefits of beta-blockers and alpha2-agonists
Venous thromboembolism prophylaxis
20 Anaesthesia for paediatric surgery
Preparation and premedication of children
Pharmacological premedication
Use of topical local anaesthesia
Anxiolytics and sedatives
Induction and maintenance of anaesthesia
Inhalational induction and maintenance
Intravenous induction and maintenance
The laryngeal mask airway
Newer non-depolarising muscle relaxants in children
Local and regional analgesia
COX-2 inhibitors in paediatrics
Acetaminophen (paracetamol)
Analgesic doses for children
Postoperative nausea and vomiting
21 Anaesthesia for eye, ENT and dental surgery
Anaesthesia for ENT surgery
Endotracheal tube or LMA for tonsillectomy?
Local anaesthesia for pain control following tonsillectomy
Use of NSAIDs for tonsillectomy
Anaesthesia for surgery for recurrent respiratory papillomatosis
Anaesthesia for eye surgery
Is there a need to starve before cataract surgery under local anaesthesia?
Is intravenous sedation useful for cataract surgery under local anaesthetic block?
Has LMA replaced ETT in day case dental anaesthesia?
22 Anaesthesia for neurosurgery
Basic principles of neurophysiology
Cerebral perfusion pressure
Cerebral oxygen metabolism
Clinical neuroanaesthesia
Management of intracranial pressure
Anaesthesia for a patient with a supratentorial mass
Maintenance of anaesthesia
Summary and recommendations
23 Cardiothoracic anaesthesia and critical care
Video-assisted thoracic surgery
Coronary artery angioplasty and stenting
Spinal and epidural analgesia
Glucose, potassium and insulin
Cerebral spinal fluid drainage
Blood loss and transfusion
Other pharmacological agents
24 Postoperative pain therapy
Evidence in support of epidural analgesia
Evidence in support of PCA
Evidence in support of NSAIDs as adjuncts
Evidence in support of acetaminophen and gabapentin as adjuncts
25 Critical care medicine
Indication for respiratory support
Conditions requiring respiratory support
Choosing the artificial airway
Respiratory support in ARDS/ALI: lung-protective ventilation
Open lung ventilation (moderate to high PEEP)
High-frequency ventilation
Respiratory support in OLD
Weaning from respiratory support
Non-invasive positive pressure ventilation (NIPPV) for weaning
Community acquired pneumonia
Severe sepsis and septic shock
Initial empirical antimicrobial therapy
Estimating the required energy
Route of nutrient administration
Management of problems with nutritional support
Prophylaxis of deep vein thrombosis
Initial treatment of venous thromboembolism
Other anticoagulants: currently not recommended
26 Emergency medicine: cardiac arrest management, severe burns, near-drowning and multiple trauma
Cardiac arrest management
What is the role of vasopressin in cardiac arrest in adults?
What is the role of amiodarone in adults with cardiac arrest?
How does biphasic defibrillation compare to monophasic defibrillation in VF and pulseless VT in adults?
What is the role of therapeutic hypothermia therapy in post cardiac arrest coma in adults?
Which fluid is best in severe burns in adults?
Which initial dressing is best in severe burns in adults?
What are the roles of other therapies in adult victims of near-drowning?
Multiple trauma in adults
Overview of initial emergency department management
Current issues and controversies in the emergency care of multiple trauma patients
Fluid resuscitation in trauma
Which fluid is best in trauma resuscitation?
Blood substitutes in trauma
Stabilisation of circulation in multiple trauma/haemorrhagic shock
In patients with multiple trauma, including head injury, does induced hypothermia therapy improve outcome?
Ca channel blockers in TBI
Hyperventilation therapy for TBI
Endpoints of trauma resuscitation: what is the evidence?
Oxygenation and perfusion
Evidence-based Anaesthesia and Intensive Care
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.