Taking knee arthroplasty as an example , patients deemed at low risk of experiencing outcomes such as postoperative pain or chronic pain  may receive intra-articular local anaesthesia infiltration ;  patients at medium risk may obtain additional analgesia via a saphe-nous nerve catheter ; and patients at high risk may also receive nerve blocks and anti-hyperalgesics .
pain and function after fast-track hip and knee arthroplasty .
catastrophizing , response to experimental heat stimuli , and post-cesarean section pain .
In 1946 , Mendelson 1 showed that pulmonary complications and death could arise in pregnant women because of aspiration of gastric contents .
Since then , prevention of aspiration of gastric contents has contributed significantly to a decrease in maternal deaths .
Warner and colleagues 2 demonstrated in a large series from the Mayo Clinic that no aspiration occurred in pregnant or post-partum women ( probably because of the routine use of prophylactic measures ) , while both its occurrence and severity were significant in emergency procedures .
formation of large informatic data bases , or clinical quality registries , linking preoperative and intraoperative clinical data , imaging , genomics , and cancer and drug prescription data bases .
References 1 Fischer HB , Simanski CJ , Sharp C , et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty .
Postoperative pain management : number-needed-to-treat approach versus procedure-specific pain management approach .
Intra- and Interrater Reliability of Ultrasound Assessment of Gastric Volume
Background : Gastric sonography can provide information about gastric content and volume that can help determine aspiration risk at the bedside . The primary objective of this study is to assess the intrarater and interrater reliability of a previously vali date d method of gastric volume assessment based on gastric antral area . The secondary objective is to evaluate the agreement between two different methods to measure gastric antral area . Methods : Three independent raters performed a st and ardized gastric ultrasound assessment in healthy subjects who had been r and omly allocated to ingest a predetermined volume of clear fluid ( apple juice ) from 0 to 400 ml . Each rater measured the gastric antral area , using twice the two-diameter method and twice the free-tracing method . The rater order was allocated at r and om and raters were unaware of the volume ingested and of one-another ’s measurements . The Guidelines for Reporting Reliability and Agreement Studies were followed for conducting and reporting this study . Results : Twenty-two volunteers were studied . Ultrasound assessment of antral cross-sectional area and volume was found to have “ nearly perfect ” intrarater and interrater reliability ( correlation coefficient > 0.8 ) with maximum differences within 13 % . A Bl and –Altman analysis suggests that the free-tracing method and the two-diameter method are essentially equivalent , within a clinical ly acceptable level of agreement . Conclusions : Ultrasound assessment of gastric volume by clinical anesthesiologists is highly reproducible with high intrarater and interrater reliability . The free-tracing method to measure antral cross-sectional area is equivalent to the two-diameter method
Taking knee arthroplasty as an example , patients deemed at low risk of experiencing outcomes such as postoperative pain or chronic pain  may receive intra-articular local anaesthesia infiltration ;  patients at medium risk may obtain additional analgesia via a saphe-nous nerve catheter ; and patients at high risk may also receive nerve blocks and anti-hyperalgesics .
pain and function after fast-track hip and knee arthroplasty .
catastrophizing , response to experimental heat stimuli , and post-cesarean section pain .
In 1946 , Mendelson 1 showed that pulmonary complications and death could arise in pregnant women because of aspiration of gastric contents .
Since then , prevention of aspiration of gastric contents has contributed significantly to a decrease in maternal deaths .
Warner and colleagues 2 demonstrated in a large series from the Mayo Clinic that no aspiration occurred in pregnant or post-partum women ( probably because of the routine use of prophylactic measures ) , while both its occurrence and severity were significant in emergency procedures .
formation of large informatic data bases , or clinical quality registries , linking preoperative and intraoperative clinical data , imaging , genomics , and cancer and drug prescription data bases .
References 1 Fischer HB , Simanski CJ , Sharp C , et al. A procedure-specific systematic review and consensus recommendations for postoperative analgesia following total knee arthroplasty .
Postoperative pain management : number-needed-to-treat approach versus procedure-specific pain management approach .