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 .
Gastric Sonography in the Severely Obese Surgical Patient: A Feasibility Study
BACKGROUND : Gastric ultrasonography allows qualitative and quantitative assessment of gastric contents and volume in nonobese subjects . In this study , we sought to determine the feasibility of gastric ultrasound in severely obese patients ( body mass index [ BMI ] ≥35 kg/m2 ) . We defined feasibility as the ability to identify a full cross section of the gastric antrum in at least 80 % of subjects when imaged in the right lateral decubitus position . METHODS : This was a prospect i ve cohort study on fasted surgical patients with BMI > 35 kg/m2 . The primary outcome measure was the feasibility of gastric sonography .  Secondary outcomes included the distribution of antral grade following an existing 3-point grading system . In addition , the antral cross-sectional area ( CSA ) and gastric volumes in this cohort were compared with historical data from a published study in nonobese individuals . Time to image capture , antral wall thickness , and depth of the antrum are also reported . RESULTS : Sixty patients ( BMI range 35.1–68.7 ) were studied . The antrum was identified in 95 % of subjects in the right lateral decubitus ( 95 % CI , 0.86–0.99 ) and 90 % of subjects in the supine position . Definition of antral grade ( 0–2 ) was possible in 88.3 % ( 95 % CI , 0.77–0.95 ) of cases . As expected , antral grade correlated with antral CSA and gastric volumes ( P < 0.0001 ) . When compared with historical data , our results suggest that severely obese patients have a larger baseline CSA and gastric volume than nonobese patients ( P < 0.001 ) but a similar gastric volume per unit of weight ( P = 0.141 ) . CONCLUSIONS : Gastric ultrasound assessment is feasible in fasted severely obese subjects . Our data also suggest that obese individuals present larger antral size and gastric volume than their nonobese counterparts
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 .