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 Fasted Surgical Patient: A Prospective Descriptive Study
BACKGROUND : Aspiration pneumonia remains a serious anesthetic-related complication . A reliable diagnostic tool to assess gastric volume is currently lacking . We recently demonstrated that gastric sonography can provide reliable qualitative and quantitative information about gastric content and volume in healthy volunteers . In the current study , we performed a prospect i ve qualitative and quantitative analysis of the gastric antrum in 200 fasted patients undergoing elective surgery . METHODS : A st and ardized gastric scanning protocol was applied before anesthetic induction . Patients were classified following a 3-point grading system based solely on qualitative sonographic assessment of the antrum in the supine and right lateral decubitus positions . RESULTS : Eighty-six patients were classified as grade 0 ( empty antrum ) ; 107 patients as grade 1 ( minimal fluid volume detected only in the right lateral decubitus position ) ; and 7 patients were classified as grade 2 ( antrum clearly distended with fluid visible in both supine and lateral positions ) . The 3-point grading system correlated with total gastric fluid volume as predicted by a previously reported mathematical model . Essentially grade 0 corresponds to a completely empty stomach , grade 1 corresponds to negligible fluid volumes ( 16 ± 36 mL ) within normal ranges expected for fasted patients , and grade 2 correlates with significantly higher predicted gastric fluid volumes ( 180 ± 83 mL ) beyond previously reported “ safe ” limits . One patient with a grade 2 antrum had an episode of significant regurgitation of gastric contents on emergence from anesthesia . CONCLUSION : We propose a 3-point grading system based exclusively on qualitative sonographic assessment of the gastric antrum that correlates well with predicted gastric volume . This grading system could be a promising “ biomarker ” to assess perioperative aspiration risk . Before it can be applied widely to clinical practice , this diagnostic tool needs to be further vali date d and characterized
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 .