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Development and Methodology of a Registry of Regional Anaesthesia

  • Michael J. Barrington
Chapter

Key Points

  • Prospectively collecting regional anaesthesia procedure-related data allows monitoring of quality of care and identification of problematic practices that may lead to complications or adverse events.

  • Monitoring the quality and safety of regional anaesthesia is of paramount importance for informed patient consent and clinical decision-making.

  • Serious, adverse events are infrequent or rare in regional anaesthesia, therefore documenting them requires large patient samples.

  • Proactively monitoring for adverse events in new healthcare processes is recommended, one example being ultrasound-guided peripheral nerve blockade. In the 2000s this emerged as a significant potential advance in clinical practice popularizing peripheral nerve blockade globally.

  • With periodic updates to practice guidelines and the ever-changing development of new approaches and technologies, use of a regional anaesthesia registry or database allows practitioners to make comparative analysis across time.

  • Clinical registries and databases facilitate qualitative, evidence-based assessment of practice, allowing less reliance on expert consensus or practice based on outdated dogma. Registries can also overcome limitations of cost and frequent lack of statistical powering associated with randomized clinical trials.

  • Registries/databases should be designed to collect as complete a dataset relating to the procedure as possible, including patient demographics, surgical information, anaesthetic type and dosage, and clinical effectiveness outcomes. Data recording and entry methods should be standardized and simple to use.

Keywords

Prospective studies Registries Nerve block Development Methodology 

Abbreviations

ARAC

The Australasian Regional Anaesthesia Collaboration

ASRA

The American Society of Regional Anesthesia and Pain Medicine

AURORA

The Australian and New Zealand Registry of Regional Anaesthesia

IOM

United States Institute of Medicine

IRORA

The International Registry of Regional Anesthesia

LAST

Local anesthetic systemic toxicity

PNB

Peripheral nerve blockade

PNI

Postoperative nerve injury

RCTs

Randomized controlled trials

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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of Anaesthesia and Acute Pain MedicineSt. Vincent’s Hospital, MelbourneMelbourneAustralia
  2. 2.Faculty of Medicine, Dentistry and Health SciencesMelbourne Medical School, University of MelbourneParkvilleAustralia

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