Current developments in anaesthesia and neuromuscular transmission.

نویسندگان

  • J M Wierda
  • R K Mirakhur
چکیده

This supplement is based on two interesting meetings where experts and opinion leaders were invited to present the state of art in their particular fields of interest. The first meeting, a symposium on the Current Developments in Anaesthesia, took place in Barcelona earlier this year, whereas the second meeting, the 7th International Neuromuscular Meeting was held last June in Belfast. The latest developments in the field of pharmacology and physiology of the neuromuscular transmission were presented in the meeting in Belfast and investigators were invited to illustrate their recent work not only in oral presentations but also in poster-discussion sessions. Only the abstracts of the posters of this meeting could be included in this supplement. The majority of scientific information presented in this supplement is from the meeting held in Barcelona. The central theme of this meeting, ‘Current Developments’, covered various aspects of concern to anaesthesiologists such as developments in health care, science, surgery, and of course, developments in anaesthetic care. The first two contributions in this supplement are dedicated to quality management and pharmacoeconomics. Two important developments can be established in the process of quality improvement, i.e. the patient becoming more and more a customer requiring optimal service and the anaesthetist evolving in the role of the perioperative physician, who manages the patient from the preoperative visit, during the operative procedure and in the postoperative period assuming responsibility for optimal management of pain and any other discomfort [1]. Pharmacoeconomics is more than simply bringing down the cost of acquisition of anaesthetic drugs [2]. Although cost-minimization is essential, a more holistic approach to anaesthetic practice appears indicated to improve quality of care. Efforts should be made to measure other potential benefits of a particular anaesthetic procedure such as the satisfaction of the surgeon and well-being of the patient. The outcome of these cost–benefit studies should be employed to optimize daily clinical practice. Anaesthetic care has been improved to a large extent due to long-term close co-operation between clinicians and the university and industrial scientists [3]. The technology of pharmaceutical research has evolved from small scale chemical synthesis and testing in animal models to selection of possible drug candidates out of huge molecular libraries followed by a high throughput large scale screening of these molecules and their structural relatives in targetassays [4]. University investigators have been working in parallel to unravel the factors governing the effect and the time-course of action of drugs [5]. Industrial funding has facilitated much of the work in the universities. Still, more and more basic research is carried out within the pharmaceutical industry itself. Although this collaboration in drug research appears essential for both the pharmaceutical companies and the universities, funding from the industry for fundamental research is under pressure. This is due on one hand to an exponentially increasing drug development cost and shortage of new leads and, on the other hand to declining profits due to increased competition and governmental price controls. Reduction in health care costs is an important argument for the transition from inpatient to day care surgery, although the growth of minimally invasive surgery has contributed much to this development [6]. The success of day care surgery has been paralleled by increase in outpatient departments for anaesthetic pre-assessment, availability of better anaesthetic drugs, and developments in surgical procedures [7]. The growth in the number of surgical interventions that can be carried out under day care conditions suggests that the boundaries of outpatient surgery in the future will be almost solely dictated by the preoperative condition of the patient. It is still an open European Journal of Anaesthesiology 2001, 18 (Suppl. 23), 1–3

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عنوان ژورنال:
  • European journal of anaesthesiology. Supplement

دوره 23  شماره 

صفحات  -

تاریخ انتشار 2001