Der Anaesthesist
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Regional anaesthetic procedures are not popular in paediatric anaesthesia in many institutions. However, regional anaesthesia is gaining ground, especially in a "new" concept of balanced paediatric anaesthesia. The decisive argument for the use of regional anaesthesia is the prolongation of pain relief further into the postoperative phase. ⋯ Good anatomic and pharmacologic knowledge should be a prerequisite for all physicians who use regional anaesthetic procedures. Continuous training and critical analysis are needed for good results. Only then can such methods be introduced into routine paediatric anaesthetic practice.
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The primary goals of scoring in emergency medicine are grading of the severity of the patient's condition, measurement of diagnostic and therapeutic efforts, forecasting the outcome, and support in decision making on triage and therapy. Scores can also be used as tools for measuring efficacy and controlling quality. There has been less experience with use of scoring systems to estimate quality of life. ⋯ Scores for use in emergency medicine should be based on physiological parameters, universally applicable and suitable for use throughout the course of diseases. Appropriate score systems are the Glasgow Coma Scale, the Rapid Acute Physiology Score, and the Mainz Emergency Evaluation Score, Trauma Score and Injury Severity Score. Scores suitable for estimation of quality of life following emergencies are the Glasgow Outcome Scale and the Glasgow-Pittsburgh Scale.
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It is the purpose of this review to outline the principles of biometric methods in clinical research. Several study designs such as cohort studies, case-control studies or randomized controlled trials are explained in detail, and their problems and their interpretation are discussed. It is demonstrated that observational studies may yield valuable information about associations between exposure and outcome variables but that only properly designed randomized clinical trials of adequate sample size make it possible to answer research questions about causal relationships. It is emphasized that good clinical research depends on properly designed studies more than on complicated statistical procedures.