Sorry for cross-posting
Dear List Members
We are currently analysing a huge retrospective database regarding outcomes
of surgical patients. This database has postoperative pain levels
(measured by visual analogue scale) distributed among two groups submitted
to different surgical procedures and two different anesthesia techniques.
The first group is composed by more painful surgeries (based on surgeons
opinion) submitted to an anesthetic technique that leads to better
post-operative pain control (regional anesthesia with continuous infusion
of anesthetics thorugh catheter in the postop period). The surgeries on the
second group are less painfull (based on surgeons opinion) and submitted to
a technique that leads to a lesser degree of post-operative pain control
(general anesthesia plus postop narcotics).
The main focus of this study is on cost analysis, but we are also assessing
the possibility of getting some effectiveness estimate. Several concerns
having being raised regarding this second analysis, and we would appreciate
your opinions regarding the following points:
1) besides future RCTs, is there any possibility of comparing both groups
using our present data?
2) being aware of all problems regarding historical controls, is it still
worth to do a rough estimate of the efficiency of pain control (among the
two anesthetic techniques) using historical average levels of pain for each
type of surgery?
3) is the present data not usefull for effectiveness conclusions at all?
Thanks for your help
Ricardo Pietrobon, MD
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