1. Reason for writing:
The aim of this research is to attempt to update best practice with regards to several areas of perioperative medicine. Particularly this thesis will investigate intraoperative fluid balance, both for intravenous crystalloid administration and blood product administration as well as postoperative analgesia in a subset of surgical patients.
These questions specifically asked are;
(a) Does the judicious use of intraoperative crystalloid administration compared with liberal intraoperative crystalloid administration minimise postoperative morbidity and mortality?
(b) Does the judicious use of intraoperative packed red blood cell administration compared with liberal intraoperative crystalloid administration minimise postoperative morbidity and mortality?
(c) Does the form of postoperative analgesia used decrease recovery time, morbidity and mortality following general surgical procedures involving the abdominal cavity?
A series of systematic reviews and meta-analysis for each of the three topics were conducted to synthesis current evidence. The aim is to determine if current evidence can be synthesised to develop a guide to clinical practice in the aforementioned areas.
It was found that neither intraoperative fluid administration, blood product administration or method of post-operative analgesia had a statistically significant impact on the patient outcomes measured.
Further research may provide sufficient data to answer the above questions. However, current data is unable to give a clear answer to guide clinical practice.