Anesthesia

Before you perform a search - DEFINE your research topic and clarify your clinical question.

Using PICO will help you to establish key concepts of your research question:

• P - Patient /Population/Problem ...Describe your patient or the problem - be specific
• I - Intervention or Exposure or Issue  ...Type of anesthesia, drug, device, treatment, procedure
• C - Comparison (if any) often procedures / drugs ... Compared to other treatment, device or standard of care (optional)
• O - Outcome ... Improved outcome; management of patient, reduction of adverse effects, etc.

The worksheet and slides below can help you formulate a searchable question.

• Identifying major concepts worksheet OR Identifying major concepts (powerpoints)

NOTE: We want to hear from you about your PICO to build a bank of PICO examples.

.CREATE a practice PICO based on these hypothetical anesthesia scenarios:

---What is the question? Can you clearly state your patient? intervention? outcome?

TRY to create a PICO from this statement:

1. We're two anesthesia residents doing a review of complications in anesthesia for laparoscopic surgery.

- What is the clinical question? Search terms? [Possible 1st PubMed (Medline) search here.]

TRY to create a Medline search from this clinical question / PICO:

2. How effective is ondansetron for preventing postoperative nausea and vomiting in adult surgical patients?

P = Adult surgical patients - how best to translate this into a MeSH term?

I = ondansetron

C = another drug / placebo

O = prevention of nausea & vomiting

Can you develop clinical questions / PICOs / Searches for these two statements?

 3. I want to find current best practices for prevention of nausea and vomiting following laparoscopic surgery.

4. I need to summarize evidence about evaluating a patient's pre-operative cardiac risk in non-cardiac surgery.

Set up a meeting to talk about translating your PICO into a search: vanessa.kitchin@ubc.ca or dean.giustini@ubc.ca

Medical subject headings (or, MeSH terms) are used, with keywords, to search (based on your PICO).

1) Here, are four commonly-used MeSH terms (where [mh] = search the MeSH field) used for anesthesia searches:

• Analgesia[MeSH] Defined by NLM's PubMed here using the MeSH Database.
• Anesthesia[MeSH] Defined by NLM's PubMed here using the MeSH Database.
• Anesthesia and Analgesia[MeSH] Defined as: "...Medical methods of either relieving pain caused by a particular condition or removing the sensation of pain during a surgery or other medical procedure."
• Anesthesiology[MeSH] - Defined as: "...a specialty concerned with the study of anesthetics and anesthesia".
• Anesthetics[MeSH] - Defined as: "...Agents capable of inducing a total or partial loss of sensation .. and pain"

2) Use a SUB-HEADING to focus your results [sh], for example:

• "Anesthesia/adverse effects"[MeSH]
  • On its own: "adverse effects"[sh] - subheading
• "Postoperative Nausea and Vomiting/prevention and control"[Mesh]
  • On its own: "prevention and control"[sh] - subheading

3) Search the Title field only, for example:

• (non-cardiac surg*[ti] risk[ti]) AND (anesthes*[ti] or anaesthes*[ti]) 

4) At the far right of PubMed, you can APPLY LIMITS and FILTERS to narrow your search results:

• Age groups / Human / English Language / Date Range
• Publication Type (e.g., Metaanalysis, Randomized Controlled Trial, Systematic Reviews, etc.)
• Use PubMed Clinical Queries to quickly retrieve clinical studies.

5) Use COMBINATION of MeSH terms / keywords to get focused results (MeSH terms) and new (not-indexed), and non-Medline (never indexed) citations using keywords, for example:

• ("preoperative care"[mh] OR "preoperative period"[mh] OR pre-operative) AND (anesthe* OR anaesthe*) 

FINAL TIPS:

• With the articles you find, edit your searches to account for any MeSH Terms in relevant papers, and
• Try Related Citations in PubMed for related articles based on similarities between the two papers.