Anesth Analg 2008; 107:746-747
© 2008 International Anesthesia Research Society
doi: 10.1213/ane.0b013e318181bb61
EDITORIAL
Introducing Focused Reviews in Obstetric Anesthesiology: A New Series
Cynthia A. Wong, MD
From the Department of Anesthesiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Address correspondence to Cynthia A. Wong, MD, Department of Anesthesiology, Northwestern University Feinberg School of Medicine, 251 E. Huron St., F5-704, Chicago, IL 60611. Address e-mail to c-wong2{at}northwestern.edu.
The practice of obstetric anesthesiology has changed in the two decades since I trained, as has the practice of all anesthesiology. Indeed, the practice of obstetric anesthesiology has changed within the past decade, and even the past 5 yr. We provide better, safer, and more efficient care to our patients. On the labor and delivery unit, we are caring for many more patients than years past. The number of women choosing neuraxial analgesia during labor has increased markedly1 commensurate with the improvement in our labor analgesia techniques. The increase in the cesarean delivery rate means that we are providing surgical anesthesia for increasing numbers of obstetric patients. It is our duty as physicians to provide the safest and most up-to-date care possible.
The necessity for practicing up-to-date medicine has been recognized across the spectrum of medicine. Life-long specialty certification is no longer acceptable. Society and accrediting organizations require that physicians continue to learn and use this new knowledge in their medical practice. To this end, the American Board of Anesthesiology requires participation in the Maintenance of Certification in Anesthesiology for any diplomates certified in or after 2000,* consistent with the American Board of Medical Specialties Maintenance of Certification program.
Most of us are generalists. We practice many different types of anesthesia, including, but not limited to, obstetric anesthesia. We must keep abreast of developments in many areas of anesthesiology. So how do we, as busy, practicing anesthesiologists, keep current on the wealth of new knowledge and practices in our field? There are, of course, a number of avenues for acquiring and incorporating new knowledge into our practice. These include attending review courses, participating in workshops, and interacting with colleagues and experts. It also includes reading journals and, in particular, review articles. The traditional review article, however, is quite long. It takes a fair amount of time and mental energy to adequately digest its contents. It also takes a lot of time and mental energy to research and write a good, traditional review article.
Most busy anesthesiologists are already over-committed, and have little uncommitted time and energy. After a busy day at work and time spent with our families, it is virtually impossible to concentrate on a long article or book chapter. However, we still need to find efficient methods to acquire new knowledge and prove that we have acquired it. To assist you in accomplishing this task, the Section on Obstetric Anesthesiology in Anesthesia & Analgesia is initiating a series of Focused Reviews, or "mini-reviews," if you will. The reviews will be written by experts in the field and published regularly. They will be quite short (several pages) and will focus on a very narrow topic. For example, instead of addressing all side effects of neuraxial opioids, the focused review will address respiratory depression after neuraxial opioids in obstetric patients.
Our first Focused Review by Carvalho,2 published in this month’s issue of the journal, addresses just this topic. It is particularly timely given the recent emphasis placed on safety and opioid-associated respiratory depression by the Anesthesia Patient Safety Foundation. The American Society of Anesthesiologists has convened a task force charged with formulating Practice Guidelines that address the use of neuraxial opioids in all patients, not just obstetric patients. Updated guidelines will come before the American Society of Anesthesiologists House of Delegates for approval in October 2008.
Other Focused Reviews to be published in the near future include reviews on awareness during general anesthesia for cesarean delivery and patient-controlled epidural analgesia techniques for maintenance of labor analgesia. Readers are welcome to submit ideas for topics to the Section Editor, Cynthia Wong, at c-wong2{at}northwestern.edu.
Finally, most Focused Review articles will be available for Continuing Medical Education through the journal. We hope that you will enjoy the review articles, and that they will assist you in acquiring and consolidating knowledge in the field of obstetric anesthesiology, and contribute to making your practice more safe, efficient, and up-to-date.
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Footnotes
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*The American Board of Anesthesiology. Maintenance of Certification in Anesthesiology General Inquires. Available at: http://www.theaba.org/mocafaq.shtml#what_moca. Accessed May 18, 2008. 
 The American Board of Medical Specialties. Maintenance of Certification. Available at: http://www.abms.org/Maintenance_of_Certification/ABMS_MOC.aspx. Accessed May 18, 2008.
 Weinger MB. Dangers of postoperative opioids. Anesthesia Patient Safety Foundation Newsletter 2007;21. Available at: http://www.apsf.org/resource_center/newsletter/2007/winter/01_opioids.htm. Accessed May 18, 2008.
 Practice Guidelines for the Prevention, Detection and Management of Respiratory Depression Associated with Neuraxial Opioid Administration. American Society of Anesthesiologists. Available at: http://www.asahq.org/clinical/Practice%20Guidelines%20for%20the%20Prevention%20Detection%20and%20Management%20of%20Respiratory%20Depression%20Associated%20With%20Neuraxial%20Opioid%20Administration.pdf. Accessed May 18, 2008.
Accepted for publication May 22, 2008.
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REFERENCES
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- Bucklin BA, Hawkins JL, Anderson JR, Ullrich FA. Obstetric anesthesia workforce survey: twenty-year update. Anesthesiology 2005;103:645–53[Web of Science][Medline]
- Carvalho B. Respiratory depression after neuraxial opioids in the obstetric setting. Anesth Analg 2008;107:956–61[Abstract/Free Full Text]
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