What are some research topics in anesthesiology and perioperative medicine that can produce reproducible and attainable results within 1 year, focusing on adult patients undergoing major surgical procedures?

Research Topics in Anesthesiology and Perioperative Medicine Achievable Within 1 Year

Focus your research efforts on quality improvement studies, observational cohort analyses, and implementation science projects that address the critical evidence gaps in perioperative care, as less than one-fifth of current anesthesiology guidelines are supported by high-quality evidence. 1

High-Priority Research Areas with Rapid Feasibility

Perioperative Neurocognitive Disorders and Delirium Prevention

• Implementation of multimodal delirium prevention bundles in surgical populations, measuring incidence reduction through before-and-after study designs 1
• Comparative effectiveness of depth of anesthesia monitoring (BIS targeting 50 vs. standard care) on postoperative delirium rates in patients over 60 years 2, 3
• Regional anesthesia techniques (fascia iliaca blocks, femoral nerve catheters) versus systemic analgesia on delirium incidence in orthopedic surgery patients 3
• Preoperative cognitive screening protocols and their impact on perioperative management decisions and outcomes 1

Geriatric Perioperative Care Quality Metrics

• Audit of anesthetic dose reduction practices (30-50% reduction from standard adult dosing) in elderly patients and correlation with hemodynamic stability and recovery times 2
• Positioning and pressure injury prevention protocols with 30-minute reassessment intervals during procedures exceeding 2 hours in elderly patients 2
• End-of-surgery checklist implementation for patients over 75 years undergoing major surgery, measuring completion rates and postoperative complication reduction 2
• Opioid-sparing multimodal analgesia protocols in cognitively impaired elderly patients, measuring pain control adequacy and delirium rates 1, 4

Perioperative Care Pathway Optimization

• Days alive and out of hospital (DAOH) as a patient-centered outcome measure across different surgical procedures, validating its utility in your institution 5
• Enhanced recovery after surgery (ERAS) protocol adherence and component effectiveness analysis for specific surgical populations 4
• Early mobilization protocols (30 minutes day of surgery, 6 hours daily thereafter) measuring compliance rates and impact on length of stay 4
• Preoperative risk factor modification programs targeting anemia, malnutrition, diabetes, and smoking cessation with measurable surgical outcome improvements 1, 4

Anesthesia Technique and Drug Management Studies

• Regional anesthesia with minimal sedation versus general anesthesia in elderly patients, comparing hypotension rates, delirium incidence, and cardiorespiratory complications 2
• Restrictive versus liberal fluid therapy protocols in high-risk patients undergoing major surgery, measuring postoperative complications 2
• Oral versus intravenous opioid administration routes and their association with postoperative delirium rates 3
• Temperature management protocols maintaining core temperature ≥36°C and impact on surgical site infections and delirium 4, 3

Implementation Science and Quality Improvement

• Perioperative hospitalist service models led by anesthesiologists, measuring length of stay, complication rates, and cost reduction 1, 6
• Surgical Safety Checklist compliance and correlation with perioperative adverse events in your institution 4
• Multidisciplinary team huddles before high-risk cases, measuring communication effectiveness and error reduction 1
• Geriatric anesthesia champion programs assessing impact on elderly patient care quality and staff education 1

Methodological Approaches for Rapid Results

Observational and Before-After Studies

• Retrospective cohort analyses using existing electronic health record data to identify risk factors and outcomes patterns 7, 5
• Prospective quality improvement initiatives implementing evidence-based bundles with concurrent data collection 1, 8
• Time-series analyses comparing outcomes before and after protocol implementation within your institution 6

Audit and Database Research

• Participation in national audit initiatives (emergency laparotomy, hip fracture databases) with local data analysis and quality metric development 1
• Large database studies examining perioperative effectiveness using administrative or clinical registry data 7
• Quality improvement metric development specific to elderly surgical patients with continuous monitoring 1

Critical Evidence Gaps Requiring Urgent Investigation

The evidence base for perioperative care of elderly patients remains critically deficient, with most recommendations extrapolated from younger populations. 1 Randomized controlled trials are less relevant for assessing multimodal interventions in elderly patients; observational studies and before-and-after interventional studies yield equally valuable information 1

Specific Understudied Areas

• Postoperative pain assessment tools in cognitively impaired patients who cannot effectively communicate pain 1
• Optimal anesthetic depth targets for different age groups and surgical procedures to minimize neurocognitive complications 2, 3
• Preoperative frailty screening and targeted interventions to reduce postoperative complications 1
• Continuity of care protocols between hospital and community settings for elderly surgical patients 1, 4

Common Pitfalls to Avoid in Perioperative Research

• Avoid studying interventions requiring extensive infrastructure changes or multi-year implementation timelines that exceed your 1-year window 8
• Do not design studies requiring large sample sizes for rare outcomes; focus on composite endpoints or quality metrics with adequate event rates 5
• Avoid research questions already answered by high-quality evidence; instead, focus on implementation gaps and local quality improvement 1
• Do not neglect feasibility assessment of data collection methods; ensure electronic health record data extraction is possible before study initiation 7
• Avoid single-center randomized trials when observational or quality improvement designs can answer the question more rapidly and pragmatically 1, 8