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EBPOM 2018 – 8 | The EPOCH trial results

The highly anticipated results of the Enhanced Peri-Operative Care for High-risk patients (EPOCH) trial, presented for the first time at EBPOM 2018. Were these results as expected? Can we make large scale quality improvement programmes work? Does this trial put ‘the big questions’ to bed?

This piece is introduced by Monty Mythen and presented by Professor Rupert Pearse, Professor of Intensive Care Medicine at Queen Mary, University of London and Carol Peden, Professor of Anesthesiology and Exec. Director of the Center for Health System Innovation, University of Southern California, University of Bath and the Institute for Healthcare Improvement (IHI).

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  1. Without direct cortical response to anesthetics, over medication by up to 30% will result. (Friedberg BL, Sigl JC: Clonidine premedication decreases propofol consumption during bispectral (BIS) index monitored propofol-ketamine technique for office based surgery. Dermatol Surg 2000;26:848-852.)
    Real time EMG/BIS brain monitoring of opioid free, propofol ketamine anesthesia is a numerically reproducible paradigm for all patients, not only the high risk ones.
    Disclaimer: No BIS maker financial support.

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EBPOM 2018 – 8 | The EPOCH trial results

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