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John Davies Thomas (1844-1893) described a two-ounce drop-bottle for chloroform in 1872 while he was a resident medical officer at University College Hospital, London. After working as a ship's surgeon, he settled in Australia. In May 1875, Thomas presented a paper on the mortality from ether and chloroform at a meeting of the Medical Society of Victoria in Melbourne, Victoria. Surveys conducted in Europe and North America had established that the mortality from chloroform was eight to ten times higher than that from ether. At that time, chloroform was the most widely administered anaesthetic in Australia. Thomas' paper was published in The Australian Medical Journal and reprinted by the Medical Society of Victoria for distribution to hospitals in the Colony of Victoria. Later that year, Thomas moved to Adelaide, South Australia, where he may have been influential at the Adelaide Hospital in ensuring that ether was administered more often than chloroform. It does not appear that Thomas' papers on anaesthesia had a significant effect on the conduct of anaesthesia in Victoria or New South Wales. [ABSTRACT FROM AUTHOR]

Post-discharge phone calls are a widely used yet suboptimal method of ascertaining recovery of day surgery patients. We compared the efficiency of an automated electronic system of follow-up, the Day Care Anaesthesia Outcomes Recording Registry (DayCOR), and a telephone call system that was standard practice in our non-profit private healthcare organisation in Victoria, Australia. We also surveyed a group of clinicians to assess their acceptance of DayCOR compared with the telephone call system. DayCOR is a web-based system which collects, alerts, manages and analyses patient-reported outcomes. Patients may opt in to respond to a 15-question survey via a link sent by text message or email. DayCOR's patient response rate was 77.5%, compared with 66.0% for the telephone call system. Both systems collected data on clinical, process, and experience outcomes. Completeness of data collection was 100% using DayCOR compared with 51%-61.4% of data items using the telephone call system. We estimated that replacing our telephone call system with DayCOR to follow up 60,000 day surgery patients a year would represent an annual cost reduction of AUD $101,345 (53%) using manual demographic data entry, and AUD$142,745 (74%) if DayCOR was integrated with the institution's existing administrative software. Seventy-eight percent of day surgery nurses and 94% of anaesthetists preferred DayCOR to the telephone call system. All anaesthetists surveyed stated that DayCOR provided more valuable feedback, and almost one-fifth had changed their clinical practice as a result. DayCOR's efficiency and acceptability will allow more effective collection of post-discharge patient outcomes than is currently possible in our institution, and will support interventional studies aimed at improving quality of recovery of day surgery patients. [ABSTRACT FROM AUTHOR]

The article presents a study which examines the anaesthesia care outcome of an enhanced recovery after surgery (ERAS) program for patients undergoing abdominal surgery in Victoria. The study shows persistent low intravenous fluid restriction rates and early urinary catheter removal in the post-ERAS period where patients had less pain and faster recovery. It also suggests that perioperative anaesthesia practices can be modified to incorporate surgical recovery program with reduced hospital stay.

The article presents the conducted study at the Royal Melbourne Hospital and the Ballarat Base Hospital, both located in Victoria to identify the percentage of patients aged 70 years old or less for elective and emergency noncardiac surgery who have the required laboratory analysis for calculating the perioperative mortality (POM) score. The study uses three preoperative risk factors, namely, age, albumin and American Society of Anesthesiologists physical status. The results showed that preoperative hypoalbuminaemia was seen in 11% of patients.

The article discusses a report on anaesthesia-related morbidity in Victoria from 1990 to 2005 conducted by the Victorian Consultive Council on Anaesthetic Mortality and Morbidity. Among the objectives of the council were to investigate the circumstances of deaths and diseases happening during or as an outcome of anaesthesia and to annually inform the Minister for Health. The council identified different categories of morbidity including airway morbidity, respiratory morbidity and cardiovascular morbidity.

The article develops a Perioperative Mortality risk score for older patients at three metropolitan teaching hospitals in Melbourne, Victoria. The mortality risk of patients increase if they develop postoperative complications. The risk score was derived using a cohort from a previous audit of older patients undergoing non-cardiac surgery. Findings revealed a 6% mortality rate by 30 days after surgery. The C-statistic for predicting 3-day mortality was 0.79, which was similar to the derivation cohort.