The Center for Anaesthesiological Research (CAR) is the name of the clinical research unit at Department of Anaesthesiology at Zealand University Køge Purpose and aim CAR conducts and coordinates research in Anaesthesiology at Zealand University Hospital (ZUH) Køge. We aim to promote a scientific and evidence-based observation, care and treatment for the benefit of patients by facilitating and supporting basic and clinical research. It is the goal of CAR to act as a driving force for a high-quality clinical environment at the Department by continuing to support and encourage both physician and nurse related research, and by the establishment of relevant research teams across specialization. The vision for CAR at the Dept. of Anaesthesiology is to carry out research that belongs to the top both nationally and internationally. This applies in particular to the areas of postoperative pain management and complications after treatment at the intensive care unit (aftercare), including treatment of ICU-acquired delirium. Research areas and strategy The overall ambition and goal of research at CAR is to improve the perioperative patient course, with a special emphasis on postoperative pain management. Furthermore, in the area of intensive care medicine, to focus on late complications/Aftercare, and on treatment of delirium. The research shall be conducted on an international level and with the highest impact on intensive-anaesthesiological practice. Multimodal pain treatment after surgery The goal is to achieve a safe and effective pain management after surgery. Our knowledge about the combination of various analgesics, as well as long-term effects hereof, is poorly investigated. Therefore, it is our aim in systematic reviews and large randomized trials to illuminate the pros and cons of analgesic pain treatment. Which drugs (analgesics) can be used and combined and to which patient populations. Regional blockade Ultrasound-guided nerve blocks are highly effective and an important part of contemporary pain management. However, the accompanying motoric block may lead to impaired mobilization and risk of falling. Likewise, it is important that the blockade has a long-lasting effect, and also to examine the quality of the pain treatment when the blockade ceases. Therefore, adjuvant therapy that prolongs nerve blocks, as well as the development of primary sensory nerve blocks, are important subjects for this research area. Persistent postoperative pain (PPP) / chronic postoperative pain All chronic pain starts as an acute pain. Most people will experience that acute pain ceases, but 10-50% develops chronic pain, which in 2-10% develops to moderate-severe pain. We do not know enough today about who develops PPP, and if this can be prevented. Perioperative medicine and optimization It is a high priority to ensure optimal surgical patient courses, both for planned and acute surgery, and here, the anaesthesiological treatment represent a cornerstone for such care. Modulation of the surgical stress response, optimization of pain and fluid treatment, and preservation of optimal circulation and blood pressure are important focus areas. Recent years have given new important knowledge of peri- and postoperative release of cardiac enzymes (troponin) as a measure of cardiovascular complications, which is an important outcome for this research area. In cooperation with the Surgical Department, we have a special focus on high-risk acute abdominal surgery (OMEGA) Intensive therapy Critical illness with treatment at the Intensive Care Unit often results in both psychological, physical and cognitive long-term impairments. Patients suffering from ICU- related delirium (confusion / hallucinations) are particularly vulnerable. Identification of such patients, including prevention and follow-up is therefore important (Aftercare). Treatment of delirium is currently not evidence-based and our knowledge about the pros and cons of the most commonly used drug treatment (haloperidol) is limited, which is a special research area for CAR. Therefore, in cooperation with the national research collaboration in intensive research (CRIC), we conduct a major international multicenter trial to investigate the benefits and harms of haloperidol treatment of ICU-acquired delirium. Cooperation CAR has a well-working collaboration with several departments at ZUH Køge, as well as regional, national, and international collaborators. In particular, we have ongoing research projects in collaboration with the Copenhagen Trial Unit (CTU), Odense University Hospital, Bispebjerg Hospital, Center for Research in Intensive Care (CRIC) and Acute and Persistent Pain Research Alliance Zealand (APPRAZ).