Anaesthesia and World War II:  When the Battlefield Becomes a Research Field - A Bibliometric Analysis

Abstract

At the outbreak of World War II, anaesthesiology was struggling to establish itself as a medical specialty. The battlefield abruptly exposed this young specialty to mass-casualty treatment, with an urgent need to provide proper fluid resuscitation, airway management, mechanical ventilation, and analgesia to thousands. But while Europe suffered under the Nazi boot, anaesthesia was ready to rise to the challenge. To measure and throw light on this evolution, we designed a bibliometric study, involving quantitative and statistical analysis of publications. Therefore, seven journals were selected, covering North American, British and German anaesthesiology literature, the surgical field, French medical practice and the military domain. Attention was focused on journal volumes published between 1920 and 1965. After reviewing the literature, we selected 12 keywords representing important advances in anaesthesiology since 1920. Titles of original articles from all selected journals editions were screened for the occurrence of any of these keywords. The results were expressed as ratios (number of titles in which these keywords occurred divided by the number of journal articles screened), per period of time. This defined what we named the “Keyword-Impact” on publications. By means of a comprehensive and extensive review of the literature, this study demonstrates statistically that WWII has accelerated progress in anaesthesiology. It also offers an objective record of the chronology of the major advances in anaesthesiology before and after the conflict. Whereas the war arguably helped to conceive anaesthesiology as a specialty, in return anaesthesiology helped to heal the wounds of war. Funding Statement: The authors received no financial support for the research and authorship of this article. Declaration of Interests: The authors declare that they have no conflict of interest.