International Anesthesia Research Society Research Articles

The Anesthesiology Physician-Scientist Pipeline: Current Status and Recommendations for Future Growth-An Initiative of the Anesthesia Research Council.

The limited number and diversity of resident physicians pursuing careers as physician-scientists in medicine has been a concern for many decades. The Anesthesia Research Council aimed to address the status of the anesthesiology physician-scientist pipeline, benchmarked against other medical specialties, and to develop strategic recommendations to sustain and expand the number and diversity of anesthesiology physician-scientists. The working group analyzed data from the Association of American Medical Colleges and the National Resident Matching Program to characterize the diversity and number of research-oriented residents from US and international allopathic medical schools entering 11 medical specialties from 2009 to 2019. Two surveys were developed to assess the research culture of anesthesiology departments. National Institutes of Health (NIH) funding information awarded to anesthesiology physician-scientists and departments was collected from NIH RePORTER and the Blue Ridge Medical Institute. Anesthesiology ranked eighth to tenth place of 11 medical specialties in the percent of "research-oriented" entering residents, defined as those with advanced degrees (Master's or PhDs) in addition to the MD degree or having published at least 3 research publications before residency. Anesthesiology ranked eighth of 11 specialties in the percent of entering residents who were women but ranked fourth of 11 specialties in the percent of entering residents who self-identified as belonging to an underrepresented group in medicine. There has been a 72% increase in both the total NIH funding awarded to anesthesiology departments and the number of NIH K-series mentored training grants (eg, K08 and K23) awarded to anesthesiology physician-scientists between 2015 and 2020. Recommendations for expanding the size and diversity of the anesthesiology physician-scientist pipeline included (1) developing strategies to increase the number of research intensive anesthesiology departments; (2) unifying the diverse programs among academic anesthesiology foundations and societies that seek to grow research in the specialty; (3) adjusting American Society of Anesthesiologists metrics of success to include the number of anesthesiology physician-scientists with extramural research support; (4) increasing the number of mentored awards from Foundation of Anesthesia Education and Research (FAER) and International Anesthesia Research Society (IARS); (5) supporting an organized and concerted effort to inform research-oriented medical students of the diverse research opportunities within anesthesiology should include the specialty being represented at the annual meetings of Medical Scientist Training Program (MSTP) students and the American Physician Scientist Association, as well as in institutional MSTP programs. The medical specialty of anesthesiology is defined by new discoveries and contributions to perioperative medicine which will only be sustained by a robust pipeline of anesthesiology physician-scientists.

Abstracts of International Anesthesia Research Society & Society of Critical Care Anesthesiologists 2023 Annual Meetings.

Abstracts of International Anesthesia Research Society & Society of Critical Care Anesthesiologists 2023 Annual Meetings.

Personalized Surgical Transfusion Risk Prediction: Reply

We thank Burton et al.1 and Zapf et al.2 for their thoughtful comments on our research on personalized surgical transfusion risk prediction.3 Both letters raise important considerations regarding variable selection for predictive models in health care, which are worth discussing in further detail.As Burton et al. note, race and ethnicity were not included as input variables in our machine learning model for surgical transfusion risk; we would like to clarify that this was intentional for several reasons, which we explain here. First, the inclusion of race in predictive models has been well-described to contribute to inequity.4 One major limitation of machine learning is that a model can only learn from its training examples—in other words, real-world clinician behaviors. If such behaviors or the societal factors contextualizing that behavior are biased, the model will also be biased. The citation provided by Burton et al. is a perfect example of this5: in this study, researchers evaluated a model trained to predict healthcare utilization after hospital discharge, with the intention to allocate additional resources to patients predicted to have high utilization. Unfortunately, black patients had low utilization because they lacked access to care, which the model learned and perpetuated. Inclusion of race as an input variable in model development encourages machine learning models to explicitly encode such latent biases, and consequently the recommendations of such models will propagate systemic inequities in care.Second, although race is a frequently collected variable in many datasets, it serves as a proxy for often unmeasured variables such as socioeconomic status, access to care, illness severity (due to poor access to care and delayed presentation), and other social determinants of health.6 Thus, although the inclusion of race as a variable may improve model discrimination, it potentially does so for the wrong reasons. Given two individuals, identical except for their skin color, it seems unjust for one to have a “better” prediction based on the population averages of their racial group, which may be due to unmeasured variables not applicable to the specific individual.Third, to the best of our knowledge, there is little evidence that race itself contributes to risk for allogeneic blood transfusion after adjustment for disease burden, socioeconomic status, and other clinical variables that are known to contribute (e.g., hematocrit). We thank Burton et al. for bringing attention to the potential pitfalls of racial adjustment and the critical importance of fairness in predictive modeling. As machine learning is increasingly used for clinical decision support, model developers must be vigilant for potential sources of bias, which can be introduced at every step of model development and implementation.7,8 As a research community, we share a responsibility to ensure that the decision support tools we create do not exacerbate, and ideally help to reduce, the health disparities that are currently present in modern medicine.9Zapf et al. raise important points about the benefits and limitations of model development using large registry datasets versus institution-specific datasets. We agree that inclusion of surgeon and anesthesiologist identifiers may further improve predictive performance. Variation in transfusion risk can occur due to differences in surgeon technique or case complexity, and it would be appropriate to adjust for these; however, they can also occur due to differences in preference for discretionary transfusion, which may be less appropriate to adjust for. By training our models on a large national database, we captured the average transfusion behavior of U.S. physicians, which we believe, on average, to be appropriate. Further customizing model predictions based on individual behavior patterns risks encoding undesirable physician practice patterns into the model; nonetheless, we acknowledge that such adjustment might be necessary for widespread adoption. Our transfer learning approach (i.e., hospital-specific procedure-specific transfusion rate) could easily accommodate the addition of a surgeon- or anesthesiologist-specific adjustment, and it would be interesting to investigate such modifications in future work.Dr. Lou was supported by the National Institutes of Health (Bethesda, Maryland; 5T32GM108539-07) and the International Anesthesia Research Society (San Francisco, California).Dr. Kannampallil has consulting relationships with Pfizer Inc. (New York, New York) and Elsevier (Amsterdam, The Netherlands) that are unrelated to this work. Dr. Hall is the Consulting Director of the National Surgical Quality Improvement Program, American College of Surgeons (Chicago, Illinois). The other authors declare no competing interests.

Vivianne Tawfik, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award

Vivianne Tawfik, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award

Kristin Schreiber, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award

Kristin Schreiber, M.D., Ph.D., a Recipient of the 2022 James E. Cottrell, M.D., Presidential Scholar Award

A Century of Progress and Collaboration Between Obstetric Anesthesiologists, Anesthesia & Analgesia, and the International Anesthesia Research Society.

The past century has seen significant advances in the practice of obstetric anesthesiology. This article will review the role of Anesthesia & Analgesia and the International Anesthesia Research Society in contributing to fundamental paradigm shifts in our understanding of obstetric anesthesiology.

Origins of the International Anesthesia Research Society, Anesthesia & Analgesia, and the World Federation of Societies of Anaesthesiologists: Lasting Legacies of Francis McMechan, MD.

Francis McMechan, MD, founded the National Anesthesia Research Society (NARS), which was the precursor to the International Anesthesia Research Society (IARS) and the first physician anesthesia organization in the United States that was devoted to the research goals of the specialty. NARS initially sponsored Current Researches in Anesthesia and Analgesia, and IARS remains the main parent organization of the journal to this day. Dr McMechan originally hoped to coordinate the scientific efforts of NARS/IARS with the political activities of several other organizations he had founded to achieve his ultimate goal of building a powerful and well-connected anesthesia community across the nation, and eventually around the world. About a decade after his death, Dr McMechan's sweeping global vision would be fulfilled by the creation of the World Federation of Societies of Anesthesiologists (WFSA). Although Dr McMechan's political organizations would eventually lose ground to the newer American Society of Anesthetists (ASA), his scientific organization and his inspiring international interest-embodied by IARS, Anesthesia & Analgesia, and WFSA-continue to thrive today.

Patient Safety During Anesthesia: 100 Years of Progress Documented in Anesthesia & Analgesia.

Anesthesiology has evolved to be a leader in addressing patient safety. Our specialty has overcome serious morbidities including explosions, fires, organ toxicity, fatal arrhythmias, and hypoxic brain damage. Anesthesia safety has been significantly improved due to modern drug development, technical advances, and a strong leadership willing to apply human factors and systems' research strategies, but patient safety concerns remain at the forefront as we strive to improve patient care even further. This year marks the centennial year since the publication of the first issue of Anesthesia & Analgesia. Today, the International Anesthesia Research Society (IARS) and Anesthesia & Analgesia continue to advance the boundaries of patient safety by disseminating practice standards, serving as a forum for novel ideas, and supporting research advancements. This review will discuss several topics published in Anesthesia & Analgesia that exemplify steady changes leading to the safe practices that we rely on currently as well as other IARS activities that have advocated and elevated patient safety within the specialty.

International Connections: The Surprising Outreach of Anesthesia & Analgesia and the International Anesthesia Research Society Over the Past 100 Years.

International Connections: The Surprising Outreach of Anesthesia & Analgesia and the International Anesthesia Research Society Over the Past 100 Years.

100 Years of Pediatric Anesthesia With Anesthesia & Analgesia: Growing Together.

As the practice of pediatric anesthesiology grew in the early 20th century, Anesthesia & Analgesia (A&A) became the most important practical resource of pediatric fundamentals for general anesthesiologists. With continued growth in the mid-20th century, focus then shifted to complex cases performed by dedicated pediatric anesthesiologists. To this day, A&A continues to serve as a crucial forum for our subspecialty as it matures. The International Anesthesia Research Society (IARS) also remains pivotal in addressing the crucial questions of modern practice, such as the recent founding of the SmartTots initiative to investigate the potential neurotoxicity of anesthetics in children. While A&A celebrates 100 years of publication, we reflect upon pediatric anesthesiology's evolution and the impact of the IARS and A&A on pediatric anesthesiology's scholarship, clinical practice, and professionalization.

John Henry Evans, MD: Founding Chairman of the Board of Governors of the International Anesthesia Research Society, and a Forgotten Pioneer of Oxygen Therapy.

The theoretical and practical foundations of modern oxygen therapy were established during the first half of the 20th century. John Henry Evans, MD, inaugural chairman of the Board of Governors of the International Anesthesia Research Society (IARS), was an early pioneer in this field. Challenging the conventional wisdom that high concentrations of oxygen were harmful when inspired over long periods, Evans advocated the continuous and extended administration of 100% oxygen in a wide range of conditions, using special apparatus developed by the Toledo Technical Appliance Company (later, the McKesson Appliance Company), which incorporated a tight-fitting facemask or nasal inhaler. In doing so, Evans became embroiled in a conflict with Alvan Barach of Columbia University College of Physicians and Surgeons, which would take nearly a decade to resolve. Additionally, Evans experimented with the subcutaneous injection and intravenous infusion of oxygen, reporting significant benefits of the former in several acute inflammatory conditions, as well as a variety of chronic ailments. While these contributions have largely been forgotten, Evans expanded the remit of anesthesiology beyond the operating theater and the original charter of the IARS and helped lay the foundations for the rational use of oxygen as a therapeutic agent in all areas of medicine.

Cortical Activity During Pain Relief: A Functional Near-infrared Spectroscopy Study of Offset Analgesia

Offset analgesia is defined by a dramatic drop in perceived pain intensity with a relatively small decrease in noxious input. Although functional magnetic resonance imaging studies implicate subcortical descending inhibitory circuits during offset analgesia, the role of cortical areas remains unclear. The current study performed task-based and connectivity analyses to elucidate the cortical correlates of offset analgesia using functional near infrared spectroscopy (fNIRS). This study was approved by the University of Pittsburgh IRB. After providing informed consent, twenty-four healthy volunteers (18-50 years old) underwent fNIRS scanning at rest and then during offset (OS) and control (Con) heat stimuli applied to the forearm. NIRS data were collected with a head probe targeting bilateral frontal and somatomotor cortices (NIRx NIRSport2). Pain intensity was recorded continuously on a computerized visual analogue scale (COVAS, Medoc). NIRS data were preprocessed and analyzed in NIRS Toolbox, a free analysis package based in Matlab. After controlling for non-neural hemodynamic responses in superficial tissues, widespread increases in cortical oxygenated hemoglobin concentration were observed, reflecting cortical activation during heat pain. OS – Con contrasts revealed deactivations in bilateral medial prefrontal cortex (mPFC) and bilateral somatosensory cortex (SSC) associated with offset analgesia. Right dorsolateral prefrontal cortex (dlPFC) showed activation only during OS. Functional connectivity analyses are ongoing. These data demonstrate opposing cortical activation patterns during offset analgesia and support a model in which right dlPFC underlies ongoing evaluation of pain intensity change. With predictions of decreasing pain intensity, right dlPFC activation likely inhibits ascending noxious input via subcortical pathways resulting in SSC and mPFC deactivation. This study identifies cortical circuitry underlying offset analgesia and introduces the use of fNIRS to study pain modulation in an outpatient clinical environment. Grant support from NIGMS T32GM075770 (BA), NIBIB R01EB028248-01 (TH), the Virginia Kaufman Endowment Fund in the form of a Pitt CTSI competitive research grant (BA, HS, AW, TH), and the International Anesthesia Research Society in the form of the Mentored Research Award (BA).

Editorial introductions.

Editorial introductions.

HYPNOSIS (HYPNOTHERAPY) IN PATIENTS UNDERGOING OPERATION: INTEGRATIVE LITERATURE REVIEW

Background: Patients undergoing operation will feel anxiety, this anxiety will affect the physiological status of the patient which can further have an impact on changes in the patient's hemodinamic and clinical status. Fear of the process that will be undertaken, imagining the pain that will be suffered and the existence of other factors, namely the lack of support for the preparation of surgery from family and people around is like a burden for the patient. Purpose: To craft existing hypnotherapy to improve the patient's readiness for surgery, anxiety/ worries and pain. Methods: Literature search from CIAHL, Scopus, PubMed, International Anesthesia Research Society (IARS), and Google Scholar 2002-2020, on this topic using hypnotherapy in preoperative preparation as keyword showed 8 related articles by other researchers. Results: From the results of literature studies it was found that there are several benefits of giving hypnosis before surgery. Hypnosis can also be termed as giving hypnotherapy. The impact is in the form of positive changes. There are various advantages of applying hypnosis to pre-operative patients in several countries such as France, Indonesia and America, including, reducing pain, reducing anxiety among patients to be undergoing surgery, preparing patients for surgery and reducing other post-operative impacts. Conclusion: Hypnosis can be applied in the cases of advanced preoperative patients, which can improve self-preparedness and can even decrease postoperative pain.

Abstract Book, 17th World Congress of Anaesthesiologists, September 1-5, 2021.

Log in or Register Get new issue alertsGet alerts IARS MEMBER LOGIN Enter your Email address: Wolters Kluwer Health may email you for journal alerts and information, but is committed to maintaining your privacy and will not share your personal information without your express consent. For more information, please refer to our Privacy Policy. Subscribe to eTOC Secondary Logo Journal Logo All Articles Images Videos Podcasts Blogs Advanced Search Toggle navigation Register Login Articles & Issues Current IssuePrevious IssuesPublished Ahead-of-Print A&A PracticeCMECollectionsSubjects中文翻译Multimedia PodcastsVideo For Authors Submit a ManuscriptInformation for AuthorsLanguage Editing Services Infographics/Other Author ServicesOpen AccessAuthor Permissions Journal Info About the JournalAbout the SocietyEditorial BoardAffiliated SocietiesAdvertisingSubscription ServicesReprintsRights and PermissionsContact UsCover Art Gallery All Articles Images Videos Podcasts Blogs Advanced Search September 2021 - Volume 133 - Issue 3S Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Anesthesia & Analgesia. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection WCA 2021 Abstracts - September 2021 SupplementAbstract Book, 17th World Congress of Anaesthesiologists, September 1–5, 2021Anesthesia & Analgesia 133(3S):p 1-1973, September 2021. | DOI: 10.1213/01.ane.0000791544.44545.82 Free Metrics Copyright © 2021 International Anesthesia Research Society Source Abstract Book, 17th World Congress of Anaesthesiologists, September 1–5, 2021 Anesthesia & Analgesia133(3S):1-1973, September 2021. Full-Size Email + Favorites Export View in Gallery Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Anesthesia & Analgesia. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Kudos Resources Export All Images to PowerPoint File Add to My Favorites Email to Colleague Colleague's E-mail is Invalid Your Name: Colleague's Email: Separate multiple e-mails with a (;). Message: Thought you might appreciate this item(s) I saw in Anesthesia & Analgesia. Your message has been successfully sent to your colleague. Some error has occurred while processing your request. Please try after some time. Export to End Note Procite Reference Manager Save my selection Kudos Publication Kudos Resources Article Level Metrics Related Videos Data is temporarily unavailable. Please try again soon. Readers Of this Article Also Read Pro-Con Debate: Do We Need Quantitative Neuromuscular Monitoring in the Era of Sugammadex? Systems Anesthesiology: Integrating Insights From Diverse Disciplines to Improve Perioperative Care Society for the Advancement of Patient Blood Management 2021 Scientific Abstracts Roles for Anesthesiologists in the Future of Medicine in the United States Anesthesia Patient Safety: Next Steps to Improve Worldwide Perioperative Safety by 2030 Back to Top Never Miss an Issue Get new journal Tables of Contents sent right to your email inbox Get New Issue Alerts Browse Journal Content Most Popular For Authors About the Journal Past Issues Current Issue Register on the website Get eTOC Alerts For Journal Authors Submit an article How to publish with us Customer Service Live Chat Chat Offline Activate your journal subscription Activate Journal Subscription Browse the help center Help Contact us at: EMAIL: [email protected] TEL: (USA): TEL: (Int’l): 800-638-3030 (within USA) 301-223-2300 (international) Privacy Policy (Updated December 15, 2022) Legal Disclaimer Terms of Use Open Access Policy Feedback RSS Feeds LWW Journals Copyright © 2022 International Anesthesia Research Society

George A. Mashour, M.D., Ph.D., Recipient of the 2021 Excellence in Research Award

George A. Mashour, M.D., Ph.D., Recipient of the 2021 Excellence in Research Award

Editorial introductions.

Current Opinion in Anesthesiology was launched in 1988. It is one of a successful series of review journals whose unique format is designed to provide a systematic and critical assessment of the literature as presented in the many primary journals. The field of anesthesiology is divided into 16 sections that are reviewed once a year. Each section is assigned a Section Editor, a leading authority in the area, who identifies the most important topics at that time. Here we are pleased to introduce the Section Editors for this issue. SECTION EDITORS Eberhard F. KochsEberhard F. KochsEberhard F. Kochs, MD, PhD, is Professor Emeritus of Anaesthesia and Intensive Care at the Klinikum rechts der Isar, Technical University Munich, Germany. Dr Kochs earned his medical degree from the University of Bonn, Germany and completed his residency at the University Hospital Eppendorf, Hamburg, Germany. In addition, Dr Kochs holds a Masters degree (Dipl.-Phys.) in physics from the University of Bonn. After specializing in anaesthesia and intensive care, he became Professor of Anaesthesiology. In 1994, he was elected as Chair of the Department of Anaesthesiology of the Technical University Munich at the Klinikum rechts der Isar and retired in 2016. Dr Kochs was a member of the Board of Trustees of the Klinikum rechts der Isar and the Klinikum Freising, Germany. In the years 2012–2013, he was President of the European Society of Anaesthesiology (ESA). He served as a member of various editorial boards and has published more than 350 peer-reviewed articles and edited several textbooks in the domain of anaesthesia, intensive care and pain medicine. Dr Kochs’ main areas of research are: neuroscience as applied to anaesthesia, intensive care and pain medicine using electrophysiology combined with neuroimaging, applying mathematical tools for assessment of changes in brain function during drug-induced unconsciousness and following brain pathophysiology (coma). Dr Kochs’ research also focuses on receptor studies including cellular signal transmission in single neurons and brain networks and clinical studies on the effects of sedatives, analgesics on long-term outcome after anaesthesia and intensive care. Richard D. UrmanRichard D. UrmanRichard D. Urman, MD, MBA, FASA is a staff anesthesiologist at the Brigham and Women's Hospital Department of Anesthesiology, Perioperative and Pain Medicine in Boston, Massachusetts, USA and Associate Professor of Anesthesia at Harvard Medical School, USA, where he also received his MD and MBA degrees. He serves as Associate Chair for Dana-Farber Cancer Institute and as a Medical Director for Procedural Sedation Services at the Brigham and Women's Hospital. In addition, he is the founding co-Director of the Center for Perioperative Research and the Director of the Perioperative Medicine Fellowship. He has edited a dozen textbooks, including the one on non-operating room anesthesia (NORA) entitled “Anesthesia Outside the Operating Room” (Cambridge Press, 2018) and has published papers on NORA safety, efficiency and outcomes. He is currently funded by the NIH, NSF, AHRQ and the industry. His research interests include pharmacology, acute pain management, patient safety and efficiency in the perioperative and periprocedural setting. He also serves as the scientific reviewer for the Department of Defense and sits on the FDA Analgesics panel. He is Editor-In-Chief of the Journal of Clinical Anesthesia. Dr Urman is active in the Society for Ambulatory Anesthesia, where he serves as Assistant Treasurer and member of the executive committee. He is also Treasurer of the Society for Perioperative Assessment and Quality Improvement (SPAQI) and Treasurer of the Association of Anesthesia Clinical Directors (AACD). Andrea U. SteinbickerAndrea U. SteinbickerProf. Dr med. Andrea U. Steinbicker is the leading staff physician at the Department of Anaesthesiology, Intensive Care and Pain Medicine at Muenster University Hospital, Muenster, Germany. She has studied medicine at the University of Duisburg-Essen, Alicante, Spain and at Muenster University, Germany. In addition, she studied Public Health and graduated with the master of Public Health. The master thesis was performed at World Health Organization (WHO) in Geneva, Switzerland. She achieved her doctoral degree at the Institute of Physiological Chemistry at the University Duisburg-Essen in 2006. Prof. Steinbicker habilitated in 2015 and was promoted to Associate Professor in 2019. During residency, she performed research as a DFG-funded postdoctoral fellow at the Massachusetts General Hospital, Harvard Medical School, in Boston, Massachusetts, USA and established her research group “Iron signaling“ at Muenster University. She is a certified anaesthesiologist, intensivist and emergency physician. Besides clinical duties, she implemented and coordinates to date Patient Blood Management at Muenster University Hospital in Germany. Until 2021, she was the speaker of the Subcommittee Haemotherapy of the German Society of Anaesthesiology and Intensive Care Medicine and is a member of the International Anesthesia Research Society. Her research focus on iron, blood management and inflammation is pursued in basic, translational and clinical research projects, as well as in education and teaching.

Abstracts of International Anesthesia Research Society & Society of Critical Care Anesthesiologists 2021 Annual Meetings.

Abstracts of International Anesthesia Research Society & Society of Critical Care Anesthesiologists 2021 Annual Meetings.

Editorial introductions.

Editorial introductions.

Abstracts of Posters Accepted to the International Anesthesia Research Society 2020 Annual Meeting

Abstracts of Posters Accepted to the International Anesthesia Research Society 2020 Annual Meeting