Anesthesiology Research Research Articles

Middle Eastern and North African: Recognizing the New US Census Category in Anesthesiology Research and Practice

Middle Eastern and North African: Recognizing the New US Census Category in Anesthesiology Research and Practice

Collaborations in publications on pediatric anesthesiology in the D-A-CH countries

Collaborations are an essential element of scientific activity and particularly important in fields such as pediatric anesthesiology, where the evidence base in general is relatively limited. Arecent scientometric analysis revealed ageographic diversification of publication activity in pediatric anesthesiology within the last two decades, accompanied by asurge in international collaborations. Given the hypothesis of asimilar growth in the activity and dynamics of publications in pediatric anesthesiology, the objective of this scientometric study was to analyze the publication activity and collaboration habits in research in pediatric anesthesiology from Germany, Austria and Switzerland (D-A-CH). This secondary analysis identified all publications on pediatric anesthesiology with an affiliation from the D‑A-CH countries between 2001 and 2020 from PubMed and Web of Science. The query parameters included the timeframe 2001-2020, authors' affiliations tied to anesthesiology departments (using various forms of the term "anesthesia"), and the mention of pediatric interest in titles or abstracts. The data underwent standardization to account for linguistic variations. The publications were assigned to astate, city and institution based on the correspondence address, to ayear based on the publication date and to asource based on the journal. The primary endpoint was publication activity and dynamics, represented by the number of publications and the respective growth rates (calculated as the linear regression slope). Secondary endpoints included the share of collaborations within and outside the D‑A-CH region (at the country and institutional level), the distribution of publication activity and the most prominent sources of publications. Between 2001 and 2020 atotal of 3406 publications on pediatric anesthesiology involving authors from the D‑A-CH countries were identified. Of these 2807 (82.4%) had acorrespondence address in D‑A-CH. The average annual growth rate of publications with acorrespondence address was + 2.9% for the D‑A-CH countries and + 7.7% for publications with collaborations. The number of publications in which an institution from D‑A-CH was named as acoauthor from acorrespondence address outside D‑A-CH also increased by an average of 7.4% per year during the study period. The majority of collaborations occurred between institutions within the D‑A-CH region, although Swiss institutions exhibited amuch higher proportion of collaborations outside the region. Of all publications with acorrespondence address 90% originated from 46cities. The most prominent source was Die Anästhesiologie for publications from Germany, and Pediatric Anesthesia for publications from Austria and Switzerland. The number of publications in pediatric anesthesiology from the D‑A-CH countries has increased over the past two decades, accompanied by asurge in collaborations. It is hoped that increased collaboration will contribute to ahigher level of evidence in pediatric anesthesiology care.

Patient Safety in Anesthesiology: Progress, Challenges, and Prospects.

Anesthesiology is considered a complex medical specialty. Its history has been marked by radical advances and profound transformations, owing to technical and pharmacological developments and innovations in the field, enabling us over the years to improve patient outcomes and perform longer, more complex surgical procedures on more fragile patients. However, anesthesiology has never been safe and free of challenges. Despite the advances made, it still faces risks associated with the practice of anesthesia, for both patients and healthcare professionals, and with some of the specific challenges encountered in low and middle-income countries. In this context, certain actions and initiatives must be carried out collaboratively. In addition, recent technologies and innovations such as simulation, genomics, artificial intelligence, and robotics hold promise for further improving patient safety in anesthesiology and overcoming existing challenges, making it possible to offer safer, more effective, and personalized anesthesia. However, this requires rigorous monitoring of ethical aspects and the reliability of the studies to reap the full benefits of the new technology. This literature review presents the evolution of anesthesiology over time, its current challenges, and its promising future. It underlines the importance of the new technologies and the need to pursue efforts and strengthen research in anesthesiology to overcome the persistent challenges and benefit from the advantages of the latest technology to guarantee safe, high-quality anesthesia with universal access.

Perioperative oxygen administration for adults undergoing major noncardiac surgery: a narrative review.

Perioperative oxygen administration, a topic under continuous research and debate in anesthesiology, strives to optimize tissue oxygenation while minimizing the risks associated with hyperoxia and hypoxia. This review provides a thorough overview of the current evidence on the application of perioperative oxygen in adult patients undergoing major noncardiac surgery. The review begins by describing the physiological reasoning for supplemental oxygen during the perioperative period and its potential benefits while also focusing on potential hyperoxia risks. This review critically appraises the existing literature on perioperative oxygen administration, encompassing recent clinical trials and meta-analyses, to elucidate its effect on postoperative results. Future research should concentrate on illuminating the optimal oxygen administration strategies to improve patient outcomes and fine-tune perioperative care protocols for adults undergoing major noncardiac surgery. By compiling and analyzing available evidence, this review aims to provide clinicians and researchers with comprehensive knowledge on the role of perioperative oxygen administration in major noncardiac surgery, ultimately guiding clinical practice and future research endeavors.

AI-Powered Web Applications for Enhanced Clinical, Research, and Professional Development

Introduction: The rapid growth of technology in the field of anesthesiology offers unique opportunities to leverage artificial intelligence (AI) for enhancing clinical, research, and administrative operations. Our team, consisting of anesthesiologists and data scientists, sought to develop a suite of web applications using generative AI to address specific challenges faced by anesthesiology departments. Objective: To design, develop, and evaluate the feasibility of a range of AI-powered web applications tailored for anesthesiologists to streamline research feasibility, literature searches, protocol drafting, text simplification, work promotion, grant writing, professional advancement, and secure communication. AI Tools developed: Data Feasibility Analysis: AI-assisted search of descriptions and schemas of multiple data warehouses to assess the feasibility of various clinical and research ideas. AI-Powered PubMed Search: AI-assisted search to effciently navigate and extract relevant publications from PubMed, including summarizing the literature found. IRB Protocol Generation: Automated drafting process for Institutional Review Board (IRB) protocol forms, ensuring adherence to regulatory standards. Text Simplification: Tool to distill complex clinical, research, or regulatory text to an 8th-grade reading level, enhancing accessibility — e.g., for patient consent forms. Work Promotion and Amplification: drafts blog posts, “tweets,” and layperson summaries of research abstracts. NIH Grant Drafting: Drafts Specific Aims page and Research Strategy sections for National Institutes of Health (NIH) style applications, ensuring compliance and coherence. Professional Advancement Assistance: Drafts Promotion & Tenure portfolios and letters of recommendations Secure AI Conversations: Integrated generative AI technology in an encrypted and secured platform, safeguarding sensitive information. Conclusions: The suite of AI-powered web applications, developed in collaboration between anesthesiologists and data scientists, showcases potential in enhancing the effciency and impact of various processes integral to anesthesiology research. The integration of these tools into daily operations can potentially revolutionize how anesthesiologists engage with research, patient care, professional development, and communication. Future endeavors will focus on rigorous validation and widespread deployment to harness the full potential of these innovations. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Predictors of Substance Use Risk in Nurse Anesthetists.

Certified registered nurse anesthetists (CRNAs) are exposed daily to highly addictive substances and stressful work environments, placing them at risk for substance use disorders (SUDs). Previous research, which is scarce, indicated that drugs of choice were opioids and propofol. Therefore, the purpose of this study was to investigate predictors of SUD risk using the World Health Organization Alcohol, Smoking and Substance Involvement Screening Test. From June to July 2020, an online survey was sent via the American Association of Nurse Anesthesiology Research Survey Service to 3,000 CRNAs with a response of approximately 225 members. CRNAs were found to be at a moderate risk for SUDs in the following categories: 10.27% for tobacco, 23.56% for alcohol, and 6.28% for cannabis. Regression analysis by substance category includes robust, differing models in this homogeneous sample. Predictors for all three models include a collection of demographic variables, religiosity, anxiety, difficulties due to anxiety, depression, substance use history, contact with the American Association of Nurse Anesthesiology Peer Assistance Program, and organizational support. Over 10% of CRNAs are at risk for developing tobacco use disorder, and almost one quarter of those surveyed are at a moderate risk for developing alcohol use disorder. These data are of concern and may indicate a shift of preferred substances used by CRNAs from controlled substances to alcohol.

Translational research updates in female health anesthesiology: a narrative review.

Females represent 49.6% of the global population and constitute a significant proportion of surgical patients and hospital admissions. Little is known about the bi-directional effects of sex and anesthetics or the impact of anesthetic interventions on long-term female health outcomes. Sex differences in pain pathways can influence pain experience and treatment effectiveness. The impact of anesthetic management on the recurrence of breast cancer is poorly understood, as are the long-term consequences of cardiovascular disease and safe and effective treatments in pregnancy. This review aims to outline recent advances in translational science in female health anesthesiology research and highlight critical research opportunities in pain, cancer outcomes, and cardiovascular disorders. We searched PubMed and summarized relevant articles published in English between December 2021 and June 2022. Studies reveal sex differences in pain pathways and highlight the importance of sex as a biological variable in experimental designs and translational medicine. Sex differences have also been observed in side effects attributed to opioid analgesics. We summarize some of the neural circuits that might underlie these differences. In the perioperative setting, specific anesthetics are implicated in metastatic seeding potential and acute and chronic pain outcomes, suggesting the importance of anesthetic selection in comprehensive care during oncologic surgery. In the peridelivery setting, preeclampsia, a cardiovascular disorder of pregnancy, affects maternal outcomes; however, biomarkers can risk-stratify females at risk for preeclampsia and hold promise for identifying the risk of adverse neurological and other health outcomes. Research that builds diagnostic and predictive tools in pain and cardiovascular disease will help anesthesiologists minimize sex-related risks and side effects associated with anesthetics and peri-hospital treatments. Sex-specific anesthesia care will improve outcomes, as will the provision of practical information to patients and clinicians about the effectiveness of therapies and behavioral interventions. However, more research studies and specific analytic plans are needed to continue addressing sex-based outcomes in anesthesiology.

Sex equality in high-quality anaesthesiology research: A descriptive bibliometric study on scientific authorships.

Sex equality in high-quality anaesthesiology research: A descriptive bibliometric study on scientific authorships.

Research Performance in Anesthesiology and Pain Medicine by Saudi Arabia

Aim: A medical practice known as anesthesia, prevents patients from feeling pain before, during and after surgical procedure. The present study aims to present the bibliometric evaluation of the Saudi Arabian research in Anesthesiology and Pain Medicine (APM) during the last 40 years from 1983 to 2022. Method: The meta-data was retrieved on 31st August 2023 from the Scopus database for conducting bibliometric research. An advance search option was used, and selected the sub-category “Anesthesiology and Pain Medicine” from the major subject area of Medicine. We excluded the documents published after 31st December 2022. We downloaded the global summary of publications on APM and later selected the Saudi Arabia from the country filter and downloaded the bibliographic information of the documents. Microsoft Excel and VOSviewer software were used for data analysis. Results: A total of 207,683 documents were found on APM worldwide and the highest number of documents has been contributed by the United States (39%). About 41% of the documents were published in the last five years (2018-2022). Saudi Arabian authors produced 1,085 (0.52%) documents in 40 years from 1983 to 2022. More than half of the documents were published in the last five years and the ratio of open-accessed documents was found higher as compared to subscription-based documents. Saudi authors collaborated with authors from 109 countries but most of the research was performed with Egypt and the United States. Saudi Journal of Anaesthesia was the most frequent source of publication. The major funding sources and most occurred keywords were also analyzed. Conclusion: The current study has examined the research growth on APM produced by Saudi Arabia for 40 years. Overall, the share of Saudi Arabia in APM research at the global level was recorded at 0.52 percent, but the share was a bit increased and reached on 0.70 percent during the last five years of study. This increase has been strongly correlated with government investment in human resources and the development of healthcare and educational infrastructure. Keywords: Bibliometric, Anesthesia, Research productivity,

Engaging patients in anesthesiology research: a rewarding frontier

Engaging patients in anesthesiology research: a rewarding frontier

Quantitative proteomic analysis reveals the effects of mu opioid agonists on HT22 cells.

Introduction: At present, the mu opioid receptor is the most important neuroaesthetics receptor in anesthesiology research, and the damage that it does to the nervous system is unknown. Methods: We investigated the effects of loperamide, an agonist of the mu opioid receptor, on protein expression in HT22 cells using stable isotope labeling of amino acids in cell culture (SILAC), immobilized metal affinity chromatography (IMAC) enrichment, and high-resolution liquid chromatography-tandem mass spectrometry (LC-MS/MS). A total of 7,823 proteins were identified. Results and Discussion: Bioinformatic analysis revealed that mu opioid receptor agonism can induce distinct changes in the proteome of HT22 cells. These findings improve our understanding of narcotic drugs.

Anesthesiology 2023: Ch-ch-ch-ch-changes.

Anesthesiology 2023: Ch-ch-ch-ch-changes.

Gender Equality in High-Quality Anesthesiology Research - A Descriptive Bibliometric Study on Scientific Authorships

As in other scientific disciplines, medicine has undergone a huge movement in sex distribution due to an increasing number of women entering the field. The effects of this shift on gender equality in anesthesiology research are discussed in this study.

Direct versus video laryngoscopy with standard blades for neonatal and infant tracheal intubation with supplemental oxygen: a multicentre, non-inferiority, randomised controlled trial

Tracheal intubation in neonates and infants is a potentially life-saving procedure. Video laryngoscopy has been found to improve first-attempt tracheal intubation success and reduce complications compared with direct laryngoscopy in children younger than 12 months. Supplemental periprocedural oxygen might increase the likelihood of successful first-attempt intubation because of an increase in safe apnoea time. We tested the hypothesis that direct laryngoscopy is not inferior to video laryngoscopy when using standard blades and supplemental oxygen is provided. We did a non-inferiority, international, multicentre, single-blinded, randomised controlled trial, in which we randomly assigned neonates and infants aged up to 52 weeks postmenstrual age scheduled for elective tracheal intubation to either direct laryngoscopy or video laryngoscopy (1:1 ratio, randomly assigned using a secure online service) at seven tertiary paediatric hospitals across Australia, Canada, Italy, Switzerland, and the USA. An expected difficult intubation was the main exclusion criteria. Parents and patients were masked to the assigned group of treatment. All infants received supplemental oxygen (1 L/Kg per min) during laryngoscopy until the correct tracheal tube position was confirmed. The primary outcome was the proportion of first-attempt tracheal intubation success, defined as appearance of end-tidal CO2 curve at the anaesthesia monitor, between the two groups in the modified intention-to-treat analysis. A 10% non-inferiority margin between direct laryngoscopy or video laryngoscopy was applied. The trial is registered with ClinicalTrials.gov (NCT04295902) and is now concluded. Of 599 patients assessed, 250 patients were included between Oct 26, 2020, and March 11, 2022. 244 patients were included in the final modified intention-to-treat analysis. The median postmenstrual age on the day of intubation was 44·0 weeks (IQR 41·0-48·0) in the direct laryngoscopy group and 46·0 weeks (42·0-49·0) in the video laryngoscopy group, 34 (28%) were female in the direct laryngoscopy group and 38 (31%) were female in the video laryngoscopy group. First-attempt tracheal intubation success rate with no desaturation was higher with video laryngoscopy (89·3% [95% CI 83·7 to 94·8]; n=108/121) compared with direct laryngoscopy (78·9% [71·6 to 86·1]; n=97/123), with an adjusted absolute risk difference of 9·5% (0·8 to 18·1; p=0·033). The incidence of adverse events between the two groups was similar (-2·5% [95% CI -9·6 to 4·6]; p=0·490). Post-anaesthesia complications occurred seven times in six patients with no difference between the groups. Video laryngoscopy with standard blades in combination with supplemental oxygen in neonates and infants might increase the success rate of first-attempt tracheal intubation, when compared with direct laryngoscopy with supplemental oxygen. The incidence of hypoxaemia increased with the number of attempts, but was similar between video laryngoscopy and direct laryngoscopy. Video laryngoscopy with oxygen should be considered as the technique of choice when neonates and infants are intubated. Swiss Pediatric Anaesthesia Society, Swiss Society for Anaesthesia and Perioperative Medicine, Foundation for Research in Anaesthesiology and Intensive Care Medicine, Channel 7 Telethon Trust, Stan Perron Charitable Foundation, National Health and Medical Research Council.

The impact of "To Err Is Human" on patient safety in anesthesiology. A bibliometric analysis of 20 years of research.

Patient safety gained public notoriety following the 1999 report of the Institute of Medicine: To Err is Human - Building a Safer Health System which summarized a culminated decades' worth of research that had so far been largely ignored. The aim of this study was to analyze the report's impact on patient safety research in anesthesiology. A bibliometric analysis was performed on all anesthesiologic publications from 2000 to 2019 that referenced To Err Is Human. In bibliometric literature, references are understood to represent an author's conscious decision to express a relationship between his own manuscript and the cited document. The anesthesiologic data base contained 1.036 publications. The journal with the most references to the IOM report is Anesthesia & Analgesia. By analyzing author keywords and patterns of collaboration, changes in the patient safety debate and its core themes in anesthesiology over time could be visualized. The generic notion of "error," while initially a central topic in the scientific discourse, was subsequently replaced by terms representing a more granular, team-oriented, and educational approach. Patient safety research in anesthesia, while profiting from a certain intellectual and conceptual head start, showed a discursive shift toward more managerial, quality-management related topics as observed in the health care system as a whole. Over the last 20 years, the research context expanded from the initial focus set forth by the IOM report, which ultimately led to an underrepresentation of research on critical incident reporting and systemic approaches to safety. Important collaborations with safety researchers from outside of health care dating back to the 1990's were gradually reduced, while previous research within anesthesiology was aligned with a broader, more managerial patient safety agenda.

Postoperative neurocognitive dysfunction in children

The Pediatric Society of Anesthesia in partnership with the FDA (Food and Drug Administration) and IARS (International Anesthesiology Research Society) have set up a Safe Kids organization, which studies the safety and anesthetic effects on the immature central nervous system. 2018).In recent years, the Food and Drug Administration (FDA) has shown a growing interest in the neurological changes that can occur in young children after exposure to intravenous and volatile anesthetics.These organizations have provided conclusive data on the safety and effects of anesthetics on the nervous system in children, as well as the ongoing concern of pediatric anesthetists for the long-term safety of the anesthetic.

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

Critical Appraisal of Anesthesiology Educational Research for 2019.

This study reviews and appraises the articles published about anesthesiology education in 2019. Through this critical appraisal, those interested in anesthesiology education are able to quickly review literature published during this year and explore innovative ways to improve education for all those involved in the practice of anesthesiology. Three Ovid MEDLINE databases, Embase.com, ERIC, and PsycINFO were searched followed by a manual review of articles published in the highest impact factor journals in both the fields of anesthesiology and medical education. Abstracts were double-screened and quantitative articles were subsequently scored by 3 randomly assigned raters. Qualitative studies were scored by 2 raters. Two different rubrics were used for scoring quantitative and qualitative studies; both allowed for scores ranging from 1 to 25. In addition, reviewers rated each article on its overall quality to create an additional list of top articles based solely on the opinion of the reviewers. A total of 2374 unique citations were identified through the search criteria and the manual review. Of those, 70 articles met the inclusion criteria (62 quantitative and 8 qualitative). The top 12 quantitative papers and the top 2 qualitative papers with the highest scores were reported and summarized.Conclusions: This critical appraisal continues to be a useful tool for those working in anesthesiology education by highlighting the best research articles published over the year. Highlighting trends in medical education research in anesthesiology can help those in the field to think critically about the direction of this type of research.

Making Healthcare Safe: The Story of the Patient Safety Movement

Making Healthcare Safe: The Story of the Patient Safety Movement

A Spotlight on Female Leaders in Anesthesiology

Article| March 2022 A Spotlight on Female Leaders in Anesthesiology Catlin Nalley Catlin Nalley Search for other works by this author on: This Site PubMed Google Scholar ASA Monitor March 2022, Vol. 86, 1–8. https://doi.org/10.1097/01.ASM.0000823020.83814.07 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Facebook Twitter LinkedIn MailTo Cite Icon Cite Get Permissions Search Site Citation Catlin Nalley; A Spotlight on Female Leaders in Anesthesiology. ASA Monitor 2022; 86:1–8 doi: https://doi.org/10.1097/01.ASM.0000823020.83814.07 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search Search Dropdown Menu toolbar search search input Search input auto suggest filter your search All ContentAll PublicationsASA Monitor Search Advanced Search Topics: leadership, schools, medical, internship and residency, operating room, professors, compassion As the field of anesthesiology evolves and grows, so does the important role women play in its ongoing success and development. The ASA Monitor had the privilege of speaking with three women whose leadership and expertise have had – and continue to have – a positive impact on anesthesiology and medicine as a whole. Margaret Wood, MBChB, FRCA, is the Emanuel M. Papper Emerita Professor of Anesthesiology and Department of Anesthesiology Emerita Chair, College of Physicians and Surgeons, Columbia University. Throughout her career, Dr. Wood has conducted extensive research in anesthesiology, publishing more than 140 articles and book chapters. She was the first woman to chair a clinical department at Columbia University, a position that she held until June 30, 2016. Dr. Wood was also the first woman to be elected as president of the Association of University Anesthesiologists (AUA). What led you to a career in anesthesiology?... You do not currently have access to this content.