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The relationship between tricuspid annular plane systolic excursion on transesophageal echocardiography and the incidence of postoperative acute kidney injury in patients undergoing coronary artery bypass grafting surgery: a multicenter prospective cohort study

To date, the relationship between the Transesophageal Echocardiography (TEE) monitoring indicator tricuspid annular plane systolic excursion (TAPSE) and the incidence of postoperative acute kidney injury (AKI)...

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Conventional versus high-voltage, long-term pulse Radiofrequency of ganglion impar in perineal pain with advanced rectal cancer: a Randomized, double-blind controlled trial

Advanced rectal cancer is a common cause of perineal pain and research on the use of radiofrequency therapy for the treatment of this pain is limited. In the present study, we aimed to compare the effectivenes...

The role of esmolol in sepsis: a meta-analysis based on randomized controlled trials

Sepsis is associated with a high incidence and mortality and poses a significant challenge to the treatment. Although esmolol has shown promise in sepsis treatment, its efficacy and safety remain contentious. ...

Assessing the clinical advantage of opioid-reduced anesthesia in thoracoscopic sympathectomy: a prospective randomized controlled trial

Opioid-reduced multimodal analgesia has been used clinically for many years to decrease the perioperative complications associated with opioid drugs. We aimed to assess the clinical effects of opioid-reduced a...

Efficacy of ozonated autohemotherapy for improvement of myocardial injury following traumatic brain injury

Traumatic brain injury is a kind of injury caused by external violence on the head. Its danger is not limited to life rescue in the early stage of the disease. Moreover, the subsequent inflammatory reaction an...

Postoperative exacerbated cough hypersensitivity syndrome induces dramatic respiratory alkalosis, lactatemia, and electrolyte imbalance

The perioperative management of patients with chronic cough or cough hypersensitivity syndrome and its sometimes severe effects is currently under-researched and under-reported.

Effects of anterior quadratus lumborum block versus erector spinae plane block on postoperative acute pain in percutaneous nephrolithotomy: a prospective, observational study

The study aimed to compare the pain-relieving effectiveness of anterior quadratus lumborum block (QLB3) and erector spinae plane block (ESPB), both of which have been documented to provide relief during abdomi...

Different ethanol exposure durations affect cytochrome P450 2E1-mediated sevoflurane metabolism in rat liver

Chronic alcohol users often exhibit an increased minimum alveolar concentration (MAC) of sevoflurane, yet the specific mechanism remains unclear. It has been reported that ethanol exposure can upregulate the p...

Effect of adductor canal block combined with infiltration between the popliteal artery and posterior capsular of the knee on chronic pain after total knee arthroplasty: a prospective, randomized, double-blind, placebo-controlled trial

Total knee arthroplasty (TKA) is accompanied by severe postoperative pain, which is reported to be an important cause of chronic pain. Ultrasound-guided adductor canal block (ACB) combined with infiltration be...

Evaluation of the effect of fluid management on intracranial pressure in patients undergoing laparoscopic gynaecological surgery based on the ratio of the optic nerve sheath diameter to the eyeball transverse diameter as measured by ultrasound: a randomised controlled trial

During gynecological laparoscopic surgery, pneumoperitoneum and the Trendelenburg position (TP) can lead to increased intracranial pressure (ICP). However, it remains unclear whether perioperative fluid therap...

Minimally invasive technique facilitates early extubation after cardiac surgery: a single-center retrospective study

Postoperative time to extubation plays a role in prognosis after heart valve surgery; however, its exact impact has not been clarified. This study compared the postoperative outcomes of minimally invasive surg...

Ultrasonic assessment of gastric solid contents in patients undergoing upper endoscope with sedation

Perioperative reflux aspiration presents a grave concern during sedation or general anesthesia, particularly when solid gastric contents prompt acute upper respiratory obstruction, potentially resulting in fat...

Index of Consciousness monitoring may effectively predict and prevent circulatory stress induced by endotracheal intubation under general anesthesia: a prospective randomized controlled trial

The primary objective of anesthesiologists during the induction of anaesthesia is to mitigate the operative stress response resulting from endotracheal intubation. In this prospective, randomized controlled tr...

Safety and efficacy of a novel dexmedetomidine nasal spray for pre-anesthetic sedation in children: a randomized, double-blind, placebo-controlled trial

Off-label intranasal administration of injectable dexmedetomidine has been widely applied in the pediatric sedation setting. However, the development of an improved drug delivery system that is easy to use is ...

Hypnosis support in anaesthesia is rarely used in German anaesthesia departments - a nationwide survey among leading physicians of anaesthesia departments

The aim of this study was to investigate whether and to what extent perioperative hypnosis and relaxation techniques are used in German anaesthesia departments, what they are, where any difficulties in their a...

The relationship between Geriatric Nutritional Risk Index (GNRI) and in-hospital mortality in critically ill patients with Acute Kidney Injury (AKI)

The role of the geriatric nutritional risk index (GNRI) as a prognostic factor in intensive care unit (ICU) patients with acute kidney injury (AKI) remains uncertain.

Effect of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia

To analyze the effects of different anesthesia depths on perioperative heart rate variability and hemodynamics in middle-aged and elderly patients undergoing general anesthesia, and to provide a basis for clin...

Gender and Race/Ethnicity dynamics in anesthesiology mentorship: results of a European survey

Mentorship is crucial to career advancement, medical education, and psychosocial support, especially for women and minorities. Although anesthesia mentoring programs have shown promise, there are no survey dat...

Perioperative pain management interventions in opioid user patients: an overview of reviews

Every year, many opioid users undergo surgery, experiencing increased postoperative complications, inadequate pain control, and opioid-related adverse effects. This overview aims to summarise and critically as...

“Ping-pong” in the heart: a case report and literature review

Ball thrombus is rare and life-threatening. The correct diagnosis and timely management are key to improving patient prognosis. Here, we present a case report and literature review of ball thrombus.

Quantification of muscle recovery in post-ICU patients admitted for acute pancreatitis: a longitudinal single-center study

Critically ill patients with severe pancreatitis exhibit substantial muscle wasting, which limits in-hospital and post-hospital outcomes. Survivors of critical illness undergo extensive recovery processes. Pre...

Does IV fentanyl, frequently used in emergency departments, change QT C value? A prospective observational study

Fentanyl is an opioid analgesic frequently used in the emergency department (ED) and is usually administered without knowing the QT C values of the patients or being monitored. However, the effect of fentanyl on Q...

Artificial intelligence-assisted interventions for perioperative anesthetic management: a systematic review and meta-analysis

Integration of artificial intelligence (AI) into medical practice has increased recently. Numerous AI models have been developed in the field of anesthesiology; however, their use in clinical settings remains ...

The effectiveness and outcomes of epidural analgesia in patients undergoing open liver resection: a propensity score matching analysis

Open liver resection necessitates a substantial upper abdominal inverted-L incision, resulting in severe pain and compromising patient recovery. Despite the efficacy of epidural analgesia in providing adequate...

Modified thoracoabdominal nerve block via perichondral approach: an alternative for perioperative pain management in laparoscopic cholecystectomy in a middle-income country

Laparoscopic cholecystectomy is known for its minimally invasive nature, but postoperative pain management remains challenging. Despite the enhanced recovery after surgery (ERAS) protocol, regional analgesic t...

Correction: Usefulness of lactate to albumin ratio for predicting in-hospital mortality in atrial fibrillation patients admitted to the intensive care unit: a retrospective analysis from MIMIC-IV database

The original article was published in BMC Anesthesiology 2024 24 :108

The annoyance of singultus: a case report of a rare adverse effect after epidural steroid injection

Cervical epidural steroid injections (ESIs) can provide effective pain management for patients suffering from chronic neck pain due to various pathological changes of the cervical spine. There are several rare...

External validation of the CARDOT score for predicting respiratory complications after thoracic surgery

The CARDOT scores have been developed for prediction of respiratory complications after thoracic surgery. This study aimed to externally validate the CARDOT score and assess the predictive value of preoperativ...

Anaesthesia and climate change: time to wake up? A rapid qualitative appraisal exploring the views of anaesthetic practitioners regarding the transition to TIVA and the reduction of desflurane

The National Health Service (NHS) has pledged to reach carbon net-zero by 2040. In alignment with this goal, a London hospital’s anaesthesia department is actively reducing desflurane use and transitioning tow...

Effects of intraoperative different fluid therapy protocols on postoperative renal functions

Planning intraoperative fluid therapy in patients undergoing major abdominal surgery is important. It was aimed to define the difference between fluid therapy protocols for renal function, bleeding and postope...

Predictive value of perioperative NT-proBNP levels for acute kidney injury in patients with compromised renal function undergoing cardiac surgery: a case control study

Acute kidney injury (AKI) significantly increases morbidity and mortality following cardiac surgery, especially in patients with pre-existing renal impairments. N-terminal pro-B-type natriuretic peptide (NT-pr...

Early oral hydration on demand in postanesthesia care unit effectively relieves postoperative thirst in patients after gynecological laparoscopy: a prospective randomized controlled trial

Postoperative thirst is one of the most intense, common and easily ignored subjective discomforts in patients after gynecological surgery. This study aimed to investigate whether early oral hydration on demand...

The relationship between anti-seizures medications and metabolic acidosis in craniotomy operations: is topiramate or zonisamide the cause of metabolic acidosis?

The most commonly prescribed anti-seizures medications (ASMs) for the treatment of epilepsy are currently topiramate, zonisamide, lacosamide, carbamazepine and levetiracetam. The objective of this study was to...

90% effective volume of 0.1% ropivacaine combined with 0.4 µg/ml sufentanil for epidural labour analgesia with push pump at a rate of 400 mL/hr and a bolus interval of 30 min: a double-blind sequential dose-finding study

It was reported that either shorter programmed intermittent epidural bolus (PIEB) intervals or high-speed bolus can produce more extensive epidural spread. We hypothesized that a combination of shortened time ...

Ability of parasternal intercostal muscle thickening fraction to predict reintubation in surgical patients with sepsis

We aimed to evaluate the ability of the parasternal intercostal (PIC) thickening fraction during spontaneous breathing trial (SBT) to predict the need for reintubation within 48 h after extubation in surgical ...

Effect of esketamine on serum neurotransmitters in patients with postpartum depression: a randomized controlled trial

The development of postpartum depression has been linked to fluctuations in the levels of neurotransmitters in the human body, such as 5-hydroxytryptamine (5-HT), dopamine (DA), noradrenaline (Norepinephrine, ...

The influence of sex on the dosage of remimazolam co-administered with remifentanil for loss of consciousness in adult patients: an up-and-down sequential allocation trial

This study aimed to determine the 50% effective dose of remimazolam co-administered with remifentanil for loss of consciousness in men and women as well as to investigate whether there are between-sex differen...

Airway management of a patient with coffin-lowry syndrome: a case report

Coffin-Lowry Syndrome (CLS) is a rare X-linked genetic disorder characterized by growth delays, facial dysmorphisms, and intellectual disabilities. Currently, there are limited published case reports regarding...

Effects of different doses of alfentanil on cardiovascular response to rapid sequence intubation in elderly patients: a parallel-controlled randomized trial

Rapid sequence intubation (RSI) have been shown to be effective in preventing reflux aspiration in patients with a full stomach during anaesthesia induction and endotracheal intubation. However, there is curre...

Effect of intra-operative Magnesium sulphate on the occurrence of post-operative delirium and insomnia in patients undergoing lumbar fixation: a randomized controlled trial

Over the last two decades, a large body of literature has focused on studying the prevalence and outcome of the postoperative delirium and sleep disturbance. The aim of this work was to evaluate the effect of ...

Use of intermediate cervical plexus block in carotid endarterectomy –an alternative to deep cervical plexus block: a case series

Carotid endarterectomy is performed for patients with symptomatic carotid artery occlusions. Surgery can be performed under general and regional anesthesia. Traditionally, surgery is performed under deep cervi...

Exploring thirst incidence and risk factors in patients undergoing general anesthesia after extubation based on ERAS principles: a cross sectional study

This study aims to comprehend the levels of dry mouth and thirst in patients after general anesthesia, and to identify the factors influencing them.

Reply to comment on: Operator gender differences in major mechanical complications after central line insertions: a subgroup analysis of a prospective multicentre cohort study

The original article was published in BMC Anesthesiology 2024 24 :267

Accessing the efficacy and peri-operative adverse effects of three different hyperbaric bupivacaine 0.5% dosages for spinal anesthesia induction in lower limb orthopedic surgeries: a randomized clinical trial

Spinal anesthesia (SA) is a conventional method for proper nerve block in abdominopelvic and lower extremity surgeries. Compared to general anesthesia, SA has reduced perioperative complications significantly....

Intermittent hemodialysis as a rewarming strategy for severe hypothermia in patients without renal failure: a case report

This case report highlights the effective use of intermittent hemodialysis (IHD) in warming a 71-year-old female patient with severe hypothermia who presented with a rectal temperature of 25 °C and signs of he...

Efficacy and safety of hydromorphone for cancer pain: a systematic review and meta-analysis

Cancer pain significantly impacts individuals’ quality of life, with opioids being employed as the primary means for pain relief. Nevertheless, concerns persist regarding the adverse reactions and effectivenes...

Positive end-expiratory pressure and postoperative pulmonary complications in laparoscopic bariatric surgery: systematic review and meta-analysis

This study compares the effect of positive end-expiratory pressure (PEEP) on postoperative pulmonary complications (PPCs) in patients with obesity undergoing laparoscopic bariatric surgery (LBS) under general ...

Differential response to preoperative exercise training in patients candidates to cardiac valve replacement

There is lack of evidence regarding safety, effectiveness and applicability of prehabilitation on cardiac surgery population, particularly in patients candidates to cardiac valve replacement. The aim of the st...

Repeated complete atrioventricular block during remifentanil administration in a pediatric patient with brain tumor and acute hydrocephalus: a case report

Remifentanil, an ultra-short-acting µ-opioid receptor agonist, is commonly used for anesthetic management due to excellent adjustability. Remifentanil is known to cause sinus bradycardia, however, because it h...

Perioperative dexmedetomidine-induced delirium in a patient with schizophrenia: a case report

Dexmedetomidine is a selective α2 receptor agonist with sedative, analgesic, anxiolytic, and anti-sympathetic effects. Dexmedetomidine is widely used for various surgical procedures performed under general ana...

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Anesthesia Thesis Topics For MD/DNB

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• Effects of intravenous dexmedetomidine in patients receiving 0 5% hyperbaric bupivacaine spinal asaesthesia.
• A comparative study of patient controlled epidural analgesia vs continous epidural infusion in labour analgesia using ropivacaine with fentanyl.
• To study correlation of extravascular lung water and compliance of lung in mechanicaly ventilated patients in ICU of a tertiary care centre.
• Combination of ropivacaine and dexmedetomidine for supraclavicular brachial plexus block using ultrasound and nerve stimulator guided technique: An intervention study to determine the effective volume.
• Comparison of efficacy of sedation with dexmedetomidine plus ketamine and propofol plus fentanyl in adult patients undergoing out-patient colonoscopy.
• To study the correlation between cerebral,rSO2 and outcomes in severe head injury cases.
• Comparision of dexmedetomidine and ketamine vs propofol and ketamine for procedural sedation in children undergoing minor cardiac procedures in cardiac catheterisation lab.
• To compare the analgesic efficacy of continuous femoral nerve block (CFNB) with local anaesthetic through a catheter versus patient controlled analgesia with intravenous morphine after total knee arthroplasty.
• Correlation between centrally versus peripherally transduced venous pressure in patients undergoing craniotomy.
• To study the incidence and risk factors of post-operative sore throat in patients undergoing elective surgeries under general anaesthesia with endotracheal tube.
• A comparative study of scoring systems used to predict difficult airway.
• An assessment of satisfaction of family members of patients admitted in the ICU.
• Comparative study of IV dexmedetomidine vs IV midazolam for sedation during tympanoplasty and modified plasty and modified radical mastoidectomy.
• Comparison between epidural tramadol and fentanyl for post operative analgesia.
• The efficacy of dexmedetomidine as an adjuvant in brachial plexus block by supraclavicular approach with 0.25% bupivacaine.
• Effect of low dose intravenous dexmedetomidine on characteristics of spinal anaesthesia with 05% hyperbaric bupivacaine.
• Effects of IV dexmedetomidine as a pre-medication on clinical profile of bupivacaine spinal anaesthesia in lower abdominal surgeries.
• Comparison of haemodynamic changes of proseal LMA and endotracheal tube for laparoscopic surgeries.
• Comparative study of intrathecal isobaric 0.5% bupivacaine and isobaric 0.75% ropivacaine for lower abdominal and lower limb surgeries.
• Comparison of recovery characteristics of desflurane, sevoflurane and propofol in patients undergoing laparoscopic cholecystectomy.
• Effect of preoperative intramuscular morphine injection for post operative analgesia in patients undergoing joint replacement surgery.
• Evaluation of efficacy of tranversus abdominis plane block for post operative analgesia in patients undergoing total abdominal hysterectomy.
• A comparative study between ropivacaine with fentanyl versus bupivacaine with fentanyl for post operative epidural analgesia in patients undergoing elective lower abdominal and lower limb surgeries.
• To compare the effect of preloading with 6% (HES) hexaethyl starch versus intravenous ephedrine for the prevention of hypotension following spinal anesthesia for parturients undergoing caesarean section.
• Comparative study of dexmedetomidine and lignocaine for attenuation of cardiovascular stress response to laryngoscopy and endotracheal intubation.
• Effect of addition of intrathecal fentanyl to hyperbaric bupivacaine (0.5%) for casearean section.
• Comparative study of the intubating conditions and cardiovascular effects following succinylcholine and rocuronium in adult elective surgical patients.
• Attenuation of the circulatory responses to endotracheal intubation with preinduction intravenous labetalol.
• Comparative evaluation of bupivacaine and bupivacaine with dexmedetomidine in subarachnoid block.
• Comparative evaluation of thiopentone sodium and propofol for electro convulsive therapy.
• Comparative study of 0.5% lignocaine with dexmedetomidine and 0.5% lignocaine in intravenous regional anaesthesia.
• Comparison of efficacy of levobupivacaine and clonidine with bupivacaine and clonidine in spinal anaesthesia for lower segment caesarean section.
• A comparative study of intrathecal dexmedetomidine and fentanyl as an adjuvant to bupivacaine.
• Comparision of bupivacaine,bupivacaine plus clonidine, bupivacaine plus dexmeditomedine intrathecally in lower abdominal surgeries.
• The effects of ephedrine infusion for the prevention of hypotension during spinal anaesthesia for elective lower segment caesarean section.
• The comparative study of epidural anaesthesia between isobaric ropivacaine 0.5% and isobaric bupivacaine 0.5% for lower abdominal surgeries in tertiary care institute.
• A comparative study on effect of adding dexmedetomidine and dexamethasone to local anaesthetics in brachial plexus block.
• A randomised study on the efficacy of ketamine and pethidine in the treatment of postoperative shivering in patients undergoing general anaesthesia.
• A double blinded randomized control trial to compare hyperbaric ropivacaine (18 mg) with hyperbaric bupivacaine (18 mg) for spinal anaesthesia in lower limb orthopedic surgeries.
• Comparative evaluation of addition of dexamethasone to two different local anaesthetics in supraclavicular brachial plexus block
• Comparative study of propofol versus ketamine as inducing agent on hemodynamic and seizure activity in modified electroconvulsive therapy.
• Prevention of sevoflurane related emergence agitation in children undergoing general anaesthesia : a comparison study between dexmedetomidine and propofol.
• A comparative study of hernial block versus subarachanoid block for elective inguinal hernia repair.
• Effect of dexmedetomidine in supraclavicular brachial plexus block as an adjuvent : A comparative study.
• Mechanical complications during insertion of central venous catheter in subclavian vein and internal jugular vein – A comparitive study.
• Comparison of ambu laryngeal mask airway with soft seal laryngeal mask airway during routine surgical procedure.
• Study of efficacy of dexmethasone as preemptive analgesic in patients undergoing total abdominal hysterectomy under spinal anaesthesia.
• A clinical assessment of macintosh,miller blades and king visionTM video laryngoscope for laryngeal exposure and difficulty in endotracheal intubation.
• Comparison of two doses of dexmedetomidine combined with ketamine for anesthesia in dilatation and curettage.
• Evaluation of effect of low dose of intravenous dexmedetomidine supplementation on sensory and motor blockade produced by intrathecal hyperbaric bupivacaine.
• Comparison of the effects of lateral and sitting position during induction of spinal anaesthesia with plain levobupivacaine in cesarean section.
• Comparitive study of bupivacaine with dexmedetomidine and bupivacaine alone in supraclavicular brachial plexus block.
• A comparative study of propofol and thiopentone with local anaesthetic spray as inducing agents for I gel insertion.
• A comparative study of perioperative effects of preemptive dose of dexamethasone versus clonidine in lower abdominal surgeries under spinal anaesthesia.
• Intravenous dexmedetomidine vs. intravenous clonidine to prolong bupivacaine spinal anesthesia.
• Comparative study of the effect of IV ketamine and IV tramadol for control of shivering in cases of caesarean section under spinal anaesthesia.
• Comparison of inj. Lignocaine (preservative free) 1.5mg/kg IV with oral pregabalin 150 mg for attenuation of haemodyanamic response to laryngoscopy and tracheal intubation.
• Comparative study of supraclavicular block using bupivacaine with perineural dexamethasone, bupivacaine with I.V. dexamethasone and bupivacaine only.
• Comparative study of intrathecal bupivacaine with fentanyl and intrathecal bupivacaine with clonidine for quality of anaesthesia and duration of post operative pain relief in patients undergoing lower abdominal and lower limb surgeries.
• A comparison of efficacy of pre-emptive analgesia with three small doses of N-Methyl-D- aspartate antagonist ketamine for improving post operative analgesia after laparoscopic surgeries,
• A study of perioperative airway and respiratory complications in children undergoing cleft lip and palate repair.
• Identification of risk factors for hypotension after spinal anaesthesia in patients undergoing casarean section.
• Use of McCoy and truview laryngoscope blades for intubation in patients with anticipated difficult airway with respect to ease of intubation and haemodynamic response.
• Audit of perioperative complication of patients unergoing turp surgeries :: an anaesthetist’s perspective.
• An audit of blood and blood products transfusion practices in elective spine surgery.
• The type of anaesthesia and outcome in preeclamptic patients undergoing caesarean section an observational study.
• Comparison of palonosetron, ondansetron, and metoclopramide in controlling post operative nausea and vomiting in obstetrical and gynaecological surgeries.
• Comparison between intranasal dexmedetomidine and intranasal midazolam for preanaesthetic sedation in children.
• Comparison between 0.125% bupivacaine and 0.125% ropivacaine for epidural analgesia during labour.
• Dexamethasone as an adjuvant to local anaesthetic in supra clavicular block a comparitive study.
• Observational study of hemodynamic effects of etomidate and propofol used as induction agents in patients planned for off pump cabg
• An observational study to compare the haemodynamic parameters following spinal anaesthesia with hyperbaric bupivacaine in hypertensive and normotensive patients.
• Correlation of leak around uncuffed endotracheal tube and postoperative morbidity in children: an observational study.
• A cross-sectional observational analysis of preoperative blood glucose levels in patients presenting for surgery.
• Monitoring of depth of anaesthesia using entropy monitor during cardiopulmonary bypass-a prospective study.
• An evaluation of procedural sedation techniques in duchenne muscular dystrophy patients undergoing stem cell therapy.
• Anaesthesia risk stratifaction: comparison between silverman-holt aggregate preoperative evaluation (SHAPE) and american society of anaesthesiologists physical status (ASA PS) evaluation systems.
• Efficacy of spinal anaesthesia for laparoscopic ventral hernia repair
• Comparative study of nalbuphine vs. pentazocine for postoperative analgesia.
• Comparative study of intrathecal isobaric levobupivacaine versus hyperbaric bupivacaine in lower abdominal surgery.
• Comparative study of 0.5% (heavy) intrathecal bupivacaine alone with 0.5% (heavy) intrathecal bupivacaine midazolam combination in patients undergoing elective inguinal hernia repair.
• Comparative evaluation of induction with propofol and sevoflurane for insertion of laryngeal mask airway in children.
• Hemodynamic behaviour,ECG changes and postoperative outcome of hypertensive and normotensive patients under spinal anaesthesia.
• The comparision of single bolus dose of dexmedetomidine with bolus plus infusion of dexmedetomidine on characteristics of spinal anaesthesia with hyperbaric bupivacaine.
• Evaluation of airway and predicting difficult endo- tracheal intubation in diabetic patients -A comparison with non diabetic patients.
• Observational study for dose-response characteristics of intrathecal hyperbaric bupivacaine(0.5%) by using sequential combined spinal epidural anesthesia (SCSEA) in patients aged over sixty year for orthopedic surgeries.
• A comparison of thyromental height with the ratio of patient’s height to thyromental distance and the upper lip bite test in predicting difficult laryngoscopy.
• A comparetive study of arterial PH and chloride levels following 6% HES 130/0.4 saline solution or 6% HES 130/0.4 balanced solution used during cardiac surgery involving cardiopulmonary bypass.
• A prospective study to compare efficacy of interlaminar vs caudal epidural steroids in chronic lower back pain.
• A prospective comparative study of ondansetron against tramadol pretreatment to reduce pain on injection of propofol.
• A comparative study between clinical efficacies of levobupivacain plain and levobupivacaine with fentanyl for urological surgeries under subarachnoid block.
• A comparison of the efficacy of fentanyl and clonidine for attenuation of pressor response to endotracheal intubation.
• Pre treatment with intravenous granisetron to alleviate pain on propofol injection: A double blind randomised controlled study using normal saline as control.
• Randomised prospective study of comparison of USG guided subcostal transversus abdominis plane block techinque (sta block) versus conventional port site infiltration techinque used in laparoscopic cholecystectomy for post operative analgesia.
• Correlation of bispectral index with depth of sedation: A comparison between dexmedetomidine versus propofol in patients undergoing infraumabilical surgery under subarachnoid block.
• Ultrasonographic measurement of optic nerve sheath diameter to detect raised intracranial pressure in head injury patients in ICU and its correlation with CT scan findings.
• Comparison between palonosetron and granisetron in prevention of postoperative nausea and vomiting (PONV) in elective laparoscopic surgeries under general anaesthesia.
• A comparison of upper Lip Bite Test with modified mallampati classification in predicting difficulty in endotracheal intubation.
• Effect of dexmedetomidine hydrochloride as an adjuvant to lignocaine hydrochlorid for intravenous regional anaesthesia.
• Postoperative nausea and vomiting -prophylaxis with palonosetron hydrochloride.
• Comparison of dexmedetomidine and midazolam for sedation in post -operative surgical patients.
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Disclaimer!

There are many methods of sample size determination. It is one of the first hurdle when someone starts writing a thesis. I have tried to give simplest way of determination of sample size. You need to show the method to your PG teacher before you include this method in your thesis. First confirm from your PG teacher and then only proceed.

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• Anesthesia Dose and Delirium—A Picture Coming Into Focus JAMA Opinion June 10, 2024 Neurology Surgery Full Text | pdf link PDF
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Top ten priorities for anesthesia and perioperative research: a report from the Canadian Anesthesia Research Priority Setting Partnership

Les dix priorités principales pour la recherche périopératoire et en anesthésie : un rapport du partenariat canadien pour l’établissement des priorités de la recherche en anesthésie, dolores m. mckeen.

1 Department of Anesthesia, Pain Management & Perioperative Medicine, Dalhousie University, Halifax, NS Canada

2 Department of Women’s & Obstetric Anesthesia, IWK Health Centre, 5850/5980 University Avenue, P.O. Box 9700, Halifax, NS B3K 6R8 Canada

Jillian C. Banfield

Daniel i. mcisaac.

3 Department of Anesthesiology & Pain Medicine, University of Ottawa, Ottawa, ON Canada

Jason McVicar

Colleen mcgavin.

4 BC SUPPORT Unit, Vancouver, BC Canada

Mary Anne Earle

Claire ward, katharina kovacs burns.

5 Patients for Patient Safety Canada, Edmonton, Canada

6 School of Public Health, University of Alberta, Edmonton, AB Canada

Donna Penner

7 Altona, MB Canada

Gilbert Blaise

8 Centre Hospitalier de l’Université de Montréal, Montréal, QC Canada

Thierry de Greef

9 Montreal, QC Canada

Katherine Cowan

10 James Lind Alliance, University of Southampton, Southampton, UK

Andreas Laupacis

11 Li Ka Shing Knowledge Institute of St. Michael’s Hospital Toronto, Toronto, ON Canada

The purpose of the Canadian Anesthesia Research Priority Setting Partnership (CAR PSP) was to identify a top ten list of shared priorities for research in anesthesia and perioperative care in Canada.

We used the methods of the James Lind Alliance to involve patients, caregivers, healthcare professionals, and researchers in determining the research priorities in Canada. In a first survey, participants submitted questions that they want research to answer about anesthesia and perioperative care. We summarized those responses into a longlist of questions. We reviewed the literature to see if any of those questions were already answered. In a second survey, participants chose up to ten questions from the longlist that they thought were most important to be answered with research. From that list, the highest ranking questions were discussed and assigned a final rank at an in-person workshop.

A total of 254 participants submitted 574 research suggestions that were then summarized into 49 questions. Those questions were checked against the literature to be sure they were not already adequately addressed, and in a second survey of those 49 questions, participants chose up to 10 that they thought were most important. A total of 233 participants submitted their priorities, which were then used to choose 24 questions for discussion at the final workshop. At the final workshop, 22 participants agreed on a top ten list of priorities.

The CAR PSP top ten priorities reflect a wide variety of priorities captured by a broad spectrum of Canadians who receive and provide anesthesia care. The priorities are a tool to initiate and guide patient-oriented research in anesthesia and perioperative care.

Résumé

L’objectif du Partenariat canadien pour l’établissement des priorités de la recherche en anesthésie (CAR-PSP) était d’établir une liste des dix principales priorités pour la recherche sur les soins anesthésiques et périopératoires au Canada.

Méthodes

Nous avons utilisé la méthodologie de la James Lind Alliance pour impliquer des patients, des aidants, des professionnels de la santé et des chercheurs afin de déterminer quelles étaient les priorités en matière de recherche au Canada. Dans une première enquête, les participants ont envoyé des questions sur les soins anesthésiques et périopératoires auxquelles ils voulaient que la recherche réponde. Nous avons résumé ces envois par une liste exhaustive de questions. Nous avons passé en revue les publications pour voir s’il existait déjà des réponses à ces questions. Dans une deuxième étude, les participants ont choisi dans la liste jusqu’à dix questions qui leur semblaient les plus importantes et pour lesquelles la recherche devrait fournir des réponses. À partir de cette liste, les questions les mieux classées ont été discutées et un classement définitif leur a été attribué au cours d’un atelier où tous les participants étaient présents en personne.

Résultats

Au total, 254 participants ont envoyé 574 suggestions de recherche qui ont été résumées en 49 questions. La littérature a été examinée pour s’assurer que ces questions n’avaient pas déjà reçu des réponses adéquates, et dans une seconde étude, les participants ont choisi jusqu’à 10 questions qu’ils jugeaient les plus importantes parmi ces 49 questions. Au total, 233 participants ont communiqué leurs priorités qui ont alors servi à choisir 24 questions ouvertes pour la discussion dans un atelier final. Dans cet atelier, 22 participants se sont mis d’accord sur une liste des dix principales priorités.

Les dix principales priorités du CAR-PSP sont le reflet d’un grand éventail de priorités venant de Canadiens de tous horizons qui reçoivent ou fournissent des soins d’anesthésie. Ces priorités sont un outil permettant d’entamer et de guider une recherche axée sur le patient dans le domaine des soins anesthésiques et périopératoires.

Current research in anesthesia and perioperative care has focused on studies to better understand physiology and applied pharmacology as well as to assess safety or postoperative pain relief. Such studies advance knowledge about anesthesia and perioperative practice but may not provide readily translatable meaningful answers to relevant patient-centred questions. 1 , 2

Summary of the CAR PSP process and timeline. CAR PSP = Canadian Anesthesia Research Priority Setting Partnership

Funding sources, vested researcher interests, publication pressure, and consumer interests are all potential contributors to influencing the research agenda, often moving it away from the needs of the patients it is meant to serve. 3 For these reasons, although there is much in common between the research that researchers and patients wish to see done, there are often important mismatches. 4 , 5

Canadian anesthesia research is generally delivered through “ responsive funding ” programs to which researchers propose topics to various funding bodies. In Canada (as is elsewhere), the funding pool for anesthesia-related research is increasingly competitive and the research community is looking for direction and funding priorities. 6 – 8 There is now recognition for a “needs-led” program, driven by a systematic approach to identifying and setting research priorities. A Canadian anesthesia and perioperative care research priority-setting framework could assist decision-makers to balance competing demands particularly as research funders are increasingly held accountable for resource allocation. 9 – 12

Most Canadians will experience at least one surgery in their lifetime. 13 In 2015–2016, there were approximately 1.47 million inpatient surgical procedures conducted in Canadian hospitals. 14 Patients receive anesthesia and perioperative care for a variety of surgeries (or for the birth of a baby), but the consistent factor for these patients is the provision of anesthesia care. The large body of knowledge and diverse experience that these patients have is rarely drawn upon.

While most researchers remain guided by the medical model, hoping to understand physiologic mechanisms or prevent adverse outcomes, the social model of research seeks to answer questions and measure outcomes that matter to patients. This approach can increase the relevance and quality of research and lead to better patient outcomes, improved patient experience, and a more sustainable healthcare system. 15 – 17 Regardless of the indication for surgery or anesthesia care, we assume that Canadian patients want to know that anesthesia care (in combination with the procedure they are undergoing) will help “ cure ” their disease, improve their health, reduce pain, or lead to the safe delivery of their newborn. But their priorities can only be truly discovered through patient-oriented research and patient engagement. 18

Patient-oriented research engages patients as partners, and focuses on patient-identified priorities and improving patient outcomes. 19 Notably, engaging patients in research does not limit the focus of the research to clinically focused questions. Patients can be, and are, engaged in preclinical research. 20 Patients’ perspectives are essential to supporting a patient-oriented approach to research, regardless of the specifics of the research question. Patients’ perspectives are also essential to understanding whether healthcare services and procedures make a difference to patients’ health status and quality of life. 21 An extensive search revealed a dearth of patient-oriented research in the published anesthesia literature. 5 , 22 , 23

Formal processes, like those established by the James Lind Alliance (JLA), are being advocated to identify shared patient-oriented priorities and to propose topics for new research. 24 Formal research priority setting is a systematic way of making the case to stakeholders for funded research on relevant, clinically important questions. 25 , 26 The JLA method focuses on joint patient, caregiver, and clinician input to develop a “ top ten” list. The JLA is a non-profit initiative, supported by the National Institute for Health Research in the United Kingdom (UK). The JLA methods for identifying shared clinician and patient/informal caregiver priorities around unanswered clinical questions have been used for over a decade to prioritize research uncertainties in almost 100 healthcare conditions internationally, including anesthesia and perioperative care priorities for the British National Institute for Academic Anesthesia (NIAA). 25 Additional information on the JLA methods is available at http://www.jla.nihr.ac.uk/ .

We set out to conduct a Canadian anesthesia and perioperative care research priority setting exercise as a rare and valuable opportunity to bring together patients, informal caregivers, and clinicians to suggest priorities for the Canadian anesthesia research agenda. 24

We used the JLA methodology to conduct a research priority setting partnership (PSP). See the Figure for the steps followed.

The Canadian Anesthesia Research Priority Setting Partnership (CAR PSP) was overseen by an independent senior JLA advisor (K.C.). We formed a steering committee (SC) with equal representation of anesthesia providers and patients/informal caregivers. The SC informed and directed all the research processes associated with the CAR PSP. This project received research ethics board approval (IWK Health Centre Research Ethics Board #1023459, June 7 2018).

Identifying and inviting partners

Where possible, Canadian partners with diverse anesthesia experiences were identified. Partners included patients and informal caregivers, clinicians, including anesthesiologists, nurses and allied healthcare professionals, all with experience of anesthesia and/or perioperative care. Medical specialty societies, professional and patient organizations and individuals were identified by the SC and invited to endorse the project and/or to nominate people for either the SC and/or attendance at the in-person final prioritization workshop. Eleven national organizations formally agreed to partner with the CAR PSP (Table  1 ).

Table 1

Partner organizations

Further partner recruitment through connections to Strategy for Patient-Oriented Research (SPOR) Units, to request aid in their respective jurisdictions, was facilitated by the Maritime SPOR Unit. The SPOR units are funded by the Canadian Institutes of Health Research to facilitate patient-oriented research. Voices and experiences from diverse and under-represented groups were specifically solicited through targeted recruitment, including contacting representative organizations.

Scope of the Canadian Anesthesia Research Priority Setting Partnership

The CAR PSP invited questions about all aspects of care during anesthesia and the perioperative period, and the management of longer-term problems that originated during this period. The management of chronic pain was not considered unless the pain originated around the time of anesthesia. The initial scope was discussed and further defined and clarified as part of the first SC meeting. This manuscript reflects the critical components of the CAR PSP protocol, and the full version is available at: http://www.jla.nihr.ac.uk/priority-setting-partnerships/anaesthesia-canada/ . To facilitate future comparison with the one existing perioperative PSP, the scope of the CAR PSP closely mirrored the UK NIAA PSP. 25

Inclusion criteria

The scope included all the work conducted by anesthesiologists, including obstetric and resuscitation care, as well as that conducted both by the wider perioperative team and the care pathway from initial intention to treat or operate onwards. “Onwards” was meant as an open-ended word signifying that long-term problems attributable to the surgery/intervention and management period must also be considered.

The perioperative period was defined to span the time from when a decision is made to have surgery or anesthesia care to the time that the patient returned to preoperative function, recovered to a stable functional level, or fully recovered from having surgery. There was no age limit and we actively encouraged involvement of people from diverse populations such as parents of newborns and young children, the elderly, Indigenous peoples, and those with disabilities.

Exclusion criteria

As the PSP focused on “perioperative care”, we excluded the surgery itself. We focused on the management of patients’ physical wellbeing within the hospital environment throughout all procedures and its impact on recovery thereafter. Many anesthesiologists provide critical care services, but this was felt to be beyond the scope of the current PSP.

Identifying unanswered questions (first survey)

We created and managed the CAR PSP online surveys using REDCap (Research Electronic Data Capture) 27 , 28 hosted at the IWK Health Centre, Halifax, NS. Web links to the CAR PSP surveys were distributed by some of the 11 partner national perioperative organization email listservs and newsletters. In addition to patient networks (e.g., Patients for Patient Safety Canada, Patient Voices Network), the surveys were promoted through the project’s website ( http://www.car-psp.ca ), Twitter (@car_psp), and Facebook (fb.me/carpsp).

Respondents to the first survey were asked to submit three questions that they would like anesthesia researchers to address. Specifically, respondents were asked “Based on your experience, what questions do you have? No question is too big or too small! Please provide up to three questions about anesthesia or perioperative care that you want research to answer. You can provide details about your own experiences, if you would like to do so.” Prior to this question, participants saw a page with plain language explanations of the terms “anesthesia” and “perioperative care.”

Respondent demographics were assessed weekly and the survey closed once efforts to gain responses from all Canadian provinces and territories, across ages, sex, and types of healthcare providers within the main groups of respondents (clinicians, patients, and caregivers) were made. Targeted efforts to recruit respondents included contacting groups like Prostate Cancer Canada (for male patients), the Society of Rural Physicians of Canada (for rural and/or family physicians), and the Assembly of First Nations (for Indigenous respondents). At our request, some organizations shared the survey via their social media and/or newsletters.

Question management

Following the first survey, all submitted questions were aggregated into a longlist of summary questions with duplicate or highly-related questions aggregated into single questions. An independent information specialist, with previous priority-setting experience from an unrelated PSP, in consultation with members of the SC, then removed any out-of-scope questions. The SC reviewed this work, and a SC subgroup worked with the project manager (J.B.) to further refine wording and to develop a final list of summary questions.

Verifying uncertainties and reviewing evidence

With the help of an evidence synthesis specialist from the Maritime SPOR Unit, the longlist of summary questions was compared with the published literature to determine the extent to which any of the questions were already answered. This process followed JLA guidance of reviewing Cochrane systematic reviews (SR) published within the past three years. Specifically, the evidence synthesis specialist retrieved Cochrane SRs by the anesthesia group, and these were reviewed by the project manager, with consultation of SC members. These longlist summary questions were subsequently divided into those “with an answer” and those “without an answer” in the scientific literature. Questions were considered unanswered if the SR was not up to date (within the last three years); the SR did not have enough available evidence; the SR evidence was of insufficient quality; or the SR was inconclusive/unable to make conclusions.

Interim prioritization (second survey)

A refined longlist of “summary” questions unanswered by the literature from the first survey was put into a second national online survey. This survey gave respondents an opportunity to review the longlist and choose which questions ought to be discussed for final prioritization. Participants across Canada were asked to choose up to ten questions that they thought were top priorities from the longlist, according to their personal or professional experience. Participants in the second survey were recruited in much the same manner as for the first survey. For the second survey, however, we also directly emailed participants from the first survey who had provided their email addresses.

To support similar representation of key partnership categories, we pre-specified that responses to the second survey would be considered by respondent category (patients and caregivers; healthcare providers) so that their priorities could be considered independently. This strategy ensured that the top ten priorities from each group were included in the shortlist for the workshop.

Final prioritization workshop

The final prioritization to determine the CAR PSP top ten priorities was held as an in-person workshop. Individuals and members from partner organizations were invited to send expressions of interest to participate. The SC sought to involve a balance of patients and healthcare providers at the workshop. Participants were selected to represent geographical and experiential diversity.

The workshop followed the JLA’s standard method, an adapted nominal group technique, in which participants work in three small groups with balanced representation of patients, caregivers, and clinicians, to rank the short-listed questions. After each group ranked its priorities, prioritizations were averaged across the three groups. This allowed for a second round of prioritization in three newly formed but similarly balanced small groups. Again, an aggregate ranking was calculated. The final top ten priorities were then determined by consensus through a large group plenary discussion facilitated by the JLA advisor (K.C.).

A total of 254 respondents submitted 574 initial questions. Nine responses were submitted in French. See Table  2 for demographic details. A total of 505 in-scope questions were aggregated into a longlist of 49 summary questions. The SC agreed that 69 questions were not in-scope, so they were not aggregated into the summary questions. Table  3 shows an example of how the initial questions were aggregated into summary questions. Following the evidence review, the SC agreed that no questions were fully answered, so the longlist of 49 questions was retained for the interim prioritization survey. Table  4 shows this longlist of questions.

Table 2

Profile and demographics from respondents of the first online survey

For the first survey, participants were able to select as many participant types as applied to them. For example, a participant could select that they were both a patient and a healthcare provider

AB = Alberta; BC = British Columbia; MB = Manitoba; NB= New-Brunswick; NL = Newfoundland and Labrador; NS = Nova Scotia; ON = Ontario; PEI = Prince Edward Island; QC = Quebec; SK = Saskatchewan. NICU = neonatal intensive care unit; RN = registered nurse

Table 3

Example explanation of how initial questions were aggregated into a summary question

Table 4

Longlist of summary questions

Summary of interim prioritization results (second survey)

A total of 233 respondents submitted their priorities for the 49 anesthesia summary unanswered questions. Ten responses were submitted in French. Table  5 shows the demographic details. The results were computed within the groups of patients/caregivers and healthcare providers (Table  6 ). The ten highest-ranked priorities for both groups were considered independently. Given that there were some differences, and some commonalities, in the ten highest-ranked priorities for both groups, this resulted in 24 questions that were most highly ranked by both groups of respondents. These were considered at the final in-person prioritization workshop.

Table 5

Profile and demographics from respondents of the second online survey

AB = Alberta; BC = British Columbia; MB = Manitoba; NB= New-Brunswick; NL = Newfoundland and Labrador; NS = Nova Scotia; ON = Ontario; PEI = Prince Edward Island; QC = Quebec; SK = Saskatchewan

Table 6

Shortlist of 24 summary questions created with equal clinician and patient/caregiver weighting from the second survey

*For questions that had a tie rank with another question within the same column (e.g., for the overall ranks from the interim survey, the first two questions were tied)

Final prioritization workshop and “top ten”

Three facilitators (one senior advisor from the JLA, and two with experience facilitating JLA PSP final workshops) supported 22 participants (14 (64%) patients/caregivers) in the final in-person prioritization workshop. Following two rounds of group-level prioritization, the full workshop agreed, by consensus, on the CAR PSP top ten priorities (Table  7 ).

Table 7

Canadian Anesthesia Research top ten priorities

The top ten list from this PSP contains many patient-oriented priorities, such as improving pain control after surgery. The list reflects shared priorities of patients and healthcare providers. For example, the priority around preventing errors and patient injuries was derived from initial questions submitted by both patients and healthcare providers and ranked highly after the second survey (patients: #3, healthcare providers: #4) and at the final workshop (#4).

The Canadian anesthesia community is changing how it thinks about research in anesthesia and perioperative care, aligning the agenda to patient-oriented research. This opportunity to engage patients’ perspectives around anesthesia and perioperative care is timely and has the potential to improve research impact and patient outcomes. 29 – 31 The CAR PSP top ten priorities reflect a wide variety of priorities that capture a broad spectrum of Canadians who receive and provide anesthesia care, and the scope of anesthesia practice. Using the CAR PSP top ten priorities to shape the Canadian anesthesia research agenda will reflect shared concerns around the impact of anesthesia and perioperative care on patient-reported outcomes and experience. These top ten priorities complement and can, in many cases, align with the typical curiosity-based research that has always been fundamental to anesthesia research.

The CAR PSP featured responses from hundreds of Canadian patients, healthcare providers, and others, and reached a consensus priority list from an initial submission of 574 questions. The CAR PSP top ten priorities included factors most important to improve patient outcomes and satisfaction, impacts of shared decision-making, error prevention, and the impact of reducing opioids at time of surgery.

The CAR PSP top ten priorities are general in-scope and should not be considered specific research question themselves, nor hypothesis generating. They should serve as starting points for researchers, funders, and decision-makers. They also identify questions around anesthesia care, where the answers can have immediate translatable impacts on our patients’ daily lives.

Strengths of our study include using an established methodology to elicit shared priorities on anesthesia and perioperative care, the number of participant submissions, and the balance of patient, caregiver and clinician participation. Even with effective promotion and publicity, a PSP may face limited stakeholder engagement. Anesthesia does not involve caring for patients with a chronic condition/disease, nor a well-defined patient group, so engagement can be challenged. The CAR PSP survey response numbers were similar to other PSPs in Canada and to the NIAA PSP. 32 , 33 (Canadian population of 37 million, approximately 3,300 anesthesiologists; UK population 61 million, approximately 11,000 anesthesiologists, NIAA PSP reported 623 respondents and 1,420 suggestions.) 13 , 25 , 34 , 35

The CAR PSP captured responses from individuals from all provinces, with a range of ages, and with a good balance of gender identity. PSPs are not designed to attract a representative sample, instead the JLA process relies on engagement, and the SC focused on getting responses from members of key stakeholder groups. Whenever the SC saw that responses from a particular group (e.g., northern communities) were lacking, we targeted outreach to those groups. Despite as many efforts as were practical within time constraints and budget, these were not always successful (e.g., no respondents from the territories) and this is a limitation.

Our focus on the entire anesthesia and perioperative care period, over a wide range of subspecialty anesthesia care for diverse surgical procedures and patient groups, could be considered too broad. This PSP, unlike some others, including the NIAA, did not group the initially submitted questions into subspecialty-related anesthesia themes or patient groups (e.g., cardiac anesthesia or pediatric patients). Subspecialty questions were grouped into more manageable broad-based summary questions. As such, there are few anesthesia subspecialty top ten priorities. Nevertheless, examples of submitted questions, the summary list of 49 questions, and the 24 highest-ranked questions are available to researchers to review on the JLA website. Researchers are encouraged to explore in more depth the original questions that contributed to the research questions in the prioritization survey. Furthermore, as a first PSP in the Canadian anesthesia community, our methods and experience could support future efforts for setting priorities within more specific aspects of perioperative care.

Limitations

Given that the surveys for this PSP were only available online, we acknowledge that they were not accessible to people who may not use, or have access to, the internet. We relied on word-of-mouth, social media, and partner organizations to advertise the surveys, so we likely missed potential respondents who are not engaged through these methods. Our surveys garnered more responses from healthcare providers than patients and caregivers, though our SC had equal representation and our final workshop had more patients and caregivers than healthcare providers.

The final workshop took place over a full day in Toronto. Although we covered expenses for travel, and provided an honorarium for patients to attend, this kind of workshop excludes potential participants who cannot take time off work or cannot travel for other reasons.

The methods used for establishing a top ten list of priorities were qualitative in nature. We followed a well-established methodology that invites a variety of perspectives to contribute in different ways (i.e., SC, participation in surveys, final workshop). All these opportunities to contribute are complementary and instrumental in arriving at a top ten list of priorities. A different top ten list of priorities may have resulted had different people joined the SC or participated in the surveys or final workshop.

Future initiatives

Only one other country, the UK, has incorporated shared patient/caregiver input regarding anesthesia research priorities. 25 The CAR PSP adds to the breadth of what is currently known from the UK. Differences in demographics, varied geographic location and population density, as well as healthcare funding models and delivery between Canada and the UK exist. As such, there is not enough experience to know whether research priorities identified in one country can be adopted by another country. An in-depth comparison of the CAR PSP top ten and the NIAA top ten is warranted to assess similarities and generalizability across countries. It appears that the top ten lists for both countries share some similar questions. For example, both PSPs identified pain after surgery and long-term effects of anesthesia as priorities for research. Differences exist, however, such as with the priority around the impact of reducing opioids during surgery appearing in the Canadian list, but not the UK one.

Additionally, we will assess how the CAR PSP priorities ranking differed between the patient/caregiver and clinician groups and impacted the CAR PSP top ten priorities.

Using the CAR PSP top ten

Following the established methodology of the JLA, the Canadian anesthesia research community now has a made-in-Canada top ten list of shared priorities that can help situate and direct their projects. Funders may choose to focus their calls for applications around these priorities. Commitment to patient-oriented research can also be shown by funding proposals that align with the top ten priorities, funding projects with patient partners as co-investigators on the research team, or including patient reviewers in the grant review processes.

The top ten priorities are not prescriptive. If a topic did not rank in the final top ten, this does not mean it is unimportant research. Researchers are encouraged to consider how their current and future projects can align with the top ten. For example, the priority of “How can anesthesiologists improve pain control after surgery?” lends itself to a broad range of research questions, from preclinical research leading to development of new drugs, to psychological interventions that help patients manage pain.

Call to action

The CAR PSP top ten priorities represent the collective wisdom of the participants who contributed to the CAR PSP and they deserve the attention of the research community. The CAR PSP top ten priorities are a call to action and serve as a valuable tool to initiate and guide patient-oriented research in anesthesia and perioperative care. This initiative is particularly important in anesthesia research where the patient perspective has not frequently been incorporated. This PSP has forged important relationships among patients/caregivers, healthcare providers, and researchers, and is a springboard for a sustained culture of patient engagement within anesthesia research.

Author contributions

Dolores M. McKeen, Jillian C. Banfield , Daniel I. McIsaac , Jason McVicar , Colleen McGavin , Katherine Cowan and Andreas Laupacis contributed to all aspects of this manuscript, including study conception and design; acquisition, analysis, and interpretation of data; and drafting the article. Mary Anne Earle , Claire Ward , Katharina Kovacs Burns , Donna Penner , Gilbert Blaise and Thierry De Greef contributed to acquisition, analysis, and interpretation of data. The Perioperative Anesthesia Clinical Trials Group ( PACT) contributed to the conception and design of the project.

Acknowledgements

We thank the editorial board of the Canadian Journal of Anesthesia who provided French language translation of the two surveys. We thank the Maritime Strategy for Patient Oriented Research (SPOR) SUPPORT Unit (MSSU) for their support and connections to other Canadian SPOR Units to request support and recruitment aid in their respective jurisdictions. Specifically, we thank Leah Boulos, Brian Condran, Julia Kontak, and Michelle Fiander. We also thank Melissa Crane for her work to synthesize the initial questions into summary questions. We are especially grateful to Katherine Cowan for her expert guidance throughout this project.

Conflicts of interest

Funding statement.

The Canadian Anesthesia Research Priority Setting Partnership was funded through a Canadian Institutes of Health Research – Strategy for Patient Oriented Research (CIHR SPOR) Collaboration Grant. This Top 10 priorities are an initial output of a grant aimed to support patient-oriented Canadian anesthesia research. Collaborating funding organizations: Association of University Departments of Anesthesia (ACUDA). Canadian Anesthesiologists’ Society (CAS). Canadian Institutes of Health Research (CIHR). Dalhousie University Department of Anesthesia, Perioperative and Pain Medicine. Northern Ontario School of Medicine Department of Anesthesia. Perioperative Anesthesia Clinical Trials Group (PACT). University of Manitoba Department of Anesthesia

Editorial responsibility

This submission was handled by Dr. Hilary P. Grocott, Editor-in-Chief, Canadian Journal of Anesthesia.

This article is accompanied by an editorial. Please see Can J Anesth 2020; 67: this issue.

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Hot topics in anaesthesia: a bibliometric analysis of five high-impact journals from 2010–2019

• Published: 22 August 2021
• Volume 126 , pages 8749–8759, ( 2021 )

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• S. G. Grace   ORCID: orcid.org/0000-0001-7583-717X 1 ,
• F. S. S. Wiepking   ORCID: orcid.org/0000-0002-3509-7549 1 &
• A. A. J. van Zundert   ORCID: orcid.org/0000-0002-1836-6831 1  

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Publication of research in anaesthesia is increasingly competitive. Understanding what topics of research are more likely to be published and where, is clearly valuable for authors seeking to optimise reach and impact of their work. This study aimed to identify the relative proportion of anaesthesia articles by topic for five anaesthesia journals over a 10-year period from 2010 to 2019, including any differences between journals and regions. We chose five anaesthesia journals based on current impact factor. All journal issues published between 2010–2019 were checked for total number of articles with only original research articles being further categorised by topic, country of research, funding status and citation count. Of 5782 original research articles analysed, the most frequent article topics published were translational studies (16%) and clinical practice (16%). Obstetric anaesthesia was the least frequent published (4%). Translational studies were the most frequently funded (84%) while articles on paediatric anaesthesia were least frequently funded (29%). The average number of citations per funded article was 37 versus 28 for non-funded articles. Translational studies were the most frequently published topic of research conducted in North America (25%) and Asia (25%), but of only average frequency in Europe (9%). Studies in obstetric and paediatric anaesthesia are less well-represented in anaesthesia literature and researchers may experience greater difficulty publishing these topics and obtaining funding accordingly. Authors should be aware of the diverse publishing tendencies of the different journals in anaesthesia in order to save time and effort when submitting research for publication.

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Abbreviations.

British Journal of Anaesthesia

European Journal of Anaesthesiology

Regional Anesthesia and Pain Medicine

High-income country

Low/middle-income country

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Acknowledgements

Many thanks to Rachel Ling and Aakanksha Sahu for their assistance with the original data collection.

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Department of Anaesthesia and Perioperative Medicine, Royal Brisbane and Women’s Hospital, Brisbane and the University of Queensland, NHB, Butterfield St, Herston, Brisbane, QLD, 4006, Australia

S. G. Grace, F. S. S. Wiepking & A. A. J. van Zundert

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Samuel Grace: concept, design, literature search, data acquisition, original draft and critical revision of draft, approval final draft; Floris Wiepking: concept, design, literature search, data acquisition, original draft and critical revision of draft, approval final draft; André Van Zundert: concept, design, literature search, data acquisition, original draft and critical revision of draft, approval final draft.

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Correspondence to A. A. J. van Zundert .

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Grace, S.G., Wiepking, F.S.S. & van Zundert, A.A.J. Hot topics in anaesthesia: a bibliometric analysis of five high-impact journals from 2010–2019. Scientometrics 126 , 8749–8759 (2021). https://doi.org/10.1007/s11192-021-04129-0

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Received : 24 May 2021

Accepted : 05 August 2021

Published : 22 August 2021

Issue Date : October 2021

DOI : https://doi.org/10.1007/s11192-021-04129-0

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