The Role of Journals for the Future Direction of Anesthesiology

Mark Arcario, MD, PhD

As the journal of the International Anesthesia Research Society, Anesthesia & Analgesia provides great value for many attendees at the IARS 2021 Annual Meeting. Using the platform of the meeting, the Editor-In-Chief of Anesthesia & Analgesia, Dr. Jean-Francois Pittet, led a session, “Perioperative Outcomes: Current Evidence and Future Priorities,” highlighting the work of journals in anesthesiology, specifically focused on perioperative outcomes. Forming the panel for the session were editors of A&A as well as other high-profile anesthesiology journals, including Shock, Obstetrics & Gynecology, and the British Journal of Anesthesia.

Judith Hellman, MD, William L. Young, M.D. Endowed Professor and Vice Chair for Research in the Department of Anesthesia and Perioperative Care and Research Lab Director at the University of California, San Francisco, took time to recognize the recent efforts of Shock. As an associate editor, she highlighted the highly translational focus of the journal, a gradual change from its basic science roots. Because anesthesiologists care for critically ill patients on a daily basis, studies from this journal, which covers topics in trauma, sepsis, and critical care, are informative and potentially transformative to their practice.

Hugh Hemmings, Jr., MD, PhD, Joseph F. Artusio Professor and Chair of Anesthesiology at Weill Cornell Medicine, as well as Editor-in-Chief of British Journal of Anesthesia, then highlighted recent work from the journal, focused primarily on how the journal is impacting perioperative outcomes. First, he highlighted an effort called StEP, which is attempting to standardize end-points across perioperative outcomes research studies. This work will likely improve future systematic reviews and meta-analyses. Moreover, Dr. Hemmings provided insightful vignettes on work published in British Journal of Anesthesia regarding topics ranging from the impact of anesthetic choice on cancer recurrence to the effect of frailty on perioperative outcomes. Overall, the journal publishes a plethora of impactful and insightful articles in all areas of anesthesiology.

John Fischer, MD, FACOG, Professor and Department Head of Obstetrics and Gynecology at the University of Minnesota, then presented work on perioperative outcomes in the journal, Obstetrics & Gynecology, where he serves as Podcast Editor. Representing the journal, Dr. Fischer reported on landmark studies in Obstetrics & Gynecology centered around enhanced recovery after surgery (ERAS) and improvement in perioperative outcomes. He reviewed studies that clearly demonstrated the benefits of ERAS principles, including shorter time to ambulation and shorter hospital stay as well as reduced opioid consumption in the perioperative period. While this holds true for open and minimally-invasive procedures, the benefit could not be demonstrated in robotic-assisted procedures. Lastly, he reported on a recent study showing that transversus abdominis plane block for caesarean delivery did not lead to high levels of bupivacaine transfer to breastmilk and poses little threat to the newborn infant.

Paloma Toledo, MD, MPH, Assistant Professor of Anesthesiology at Northwestern University Feinberg School of Medicine, discussed the impact of Anesthesia & Analgesia on perioperative outcomes research. Initially noting that anesthesia-related deaths have decreased dramatically over the past 50 years due to research and advances in anesthesiology, the next big issue to tackle is perioperative organ failure. Using perioperative myocardial infarction as an example, Dr. Toledo presented the MINS study, which examined a variety of perioperative factors that contribute to type II myocardial infarction, the more common type of the two, relating this to preventable causes. Moreover, she highlighted how the journal altered its normal function during the SARS-CoV2 global pandemic to be more readily accessible to a wide audience in order to disseminate the knowledge anesthesiologists possessed in order to better care for these patients around the globe. Lastly, using the topic of maternal mortality, she discussed how the journal could be a platform to further promote the work of anesthesiologists moving beyond the operating room into changing public health.