The Definition and Aims of Anesthesia: a Delphi-based Consensus Statement.

IF 4.7 3区 医学 Q1 ANESTHESIOLOGY
Joana Berger-Estilita, Basak Ceyda Meco, Edoardo DeRobertis, Wolfgang Buhre, Peter Kirkegard, Karina Jakobsen, Martin Soehle, Federico Bilotta, Falk von Dincklage, Idit Matot, Yotam Weiss, Vincent Bonhomme, Lian Kah Ti, Ivan Rimstad, Clifford Shelton, Bartosz Kozlowski, Sarah Saxena, Paul McConnell, Anil Hormis, Ahed Zeidan, Jan Mulier, Lisbeth Evered, Paola Aceto, Daniel Schmukler, Patrice Forget, Claudia Marquez Simoes, Luiz Fernando Falcao, Maria Wittman, Ismail Gönegur, Finn Michael Radtke
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引用次数: 0

Abstract

Background: Anaesthesia is crucial in ensuring patient comfort and safety during surgical procedures by inducing a temporary loss of sensation, memory, and consciousness. However, its multifaceted nature presents challenges in defining its aims and expected outcomes. This study aimed to establish a consensus on anaesthesia's definition and core aims using a structured Delphi process.

Methods: We conducted a modified three-round eDelphi method involving 23 international experts. Participants engaged in iterative online surveys to refine a consensus definition and aims. Consensus was predefined as achieving ≥80% agreement. The process included external expert reviews to enhance objectivity and validity. Statistical analyses included median, interquartile range (IQR), and agreement percentages.

Results: The Delphi process resulted in consensus on 49 aims and a refined definition of anaesthesia. The final definition emphasises safe, effective, individualised, patient-centred, and empathetic care, ensuring optimal surgical conditions while enhancing patient outcomes. Key aims included preoperative optimisation, stress and pain reduction, organ function preservation, prompt emergence and recovery, interdisciplinary teamwork, continuous outcome assessment, and sustainability in anaesthesia practices. The final agreement rate for the updated definition was 82.6% (median: 10, IQR: 9-10). Additionally, environmental sustainability was recognised as an integral aim.

Conclusion: The consensus developed in this study provides a structured framework for defining anaesthesia's objectives, improving patient-centred care, guiding clinical practice, and fostering research. By incorporating sustainability and long-term patient outcomes, the consensus supports the evolution of precision anaesthesia. Future research will validate these defined aims in various perioperative settings and refine the consensus based on real-world applications.

麻醉的定义和目的:基于delphi的共识声明。
背景:麻醉在外科手术过程中通过诱导暂时的感觉、记忆和意识丧失来确保患者的舒适和安全是至关重要的。然而,其多面性给确定其目标和预期结果带来了挑战。本研究旨在使用结构化德尔菲过程建立麻醉定义和核心目标的共识。方法:采用改良的三轮eDelphi法,23名国际专家参与。参与者参与了反复的在线调查,以完善一致的定义和目标。共识被定义为达到≥80%的一致性。该过程包括外部专家审查,以提高客观性和有效性。统计分析包括中位数、四分位差(IQR)和一致性百分比。结果:德尔菲过程产生了49个目标的共识和麻醉的细化定义。最终定义强调安全、有效、个性化、以患者为中心和移情护理,确保最佳的手术条件,同时提高患者的治疗效果。主要目标包括术前优化、减轻压力和疼痛、器官功能保存、迅速出现和恢复、跨学科团队合作、持续的结果评估和麻醉实践的可持续性。更新定义的最终一致性率为82.6%(中位数:10,IQR: 9-10)。此外,环境可持续性被认为是一个不可或缺的目标。结论:本研究中形成的共识为定义麻醉目标、改善以患者为中心的护理、指导临床实践和促进研究提供了一个结构化的框架。通过结合可持续性和长期患者结果,共识支持精确麻醉的发展。未来的研究将在各种围手术期环境中验证这些定义的目标,并根据实际应用完善共识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.70
自引率
5.50%
发文量
150
审稿时长
18 days
期刊介绍: Anaesthesia, Critical Care & Pain Medicine (formerly Annales Françaises d''Anesthésie et de Réanimation) publishes in English the highest quality original material, both scientific and clinical, on all aspects of anaesthesia, critical care & pain medicine.
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