Anesthesia and analgesia最新文献

{"title":"Sexual Harassment in Academic Anesthesiology: A Survey of Prevalence, Sources, Impact, and Recommendations.","authors":"Maya J Hastie, Aaron Mittel, Vidya Raman, Joseph Szokol, Robert Whittington, Maria Bustillo, Shahla Siddiqui, Tracey Straker, Tetsuro Sakai, Valerie Armstead, Jeanine Wiener-Kronish, Chelcie Jewitt, George A Mashour","doi":"10.1213/ANE.0000000000007282","DOIUrl":"10.1213/ANE.0000000000007282","url":null,"abstract":"<p><strong>Background: </strong>A report by the American Association of Medical Colleges (AAMC) showed that academic anesthesiology has the highest prevalence of sexual harassment among specialties for both men and women. We aimed to explore the prevalence, sources, and impact of sexual harassment on anesthesiologists in academic centers in the United States and Canada. We also sought recommendations for its mitigation.</p><p><strong>Methods: </strong>An anonymous online survey instrument was designed based on a previously published report, yielding 39 questions, including demographics and 4 open-ended questions. The survey was sent via email to Association of University Anesthesiologists (AUA) members, who were encouraged to share across academic anesthesiology departments in the United States and Canada.</p><p><strong>Results: </strong>A total of 626 responses were received; after exclusion of incomplete and nonfaculty responses, 484 complete survey responses were analyzed. 52.9% of respondents identified as men and 45.9% as women; 3 respondents (0.6%) identified as nonbinary, and 3 respondents (0.6%) preferred not to answer. 43.6% of respondents perceived there is sexual harassment in academic anesthesiology. Significantly more women than men reported presence of sexual harassment in academic medicine (65.3% vs 38.3%, P < .001), in academic anesthesiology (59.5% vs 30.1%, P < .001), and in their place of work (37.8% vs 18.3%, P < .001). 14.5% of men and 43.2% of women had experienced sexual harassment at least once in the past 12 months ( P < .001). 43.7% of women reported ever experiencing unwanted physical contact in the workplace compared to 16.8% of men; 74.3% of women reported ever experiencing verbal or nonverbal conduct in the workplace related to gender that caused embarrassment, distress, or offense compared to 24.6% of men ( P < .001). 8.2% of men reported feeling their clinical ability doubted, compared to 87.8% of women ( P < .001). Experiences of sexual harassment were most consistent with verbal and nonverbal behaviors that convey hostility, objectification, or exclusion of members of one gender. Colleagues from anesthesiology were most likely to be reported as the source of sexual harassment (44.6% of unwanted physical contact, 59% of verbal or nonverbal conduct). The impact was described along 4 themes: emotional, cognitive, behavioral, and professional. Participants made recommendations for eliminating sexual harassment by raising awareness, providing education, establishing reporting, offering support, and ensuring accountability.</p><p><strong>Conclusions: </strong>This survey confirms the high prevalence of sexual harassment in academic anesthesiology. The most common sources are anesthesiology colleagues. The recommendations for leaders and institutions include creating a professional environment free from harassment with support for targets and accountability for instigators.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"856-867"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Power of Education to Reduce the Carbon Footprint of Volatile Anesthetics in Clinical Practice.","authors":"Arne Schwiethal, Sascha Treskatsch, Jannis Michael, Moritz Höft, Claudia D Spies, Susanne Koch","doi":"10.1213/ANE.0000000000007375","DOIUrl":"10.1213/ANE.0000000000007375","url":null,"abstract":"<p><strong>Background: </strong>Due to their chemical nature as fluorinated hydrocarbon compounds, volatile anesthetics are highly potent greenhouse gases, with desflurane having by far the largest CO 2 -equivalent (CO 2 e) footprint. In everyday clinical practice, the CO 2 e footprint can easily be reduced through the increased use of propofol or sevoflurane as well as low- and minimal-flow techniques or through the more frequent use of regional anesthesia techniques. We wanted to assess to what extent educational measures on sustainability aspects of the use of volatile anesthetics had an impact on daily practice in anesthesiology departments and to what extent this influenced the hospital's CO 2 e emissions.</p><p><strong>Methods: </strong>We conducted an observational data analysis of the consumption of anesthetics (sevoflurane, desflurane, isoflurane, and propofol) at all 3 clinical Charité campuses in the period from 2015 to 2023. The CO 2 e emissions were calculated for sevoflurane, desflurane, and isoflurane. External and internal (top-down or bottom-up) educational measures focusing on sustainability in anesthesia took place from September 2018 on. Shifts in CO 2 e emissions related to the educational measures are shown in a run chart. The number of surgeries, surgery duration, and purchasing costs were included in the analysis.</p><p><strong>Results: </strong>CO 2 e emissions of volatile anesthetics were reduced by 90.3% from the baseline epoch (years 2015-2017) before educational interventions took place to 2023: CO 2 e 1470 tons (mean 2015-2017), to 191 tons (2022) to 142 tons (2023). This change was brought about by the phasing out of desflurane and the use of propofol or sevoflurane and regional anesthesia where appropriate. The fastest and most sustainable changes were seen after internal top-down measures. The total cost of anesthetics also fell over the period under review (from €541,102/$594,238 in 2015 to €281,646/$309,303 in 2023).</p><p><strong>Conclusions: </strong>Educational measures for anesthesiologists about the climate-damaging effects of volatile anesthetics-especially desflurane-can significantly reduce CO 2 e emissions in anesthesia clinics. On the positive side, these measures have also reduced the annual costs for anesthetics.</p>","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"868-875"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12410085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143497942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opioid Preconditioning in Heart Failure: New Frontier or Old Dog?","authors":"Detlef Obal, Yu Liu","doi":"10.1213/ANE.0000000000007388","DOIUrl":"10.1213/ANE.0000000000007388","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":"702-705"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143254231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phenylephrine Infusions for the Prevention of Spinal-Induced Hypotension: Do We Need Any More Evidence?","authors":"Ashraf S Habib","doi":"10.1213/ANE.0000000000007512","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007512","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":"141 4","pages":"732-735"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074229","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Perioperative Management Core Knowledge Certificate.","authors":"","doi":"10.1213/ANE.0000000000007746","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007746","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":"141 4","pages":"693"},"PeriodicalIF":3.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor.","authors":"Elana B Lubit","doi":"10.1213/ANE.0000000000007773","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007773","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Commitment to Trust and Integrity in Science: Implications for Pain and Anesthesiology Research.","authors":"Tonya M Palermo, Didier Bouhassira, Karen D Davis, Hugh C Hemmings, Robert W Hurley, Joel Katz, Jaideep J Pandit, Theodore J Price, Michael E Schatman, Stephan K W Schwarz, Dennis C Turk, Marc Van de Velde, Matthew D Wiles, Tony L Yaksh, David Yarnitsky","doi":"10.1213/ANE.0000000000007632","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007632","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145129911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response.","authors":"Vlasios Karageorgos, Panagiota Darivianaki, Anastasia Spartinou, Vasileia Nyktari, Panagiotis Simos, Alexandra Papaioannou","doi":"10.1213/ANE.0000000000007766","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007766","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response.","authors":"Ilana Sebbag, Sonny Cheng","doi":"10.1213/ANE.0000000000007768","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007768","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response.","authors":"Edgardo E Reynoso, Richard L Applegate, Melissa D McCabe","doi":"10.1213/ANE.0000000000007771","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007771","url":null,"abstract":"","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":3.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145074219","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}