Major Anesthesia-Related Events in the 2000s and Beyond

Abstract

SummaryThe dramatic scientific and technologic advances of anesthesia in preceding decades slowed in the 2000s, with maturation of the specialty and associated subspecialties. Certificates attesting expertise in anesthesiology and subspecialities now require or will require recertification.Except for sugammadex, no new anesthesia-related drugs were released for use, and few new drugs are on the horizon. New uses for old drugs were found such as administering ketamine to lessen postoperative dependence on opioids, and substituting intrathecal 2-chloroprocaine for lidocaine to avoid lidocaine-associated transient neurologic syndrome. The 2000s saw technical advances such as the GlideScope, the first of many video-laryngoscopes, and increased adoption of ultrasound-assisted regional anesthesia. Several societies recommended ultrasound guidance for insertion of central venous catheters.Fears that increased risk precluded outpatient surgery for ASA PS III patients were shown to be unfounded, and approximately 80 % of elective surgical and diagnostic procedures in the US were performed on an outpatient basis. However, office-based sedation appeared to increase risk relative to that in free-standing ambulatory surgery centers (ASCs), probably because of less oversight and training of those delivering sedation. The Lifebox Foundation promoted the 2004 Global Oximetry initiative of the WFSA, to make oximetry and capnography available and thereby diminish mortality in low-income regions of the world.Three major worldwide instances of plagiarism, fraud, and lack of informed consent by anesthesiologists were revealed, resulting in retraction of a record number of publications, and prosecution and incarceration of at least one investigator.The percentage of women anesthesia residents in the US increased from 27 % in 2000 to 38 % in 2010, women increasingly chaired Departments of Anesthesia, and 9 of 22 SAMBA Presidents were women. In the 2000s, governing agencies in the US and Europe progressively limited duty hours of residents in all specialties. In 2005, Pandit noted that only 6 of 23 UK universities sustained departmental or divisional structures for anesthesia.