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The ESAIC is dedicated to supporting professionals in anaesthesiology and intensive care by serving as the hub for development and dissemination of valuable educational, scientific, research, and networking resources.


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Congresses

The ESAIC hosts the Euroanaesthesia and Focus Meeting congresses that serve as platforms for cutting-edge science and innovation in the field. These events bring together experts, foster networking, and facilitate knowledge exchange in anaesthesiology, intensive care, pain management, and perioperative medicine. Euroanaesthesia is one of the world’s largest and most influential scientific congresses for anaesthesia professionals. Held annually throughout Europe, our congress is a contemporary event geared towards education, knowledge exchange and innovation in anaesthesia, intensive care, pain and perioperative medicine, as well as a platform for immense international visibility for scientific research.


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Professional Growth

The ESAIC's mission is to foster and provide exceptional training and educational opportunities. The ESAIC ensures the provision of robust and standardised examination and certification systems to support the professional development of anaesthesiologists and to ensure outstanding future doctors in the field of anaesthesiology and intensive care.


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Research

The ESAIC aims to advance patient outcomes and contribute to the progress of anaesthesiology and intensive care evidence-based practice through research. The ESAIC Clinical Trial Network (CTN), the Academic Contract Research Organisation (A-CRO), the Research Groups and Grants all contribute to the knowledge and clinical advances in the peri-operative setting.


Learn more about the ESAIC Clinical Trial Network (CTN) and the associated studies.

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EU Projects

The ESAIC is actively involved as a consortium member in numerous EU funded projects. Together with healthcare leaders and practitioners, the ESAIC's involvement as an EU project partner is another way that it is improving patient outcomes and ensuring the best care for every patient.


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Patient Safety

The ESAIC aims to promote the professional role of anaesthesiologists and intensive care physicians and enhance perioperative patient outcomes by focusing on quality of care and patient safety strategies. The Society is committed to implementing the Helsinki Declaration and leading patient safety projects.


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Sustainability

To ESAIC is committed to implementing the Glasgow Declaration and drive initiatives towards greater environmental sustainability across anaesthesiology and intensive care in Europe.


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Partnerships

The ESAIC works in collaboration with industry, national societies, and specialist societies to promote advancements in anaesthesia and intensive care. The Industry Partnership offers visibility and engagement opportunities for industry participants with ESAIC members, facilitating understanding of specific needs in anaesthesiology and in intensive care. This partnership provides resources for education and avenues for collaborative projects enhancing science, education, and patient safety. The Specialist Societies contribute to high-quality educational opportunities for European anaesthesiologists and intensivists, fostering discussion and sharing, while the National Societies, through NASC, maintain standards, promote events and courses, and facilitate connections. All partnerships collectively drive dialogue, learning, and growth in the anaesthesiology and intensive care sector.


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Guidelines

Guidelines play a crucial role in delivering evidence-based recommendations to healthcare professionals. Within the fields of anaesthesia and intensive care, guidelines are instrumental in standardizing clinical practices and enhancing patient outcomes. For many years, the ESAIC has served as a pivotal platform for facilitating continuous advancements, improving care standards and harmonising clinical management practices across Europe.


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Publications

With over 40 years of publication history, the EJA (European Journal of Anaesthesiology) has established itself as a highly respected and influential journal in its field. It covers a wide range of topics related to anaesthesiology and intensive care medicine, including perioperative medicine, pain management, critical care, resuscitation, and patient safety.


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Membership

Becoming a member of ESAIC implies becoming a part of a vibrant community of nearly 8,000 professionals who exchange best practices and stay updated on the latest developments in anaesthesiology, intensive care and perioperative medicine. ESAIC membership equips you with the tools and resources necessary to enhance your daily professional routine, nurture your career growth, and play an active role in advancing anaesthesiology, intensive care and perioperative medicine.


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ESAIC News

Is neuromuscular monitoring the wave of the future in general anaesthesia?  

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To monitor or not to monitor – that is the question at the center of the debate over quantitative neuromuscular monitoring, going on at Euroanaesthesia 2024.  

Neuromuscular blocking agents (NMBAs) are used to improve airway management and facilitate intubation during general anaesthesia. However, results from large retrospective studies have revealed a link between the use of NMBAs and relaxant-associated postoperative complications,1 which were shown to occur despite adequate reversal with acetylcholinesterase inhibitors or encapsulating agents. With the recent expiration of its patent, sugammadex has become increasingly available in generic formulations at hospitals across Europe, raising new questions about the practices related to the reversal of neuromuscular block in general anaesthesia and the methods for preventing adverse events.  

To address the major risks associated with NMBAs, including residual paralysis and postoperative pulmonary complications, ESAIC and the American Society of Anaesthesiologists (ASA) have issued guidelines2,3 that recommend quantitative neuromuscular monitoring, with the use of devices that measure the depth of muscle relaxation during the intubation process. According to these consensus statements, quantitative neuromuscular monitoring is the only reliable method to ensure adequate recovery from the adverse effects of NMBAs in the postoperative period. Nevertheless, anaesthesiologists may find it easier to cling to old habits, such as reliance on the subjective evaluation of clinical signs to confirm recovery from neuromuscular block. Data preceding the ESAIC guidelines showed that less than one-fifth of patients across Europe underwent quantitative neuromuscular monitoring during general anaesthesia.1  

While the ESAIC and ASA guidelines have identified the switch to routine quantitative neuromuscular monitoring as the most crucial step toward improving patient outcomes, promoting the widespread use of this method is a long-term strategy. The implementation of quantitative monitoring in clinical practice must break down barriers such as the lack of institutional standards and protocols, time constraints, suboptimal clinician training, and the limited availability of quantitative train-of-four (TOF) monitors in clinical practice. Misconceptions about the pharmacokinetics of NMBAs and residual block may constitute another roadblock in the way of optimising the perioperative management of neuromuscular blockade.  

The lack of reliable information about the role and efficacy of neuromuscular monitoring during general anaesthesia persists in the European practice of anaesthesiology, despite the recent recommendations. In some clinical settings, quantitative neuromonitoring is considered unnecessary when sugammadex is used to reverse the effects of aminosteroidal agents such as rocuronium or vecuronium. However, anytime a NMBA is administered, neuromuscular monitoring should be used to guide administration and adequately reverse the effects of neuromuscular blockade, according to the recent guidelines. Quantitative neuromuscular may also be perceived as expensive, difficult to interpret, and likely to fail during surgical procedures. 

While clinical signs have traditionally been used to confirm adequate reversal of neuromuscular blockade, these are unreliable in unconscious patients. Instead, ESAIC recommends the use of ulnar nerve stimulation and quantitative neuromuscular monitoring at the adductor pollicis muscle to exclude residual paralysis. Moreover, monitoring of neuromuscular blockade should be continued until a TOF ratio of more than 0.9 has been attained. The guidelines emphasise the limitations of qualitative devices and clinical assessment in distinguishing between adequate recovery and minimal levels of residual blockade, and the significance of distinguishing between deep, moderate, shallow, and minimal levels of neuromuscular blockade.  

As long as some clinicians remain skeptical about the role of intraoperative monitoring in reducing the rates of NMBA-related complications, the controversy is alive and well. During a pro-con debate on Monday, Prof. Thomas Fuchs-Buder, MD, and his co-speakers will address common misconceptions about the use of neuromuscular monitors and reversal agents in the practice of anaesthesiology, as well as the importance of educating clinicians about quantitative monitoring. Fuchs-Buder, a professor of anaesthesiology at the University of Lorraine, Centre Hospitalier Universitaire de Nancy, Hôpitaux de Brabois, in France, is a co-author of the ESAIC guidelines and a lead researcher in the field of neuromuscular monitoring during anaesthesia.   

References: 

  1. Kirmeier E, Eriksson LI, Lewald H, et al; POPULAR Contributors. Post-anaesthesia pulmonary complications after use of muscle relaxants (POPULAR): a multicentre, prospective observational study. Lancet Respir Med 2019;7(2):129-140.  
  2. Fuchs-Buder T, Romero CS, Lewald H, et al. Peri-operative management of neuromuscular blockade: A guideline from the European Society of Anaesthesiology and Intensive Care. Eur J Anaesthesiol 2023;40(2):82-94. 
  3. Thilen SR, Weigel WA, Todd MM, et al. 2023 American Society of Anesthesiologists Practice Guidelines for Monitoring and Antagonism of Neuromuscular Blockade: A Report by the American Society of Anesthesiologists Task Force on Neuromuscular Blockade. Anesthesiology 2023;138(1):13-41.

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