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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.



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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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.



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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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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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.



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



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.



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.



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.



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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Newsletter 2021

Newsletter August 2021: Post-mastectomy management of pain and postoperative nausea-vomiting

Letter to editor
Tzima Maria
Trainee Anaesthesiologist

Mendonça et al1 recently published their work on intra-operative esmolol administration in relation to pain treatment following mastectomy. In their work, as a primary outcome, they assess postoperative pain and as secondary, postoperative nausea and vomiting(PONV), blood pressure, heart rate, Bispectral Index(BIS), use of anaesthetics, analgesic medication and time to emergence differences between a group of patients administered esmolol and a control, normal saline group. Although larger trials are still needed, Watts2 and Gelineau3 have performed similar studies; the first showed that esmolol reduced postoperative pain versus placebo, while the second, in a double-blind manner, concluded that evidence was insufficient, although intraoperative opioid consumption was reduced.

Mendonça et al take profit from esmolol’s action as an antinociceptive, acting in the cingulate cortex and trigeminal nucleus, suppressor of adrenergic and inflammatory response, activator of locus coreleus and inhibitor of sodium and calcium transmission, and thus reducing pain. PONV incidence is decreased due to lower opioid consumption and more stable CVS. Their protocol included a bolus dose of 0,5mg/kg in 10 minutes and a constant infusion rate of 100/mcg/kg/min. The side effects of esmolol were treated with symptomatic medication, atropine 0,01 mg/kg for low heart rate and ephedrine 5mg for low blood pressure.  Fentanyl was administered in bolus doses of 50mcg.

As it is already known that mastectomy is followed by an increased incidence of PONV and neuropathic pain, this study offers information of crucial clinical importance. King et al4 compared opioid free anesthesia versus conventional anaesthesia and found no statistical difference in PONV or postoperative opioid needs, a modest decrease in pain scores was noted though. Dinh et al5 applied an ERAS protocol versus a usual care protocol and noticed reduced opioid needs postoperatively, decreased PONV and pain scores.

Persistent post-mastectomy pain (PPMP) is very common, so it has attracted much attention. Pain management after mastectomy is difficult to manage, as it is associated with social, psychological and functional issues. Radiation, lymph nodes resection, lymphoedema, tissue fibrosis are related to persistent pain. Sociodemographic factors, such as being in an ethnic minority, young age and also preoperative painful situations, favour PPMP. 6

Pain management demands a multimodal approach. Pickering et al7 proved the effect of memantine, a NMDA receptor antagonist on pain in animals. Reyad et al 8 administered 75mg pregabalin twice a day for a week, starting from the morning of surgery, with reduced pain scores.

Esmolol is a selective, short-acting, β1-adrenoreceptor antagonist, which is metabolised by plasma esterase. Its properties as an anaesthetic adjunct is unknown and it acts both peripherally and centrally. Cautious use is demanded in cases of renal insufficiency, due to renal excretion of its metabolite. In doses between 50-300mcg/kg/min, its metabolism is independent of renal or hepatic function. Esmolol decreases heart rate and blood pressure and it is contraindicated in bradycardia, heart block greater than first degree, heart failure and cautious use is crucial in diabetes and bronchospasm.  In comparison with other non-opioid analgesics, esmolol shows similar results to lidocaine and less sedated patients. 9 Not only this, but it offers haemodynamic stability after surgery.10 

In conclusion, multimodal pain treatment after mastectomy needs serious attention. Preoperative factors should be identified, psychological issues should be addressed and pain management should include a variety of medications, as mentioned above. Esmolol, in doses mentioned, offers important advantages and with an elimination half-life of 9 minutes, its effects are both rapid and transient. By reducing opioids, less sedation and PONV and faster patient discharge are noticed. 11Esmolol seems to act as a promising adjunct, though more clinical trials should be carried out in order to produce more reliable results.



  1. Mendonça, F T.; Tramontini, A J.; Miake, H I et al.  Eur J  Anaesthesiology 2021;38:735 doi: 10.1097/EJA.0000000000001512
  2. Watts R, Thiruvenkatarajan V, Calvert M, et al.. J Anaesthesiol Clin Pharmacol 2017; 33:28
  3. Gelineau AM, King MR, Ladha KS, et al. AnesthAnalg 2018; 126:1035 – 1049.
  4. King CA, Perez-Alvarez IM, Bartholomew AJ, et al.. Breast J. 2020;26:1742. doi: 10.1111/tbj.13999
  5. DinhKH, McAuliffe PF, Boisen M, et al. Ann Surg Oncol. 2020;27:4828. doi: 10.1245/s10434-020-08880-1
  6. Tait R, Zoberi K, Herndon C, J Pain, 2018; 19:1367
  7. Pickering G, Morel V, Joly D, et al. Trials. 2014;15:3317
  8. Reyad RM, Omran AF, Abbas et al. J Pain Symptom Manage. 2019;5:1
  9. Bajracharya JL, Subedi A, Pokharel K, et al BMC Anesthesiol. 2019;191:198.
  10. Vahabi S, Rafieian Y, Abbas Zadeh A. J Invest Surg. 2018;3:82
  11. Harless M, Depp C, Collins S,et al. AANA J. 2015;83:167


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