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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.

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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.



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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.



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Newsletter 2021

Newsletter June 2021: Clinical corner - The quest for a smooth extubation!

Marcelo Sperandio Ramos

Clinical corner – The quest for smooth extubation! – I banned air from the ETT cuff for good…

It is known for a fact that tracheal extubation is associated with a significant risk of complications, – The Difficult Airway Society (DAS) developed a guideline for the management of tracheal extubation in 2012. While the DAS guideline provides an excellent starting point in developing strategies for achieving successful extubation, it does not provide a distinction between successful extubation and smooth extubation. The concept of smooth emergence was mentioned in the DAS guideline as desirable for the success of certain surgical procedures, but it did not specify which procedures. Despite much of the discussion regarding extubation techniques in the literature, there is no precise definition of “smooth extubation”. Coughing during emergence from general anaesthesia affects 40 to76% of intubated patients. Among the physiological sequelae of peri-extubation coughing, we can cite complications as neck haematoma after thyroidectomy or carotid endarterectomy, wound dehiscence after laparotomy, and intracerebral haemorrhage after intracranial surgery. As such, the ”quest for a smooth extubation” has been pursued in the literature, as I do so in my practice. Multiple medications have been shown to reduce emergence coughing in isolation, such as lidocaine (I.V., intracuff, topical, and tracheal routes), dexmedetomidine, fentanyl, and remifentanil. Beyond the humanitarian aspect the ”smooth extubation” should be a goal to be pursued even in ordinary anaesthesia, because it is a potentially avoidable source of complications for any patient. It is uncertain; however, which combination of measures and/or medication is the most effective for reducing this adverse event. Studies are limited by small sample sizes and heterogenous medication dosages. These limitations are also reflected in the published systematic reviews and meta-analyses. , . Importantly, studies are sparse with a meaningful head-to-head comparison of medications. As such, the comparative effects of these medications to reduce perioperative cough are unknown.

It should be noted that the COVID-19 pandemic has heightened the importance of developing our knowledge of effective techniques to achieve smooth emergence. In an effort to reduce the transmission of COVID-19 to healthcare workers, smooth extubation may contribute to primary prevention by reducing coughing, bucking, and aerosolisation.

Among methods used to apply a local anaesthetic to the mucosa, intracuff lidocaine, in addition to the local anaesthetic effect and suppressing complications during extubation, prevents diffusion of nitrous oxide into the ETT cuff without delaying awakening. Coughing during emergence from general anaesthesia is a common clinical problem. Inflation of the endotracheal tube cuff with lidocaine would create a reservoir of local anaesthetic, which might diffuse across the cuff membrane to anaesthetize the mucosa and attenuate tracheal stimulation. Lidocaine efficacy has long been known since was evaluated in a Cochrane review in 2009. Lidocaine administered as a cuff inflation medium reduces sensitive input from the tracheal mucosa through its continuous topical anaesthetic effect. Alkalinised lidocaine could have a potential advantage over its non-alkalinised variety, with a quicker onset, duration, and quality of the block, despite the possibility of completely losing its anaesthetic action due to precipitation if a minimal error in the addition of bicarbonate occurs.

By filling the cuff with lidocaine, diffusion of the uncharged base form of the drug occurred across the hydrophobic PVC walls of the ETT cuff. Lidocaine binds avidly to the respiratory mucosa, where it exerts its action blocking the sensitive input from the tracheal mucosa. The absorption characteristics of the mucosa, epithelial thickness, number of membrane pores and tissue pH also serve to delay absorption. Thus, the tracheal mucosa in direct contact with the ETT cuff wall can be anaesthetised locally with a longer than expected effect of lidocaine and with intact supraglottic reflexes, preventing aspiration in these patients even though buffered lidocaine could achieve better results – even plain 2% lidocaine injected into the ETT cuff, not only reducing the incidence of a sore throat but also enables improved ETT tolerance and helps in producing smooth extubation in patients with hyperactive airways.

Based on all the mentioned literature and my observation during my clinical practice, I switched room air for lidocaine into the cuff since 2000, and since then I have been employing lidocaine for filling the cuffs for good.



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