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About

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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Congress Newsletter 2023

Persistent Postoperative Opioid Use in Europe — Can Uniform Guidelines Stop an Opioid Epidemic in Its Tracks?

Over the past three decades, the misuse and abuse of opioid agents has cast a long shadow over healthcare systems, particularly in North America, where this public health emergency has been dubbed the opioid epidemic. Whether this shadow will expand to engulf the European nations remains to be seen. Although many European countries have recently registered upward trends in the long-term postoperative use of opioids and opioid-involved deaths, regional differences make it hard to paint a clear picture, according to data presented at the 2023 Euroanaesthesia Congress.

Providing safe, effective pain management in the era of opioid overdoses has become a challenge for healthcare professionals, said Prof. Patrice Forget, MD, Clinical Chair in Anesthesia at the University of Aberdeen, UK. For anesthesiologists, the problem is compounded by the fact that opioid substances like fentanyl are essential tools in the armamentarium used to provide analgesia and sedation during general anaesthesia or monitored anaesthesia care.

Paul Janssen’s success in synthesizing fentanyl in 1962 revolutionized the field of anaesthesia, but also ushered in an era of reliance on opioids for pain control. However, opioid agents may not be the best option for pain management in the postoperative period, especially when prescribed for long-term use, Forget noted. Data regarding the use of oxycodone for chronic pain showed that many individuals develop acute tolerance to this agent within one to two months after initiation. Attempts to overcome this phenomenon by prescribing larger doses were partly responsible for the large-scale opioid dependence in North America. Acute tolerance has also been reported with the use of ultrashort-acting remifentanil, which is a mainstay in anaesthesia practice. Moreover, this agent has been shown to cause hyperalgesia after discontinuation, leading to worse pain outcomes, particularly when used in high doses. “[We have to] question the capacity to improve pain outcomes using these opioids during surgery,” Forget said.

While opioid use has significantly increased in many European countries over the past decade, the differences in regional trends point to a multifaceted healthcare crisis, the speaker remarked. Significant increases in opioid prescriptions in countries like the United Kingdom or Germany may suggest overprescribing practices, whereas some Eastern European countries may still have to overcome inadequate access to opioid agents.

Data gathered since 2015 have also revealed regional differences within the United Kingdom, according to Forget, who coordinates the activities of the PANDOS ESAIC Research Group. Between 2015 and 2020, the volume of opioid prescriptions has remained stable in England, with pronounced regional differences. Scotland has witnessed a massive increase in the number of opioid-involved deaths since 2013, a phenomenon that worsened during the COVID-19 pandemic because of the limited access to addiction medicine services. “There is definitely an entire generation that has been, during the last decades, exposed to opioids,” Forget said. “Some of these [individuals] are now dying from opioid-related [causes].”

Although many regions in Europe lack high-quality data about opioid prescribing practices and their outcomes, safe pain management remains a goal rather than a reality across Europe, which is not immune to the risk of opioid dependence. “We have much to learn from each other,” Forget said, noting that the heterogeneous information gathered from different regions creates a complex picture that is hard to analyze.

A systematic review of persistent postoperative opioid use in Europe, co-authored by Forget, showed that between 2% and 41% of patients were opioid users three months after surgery. In nine of the 12 included studies, individuals who had undergone total hip or total knee arthroplasties reported opioid use rates between 8% and 41% after three months.  While these limited data reveal trends, they do not tell the whole story, Forget said. Even when available, the numbers do not reflect patients’ quality of life, efficacy of opioids in treating chronic pain, or risk factors for intravenous drug use, such as exposure to high doses.

Public health data from Scotland have also shown that opioid-related mortality peaks within 12 weeks of hospital discharge.  But in the absence of uniform guidelines, European practitioners must exercise clinical judgment when it comes to pain management post-discharge from the hospital. In some countries, such as the United Kingdom, clinicians can rely on national guidelines for the perioperative care of adults. The National Institute for Health and Care Excellence guidelines emphasize multimodal analgesia and promotion of early functional return, rather than placing pain intensity at the center of the equation. “Physical status is important even if pain intensity is something that should be considered, especially when trying to individualize and consider patient choice,” Forget said. “We need to try to balance the risks and benefits of opioid prescriptions. Maybe one size does not fit all, maybe we should personalize better and progress to a realistic medicine approach.”

The absence of European guidelines on perioperative pain management is an obstacle to the implementation of non-opioid and opioid-sparing strategies for pain control, the speaker noted. The PANDOS ESAIC Research Group has been formed to investigate the role of opioids in perioperative care and generate recommendations that can guide protocol in hospitals across Europe. A rational approach to perioperative analgesia requires rooting out unnecessary prescribing practices without creating obstacles to optimal pain management, Forget concluded.