Authors: Berger-Estilita J et al.
Anaesthesia Critical Care & Pain Medicine. 2025. DOI: 10.1016/j.accpm.2025.101614
Summary
This Delphi-based consensus statement sought to formally define anesthesia and articulate its core aims using a structured, international expert process. Although anesthesia is central to modern surgery, its expanding scope—spanning perioperative medicine, patient safety, long-term outcomes, and systems-level responsibilities—has made a unified definition increasingly challenging. The authors aimed to address this gap through a rigorous, consensus-driven methodology.
Using a modified three-round electronic Delphi process, 23 international anesthesia experts participated in iterative surveys to refine both a definition of anesthesia and a comprehensive list of its aims. Consensus was predefined as at least 80% agreement. External expert review was incorporated to enhance objectivity and global relevance. Statistical analysis focused on agreement rates and central tendency across rounds.
The process resulted in consensus on a refined definition of anesthesia and 49 distinct aims. The final definition emphasizes anesthesia as safe, effective, individualized, patient-centered, and empathetic care that facilitates optimal surgical conditions while improving short- and long-term patient outcomes. Beyond traditional intraoperative goals, the agreed aims span the entire perioperative continuum, including preoperative optimization, reduction of stress and pain, preservation of organ function, timely emergence and recovery, interdisciplinary teamwork, and continuous assessment of outcomes.
Notably, environmental sustainability emerged as a core aim of modern anesthesia practice, reflecting growing recognition of anesthesia’s environmental footprint and professional responsibility in climate stewardship. Patient-reported outcomes and long-term well-being were also highlighted, underscoring a shift away from purely process-based metrics toward meaningful patient-centered endpoints. The final definition achieved an agreement rate of 82.6%, supporting its validity and acceptability among a diverse, international panel.
Key Points
A Delphi process achieved consensus on a formal definition of anesthesia and 49 core aims.
The final definition emphasizes safety, effectiveness, individualization, and patient-centered care.
Anesthesia aims extend beyond intraoperative management to the full perioperative continuum.
Environmental sustainability is recognized as a core professional responsibility in anesthesia.
Patient-reported outcomes and long-term well-being are central to modern anesthesia practice.
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