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Sieber F, McIsaac DI, Deiner S, Azefor T, Berger M, Hughes C, Leung JM, Maldon J, McSwain JR, Neuman MD, Russell MM, Tang V, Whitlock E, Whittington R, Marbella AM, Agarkar M, Ramirez S, Dyer A, Friel Blanck J, Uhl S, Grant MD, Domino KB. 2025 American Society of Anesthesiologists Practice Advisory for Perioperative Care of Older Adults Scheduled for Inpatient Surgery. Anesthesiology 2025; 142:22-51. [PMID: 39655991 DOI: 10.1097/aln.0000000000005172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2024]
Affiliation(s)
- Frederick Sieber
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland
| | - Daniel I McIsaac
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada
| | - Stacie Deiner
- Department of Anesthesiology, Geisel School of Medicine and Dartmouth Health, Hanover, New Hampshire
| | - Tangwan Azefor
- Department of Anesthesiology and Critical Care Medicine, Johns Hopkins Hospital, Baltimore, Maryland
| | - Miles Berger
- Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina
| | - Christopher Hughes
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Jacqueline M Leung
- Department of Anesthesia and Perioperative Care, University of California-San Francisco, San Francisco, California
| | - John Maldon
- Washington Medical Commission, Seattle, Washington
| | - Julie R McSwain
- Department of Anesthesia and Perioperative Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Mark D Neuman
- Department of Anesthesiology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Marcia M Russell
- Department of Surgery, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California; Veterans Affairs Greater Los Angeles Health Care System, Los Angeles, California
| | - Victoria Tang
- Division of Geriatric Medicine, Department of Medicine, University of California-San Francisco, San Francisco, California
| | - Elizabeth Whitlock
- Department of Anesthesia and Perioperative Care, University of California-San Francisco, San Francisco, California
| | - Robert Whittington
- Department of Anesthesiology and Perioperative Medicine, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California
| | | | | | | | - Alexandre Dyer
- American Society of Anesthesiologists, Schaumburg, Illinois
| | | | - Stacey Uhl
- American Society of Anesthesiologists, Schaumburg, Illinois
| | - Mark D Grant
- Division of Epidemiology and Biostatistics, University of Chicago, Chicago, Illinois
| | - Karen B Domino
- Committee on Practice Parameters, American Society of Anesthesiologists, Schaumburg, Illinois; Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, Washington
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Riedel B, Dubowitz J, Yeung J, Jhanji S, Kheterpal S, Avidan MS. On the horns of a dilemma: choosing total intravenous anaesthesia or volatile anaesthesia. Br J Anaesth 2022; 129:284-289. [PMID: 35835606 DOI: 10.1016/j.bja.2022.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/01/2022] [Accepted: 06/03/2022] [Indexed: 11/02/2022] Open
Abstract
There are two established techniques of delivering general anaesthesia: propofol-based total intravenous anaesthesia (TIVA) and volatile agent-based inhaled anaesthesia. Both techniques are offered as standard of care and have an established safety track record lasting more than 30 years. However, it is not currently known whether the choice of anaesthetic technique results in a fundamentally different patient experience or affects early, intermediate-term, and longer-term postoperative outcomes. This editorial comments on a recently published study that suggests that inhaled volatile anaesthesia might be associated with fewer postoperative surgical complications than propofol-based TIVA for patients undergoing colorectal cancer surgery. We consider the strengths and limitations of the study, place these findings in the context of the broader evidence, and discuss how the current controversies regarding anaesthetic technique can be resolved, thereby helping to bring precision medicine into the modern practice of perioperative care.
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Affiliation(s)
- Bernhard Riedel
- Department of Anaesthesia, Perioperative Medicine and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia; Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne, VIC, Australia.
| | - Julia Dubowitz
- Department of Anaesthesia, Perioperative Medicine and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, VIC, Australia; Department of Critical Care, University of Melbourne, Melbourne, VIC, Australia
| | - Joyce Yeung
- Department of Critical Care Medicine, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Warwick Medical School, University of Warwick, Coventry, UK
| | - Shaman Jhanji
- Department of Anaesthesia, Perioperative Medicine and Critical Care, Royal Marsden Hospital, London, UK; Division of Cancer Biology, Institute of Cancer Research, London, UK
| | - Sachin Kheterpal
- Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA; Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA
| | - Michael S Avidan
- Department of Anesthesiology, Washington University School of Medicine in St Louis, St Louis, MO, USA
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