The Definition and Aims of Anesthesia: a Delphi-based Consensus Statement

BACKGROUND: Anaesthesia is crucial in ensuring patient comfort and safety during surgical procedures by inducing a temporary loss of sensation, memory, and consciousness. However, its multifaceted nature presents challenges in defining its aims and expected outcomes. This study aimed to establish a consensus on anaesthesia's definition and core aims using a structured Delphi process.

METHODS: We conducted a modified three-round eDelphi method involving 23 international experts. Participants engaged in iterative online surveys to refine a consensus definition and aims. Consensus was predefined as achieving ≥80% agreement. The process included external expert reviews to enhance objectivity and validity. Statistical analyses included median, interquartile range (IQR), and agreement percentages.

RESULTS: The Delphi process resulted in consensus on 49 aims and a refined definition of anaesthesia. The final definition emphasises safe, effective, individualised, patient-centred, and empathetic care, ensuring optimal surgical conditions while enhancing patient outcomes. Key aims included preoperative optimisation, stress and pain reduction, organ function preservation, prompt emergence and recovery, interdisciplinary teamwork, continuous outcome assessment, and sustainability in anaesthesia practices. The final agreement rate for the updated definition was 82.6% (median: 10, IQR: 9-10). Additionally, environmental sustainability was recognised as an integral aim.

CONCLUSION: The consensus developed in this study provides a structured framework for defining anaesthesia's objectives, improving patient-centred care, guiding clinical practice, and fostering research. By incorporating sustainability and long-term patient outcomes, the consensus supports the evolution of precision anaesthesia. Future research will validate these defined aims in various perioperative settings and refine the consensus based on real-world applications.