ESA Newsletter vol26 - spring 2006

24 Pages·2006·0.81 MB·English

Volume 26 Spring 2006 Editor: Gordon Lyons Co-Editors: Francis Bonnet, Andrea Kurz, David Robins
A b s t r a c t Nu m b e r s B u c k t h e Tre n d
Numbers up for Madrid clerical staff and research assistants. The percentage accepted can be used an indi-
additional bureaucracy created by the cation of quality, and this has not changed
Year after year the number of abstracts
additional certification and more detailed significantly. It certainly has not fallen.
submitted to Euroanaesthesia has been
ethical submission has acted as a deter-
in the region of 1200. Since the publi- Euroanaesthesia continues to mature
rent to many ‘interested amateurs’ who
cation of Directive 2005/20/EC of the as the major event in European anaesthe-
would otherwise have continued to seek
European Commission in April last year, siology, and current predictions are that
answers to unsolved problems.
there has been much gloom over the there will be an increase in delegate num-
prospects for research in Europe, and so In addition to scaling the paper moun- bers for Madrid over Vienna. More abstracts
when 1530 abstracts appeared for scor- tain, pharmaceutical companies are trou- bring more delegates, which pleases the
ing, the Scientific Programme bled by increasing costs in the develop- Scientific Programme Committee, the
Committee was pleasantly surprised. ment of new drugs. Consequently the larg- Treasurer, and supporting industry. The
Indeed, they were delighted! Not only er companies are already establishing Scientific Programme Subcommittees
have the abstracts arrived from all research offices in India and China, where strive to put together a scientific pro-
points of Europe, but also from more high quality research is possible, but with gramme that is topical, varied and deliv-
distant parts ofthe world. It is hearten- asignificantreduction in expense. Europe, ered by experts, since this is what draws
ing to note that such a breadth of perhaps, is no longer seen as the ideal attendees. The market research that fol-
research – clinical and laboratory – is place for pharmaceutical research, lows each meeting lists complaints com-
being carried out in anaesthesia. We although there is undoubtedly a variation mon to many large meetings; occasional
congratulate these researchers and around this continent in the cost of carry- overcrowding, indistinct speakers, and
thank them for coming to ingout clinical trials. parallel programming. But the feedback
Euroanaesthesia 2006 in Madrid. forms returned by delegates during the
No clues
meeting are also full of appreciation and
Detailed guidelines
An examination of the sources of suggest that the content is right. Please
The Research Directive, which was pub- abstracts (Table 1) does not provide an remember to fill these forms in at Madrid.
lished in April last year, was intended to explanation as to why there are more this Interestingly, the most successful lectures
introduce Good Clinical Practice into all year. The greatest proportion of submitted tend to be those which cover standard,
areas ofclinical research. This was equiva- abstracts come, as is often the case, from well recognised topics, rather than the lat-
lent to asking individual clinical the host country, and the Scientific est developments in a subspeciality area or
researchers to meet the same research Programme Committee feel encouraged by anew monitoring technique.
standards that the pharmaceutical compa- this display of local enthusiasm for
Madrid programme
nies were obliged to meet. Unlike the Euroanaesthesia. All submitted abstracts
pharmaceutical industry, however, individ- are scored on the same scale, and those Highlights of Euroanaesthesia 2006
ual clinical researchers have significant that achieve an aggregate score of 50 or include an opening lecture on “Mass casu-
limitations on their support in terms of more are accepted for presentation. The alties: The Madrid experience” by Juan
Highlights
ESAGeneral Profile Anaesthetists no UK Anaesthetists European Diploma Euroanaesthesia
Assembly invitation of the ERC longer required in Private Sector in Anaesthesiology 2006
for routine Pay Dispute and Intensive Care:
ESACommittees & NSAIDs
cataract surgery Report Of The
Members - 2006 Training in Serbia
Sadness in Kosovo Examination
Correspondence
Explaining NASC Committee - 2005
• PAGE 3-7 • • PAGE 8-13 • • PAGE 14-15 • • PAGE 16-17 • • PAGE 19-22 • • PAGE 23 •
Copyright2006 - TheEuropean Society of Anaesthesiology a.i.s.b.l. (ESA)
No part of this Newsletter may be reproduced without prior permission. The views expressed in this Newsletter are not necessarily those of the ESA.
Whereidentified,theopinions are those of the author. Otherwise the views expressed are those of the Editor(s).
The ESA cannot be responsible for the statements or views of the contributors.
CONTINUED Navia Roque. Surely this lecture will
PFARGOEM 1 have something to teach all dele- Part of the world & Country pSeurb cmoiutntetrdy peArc cceoputnetdry p%era cccoeupntterdy
gates: most of us are horrified at the
Asia (95 of 134 accepted = 71%)
. thought of having to manage such a ter- China 23 13 57%
. rible disaster. Experts from around the India 4 2 50%
.
world are contributing to Madrid Japan 31 26 84%
s Euroanaesthesia over the following four Republic of Korea 56 39 70%
r Singapore 3 3 100%
days. Professor J. Martyn from Boston, USA
e Taiwan 14 9 64%
b will update us on the neuromuscular junc- Thailand 3 3 100%
m tion: he is internationally recognised for
Australia & New Zealand (1 of 2 accepted = 50%)
his work in this field. A Trans Esophageal
u Australia 1 1 100%
Echo workshop will be run by two very New Zealand 1 0 0%
n
famous names: Poelaert and Scholz. Peter
East Europe (128 of 227 accepted= 56%)
t Marhofer will discuss the practicalities of Albania 11 6 55%
c peripheral nerve blocks in the lower Armenia 3 3 100%
a extremity: this is a very topical subject, Bulgaria 6 1 17%
r Croatia 15 7 47%
t being covered by its leading world author-
Czech Republic 14 10 71%
s ity. Massive intraoperative blood loss will
b Estonia 5 3 60%
be covered by Oliver Habler (Germany); Hungary 10 8 80%
A
and maximum recommended doses of local Latvia 4 1 25%
anaesthetics will be discussed by the guru Lithuania 4 4 100%
on this topic, Per Henrik Rosenberg Macedonia 20 5 25%
Poland 42 30 71%
(Finland). Do not forget all the intensive
Romania 25 16 64%
care refresher lectures and symposia – you
Russia 35 21 60%
will learn all you need to know about crit-
Serbia and Montenegro 23 9 39%
ical careif you attend all of them! There is Turkey 113 70 62%
undoubtedly something for every clinical Slovenia 2 2 100%
anaesthetist at the Madrid meeting, and Ukraine 7 2 29%
we hope you will find the programme as Uzbekistan 1 0 0%
stimulating as we do. Middle East & Africa (35 of69 accepted=51%)
Egypt 1 1 100%
Vote of confidence Iran 33 16 48%
Israel 3 1 33%
All the officers of the ESA are enthusi-
Saudi Arabia 6 4 67%
astic about our annual scientific meeting;
South Africa 3 3 100%
they studythe various sources of feedback Tunisia 22 10 45%
with interest. Abstract (Table on this United Arab Emirates 1 0 0%
page) and delegate numbers for Madrid are North America (40 of48 accepted=83%)
encouraging statistics. Registrations to Canada 15 14 93%
Euroanaesthesia 2006 predict a busier USA 33 26 79%
meeting than last year. Delegate feedback South and Central America (8 of 11 accepted=73%)
Argentina 1 1 100%
from Madrid will be just as important and
Brazil 5 4 80%
everyone is urged to complete the forms
Chile 2 2 100%
for each of the sessions they attend. Colombia 1 1 100%
Venezuela 2 0 0%
Finally, can we say how much we are
looking forward to the meeting in Madrid West Europe (737 of 1039 accepted= 71%)
Austria 30 26 87%
this June: we wish all of you an educa-
Belgium 67 63 94%
tional and enjoyable congress, seeing lots Denmark 10 9 90%
of old friends and making many new Finland 17 15 88%
ones.l France 81 63 78%
Germany 148 134 91%
Greece 89 52 58%
Iceland 1 0 0%
Ireland 10 9 90%
Italy 94 54 57%
Norway 3 3 100%
Portugal 36 22 61%
Spain 225 126 56%
Sweden 15 12 80%
Switzerland 28 25 89%
The Netherlands 11 10 91%
United Kingdom 61 44 72%
TOTALS 1530 1044 68%
2
Eu r o a n a e s t h e s i a 2 0 0 6 M a d r i d
E S A G e n e r a l A s s e m b l y Me e t i n g
On behalf of the Board of Directors, I am pleased to invite ESA members to the Annual General
Assembly of the European Society of Anaesthesiology which will be held in room N105at the IFEMA
Centre, Madrid, Spain on Monday – June 5th,2006 from 12:30-13:30 h.
Active, Affiliate, Honorary, Retired and Trainee Personal Members and one representative of
each Member Society may attend, but only Active Personal Members may vote. There are no proxy
votes.
The minutes of the last General Assembly held in Vienna, Austria were published in the ESA Newsletter
(Summer 2005 - vol.23). The ESA Newsletter and the By-Laws are both available on the ESA website.
This year’s ESA Council will elect the President-Elect to the Board of Director to assume office January 1, 2007.
The official call for candidates for this election will be sent to the Council.
The agenda for this year’s General Assembly is:
1. Approval of the minutes of the 2005 General Assembly
2. President’s report*
3. Secretary’s report*
4. Treasurer’s report*
5. Approval ofthe 2005 Annual Accounts and 2006 budget*
6. Relieve the Board of Directors and Auditors of their liability for the 2005 accounts*
7. Council Activity Report*
8. Any other business
9. Date and place of next meeting
Ilook forward to meeting you in Madrid.
Yours sincerely,
Eberhard Kochs
Secretary, ESA
A b b o t t L a b o r a t o r i e s
European Diploma in Anaesthesiology
Su s p e n d e d f o r & Intensive Care
I n a p p r o p r i a t e H o s p i t a l i t y HYPNOS FOUNDATION SCHOLARSHIPS
The Hypnos Foundation was instituted in 1992 at the Department
Breach of code
of Anaesthesiology, Inselspital, University of Bern, Switzerland. The
The Association ofthe British Pharmaceutical Industry has tem- aim of this foundation has been to support education in anaesthe-
porarily suspended the membership of Abbott Laboratories. It siology in Eastern European countries.Ithas now been decided to
follows a breach in the code of conduct that occurred in 2004, support specialist anaesthesiologists who have passed the Part I
when an employee offered hospitality to some health profes- EDA(MCQ) to enable them to sit for the Part II (oral) examination.
sionals that included entertainment at a club. The opinion of
For further information, contact:
the ABPI was that this would bring discredit upon the industry.
House in order Mrs. Elisabeth Scheidegger,
Department ofAnaesthesia,
An anonymous complaint blew the whistle on some activities of
Inselspital,
Abbott employees in the UK. Since the incident, Abbott has indi-
3010 Bern, SWITZERLAND
cated that some employees have left, and that it has tightened up
Tel: [phone] / 3965
its procedurestopreventarecurrence. l
Fax: [phone]
e-mail: [email protected]
www.euroanesthesia.org
www.anaesthesia.unibe.ch
3
E S A C o m m i t t e e s & Me m b e r s - 2 0 0 6
(Ratified by the Board of Directors on March 3, 2006)
(* Indicates no voting rights) (Members of the individual subcommittees can be viewed on
ESA Board the ESA website www.euroanesthesia.org)
President Peter Simpson (UK) Examination Committee
Past - Presidents Thomas Pasch (CH)
The committee supervises/co-ordinates/advises on the organ-
Hans-Joachim Priebe (DE)
isation of the European Diploma in Anaesthesiology and Intensive
Philippe Scherpereel (FR)
Care, and maintains/improves the standard of the examination.
President Elect NEW
The Chairperson is appointed by, and reports to, the ESA Board of
Secretary Eberhard Kochs (DE)
Directors. The committee members include the Director of Part 1
Treasurer Martin Tramèr (CH)
MCQ Bank , the Director of Part 2 Guided Question Bank, a repre-
Interim NASC Chairperson Philippe Scherpereel (FR)
sentative of the UEMS/EBA and the Examinations Administrator.
Non-Officer Gordon Drummond (UK)
Paolo Pelosi (IT) Chairperson Zeev Goldik
Klaus Olkkola (FI) Members Ed Hammond Eric Buchser
Nominations Committee Lars Wiklund Hans Knape
Anne Dewaegenaere*
Chairperson Thomas Pasch
Members Hans-J. Priebe Jurgen Schüttler Subcommittee Part 1
Peter Simpson Hugo Van Aken The subcommittee is responsible for the practical organisation
Alan Aitkenhead Jiri Malek oftheExamination Part 1.
Zeynep Kayhan
TheChairperson is theDirector of Part 1 MCQ Bank and reports
Scientific Programme Committee
to the Examination Committee. The subcommittee members
Determines the scientific programme for the annual include the Chairperson of the Examination Committee, member(s)
Euroanaesthesia meeting, monitors the process of the scientific with special responsibility for translations(1 member per language
programme at the Euroanaesthesia meeting, assesses abstracts into which MCQs are translated), representatives from those coun-
submitted forpresentation at themeeting, selects the winners and tries using the examination as their national examination, an indi-
awards the prizes for the Best Abstracts Prize Competition, pub- vidual in charge of the MCQ Bank Basic Sciences, an individual in
lishes the Refresher Course Lectures Book and carries out other chargeoftheMCQ Bank Anaesthesia, an individual in charge of the
functions as decided by the ESA Board of Directors. MCQ Bank Intensive Care and the Examinations Administrator.
The ESA Board of Directors through proposals from the Chairperson Ed Hammond
Nominations Committee appoints the Chairperson of the Scientific Members Zeev Goldik Wolfgang Toller
Programme Committee. S/he also sits ex officio on the Annual Klaus Unertl FlaviaPetrini
Estibaliz Alsina Albert Urwyler
Meetings Committee, the Academic Affairs Committee and the
Andrew McIndoe Svetlana Rutter
Research Subcommittee of the Academic Affairs Committee. The
Andrey Varvinski Jean-Pierre Haberer
Chairperson has a term of office of 3 years with a further year as
AnneDewaegenaere*
retiring Chairperson.
Subcommittee Part II
Chairperson Jennifer Hunter
The subcommittee is responsible for the practical organisation
Members Jonathan Bannister
of the Examination Part 2.
(Refresher Course Editor
Raf Kinnaer*(Programme Administrator) TheChairperson is theDirector of Part 2 MCQ Guided Question
Chairperson Subcommittee Bank and reports to the Examination Committee. The members
Andrew Fairley Smith Evidence Based Practice include the Chairperson of the Examination Committee, represen-
and Quality Assurance
tatives from host centres for the Part 2 examination, up to four (4)
Jan Jakobsson Ambulatory Anaesthesia
senior examiners from four different countries and the
Andreas Hoeft Monitoring: Equipment and Computers
Examinations Administrator.
Wolfgang Schlack Clinical and Experimental Circulation
Jaume Canet Respiration Chairperson Eric Buchser
Donat R. Spahn Transfusion and Haemostasis Members Zeev Goldik Anne Aas Hunting
Basil F.Matta Neurosciences Peter Biro Brian Sweeney
Bernadette Veering Local and Regional Anaesthesia Jürgen Schüttler Anne Dewaegenaere*
ClaudeMeistelman Pharmacology Academic Affairs Committee
George Meakin Paediatric Anaesthesia
Co-ordinates/guides/advises/discusses/proposes issues relat-
and Intensive Care
Giorgio Capogna Obstetric Anaesthesia ed to research, education & training, finances & budget, FEEA, and
Gernot Marx Intensive Care Medicine UEMS/EBA.
Bernd Böttiger Resuscitation and Emergency Medicine The Committee is chaired by the ESA President and comprises
Mervyn Maze Acute and Chronic Pain Management
the Chairpersons of the Scientific Programme Committee, the
Hugo Van Aken Education, Research and Presentation
Research Subcommittee, the Education & Training Subcommittee,
(to be decided) - Ethics
theNominations Committee, a representative of FEEA* and a rep-
Marcus Rall Patient Safety
resentative oftheUEMS/EBA*.
4
CONTINUED The Academic Affairs Committee Chairperson reports to Chairperson Philippe Scherpereel
FROM
PAGE 4 the ESABoard of Directors. Members Giorgio Conti Karel Cvachovec
Zeev Goldik Eberhard Kochs
Chairperson Peter Simpson
Olav Sellevold Stefan Trenkler
Members Jennie Hunter Thomas Pasch
. Laszlo Vimlati Michael Ward
. Paolo Pelosi Philippe Scherpereel
. Zeev Goldik Hans Knape*
s Maurice Lamy* European Journal of Anaesthesiology (EJA)
e
Research Subcommittee Editorial Board
e
t The committee determines areas of scientific policies and The EJA Editorial Board deals with strategic and business
t
i assumes responsibility for assessing grant applications. The issues relating to the publication of the Journal, and appoints the
m Chairperson reports to the Academic Affairs Committee and must editors. The Editorial Board comprises the Chairperson (appointed
m bean ESA Board member. The members include the Chairperson of by the Board of Directors), the Editor in Chief, the Deputy Editor
the Scientific Programme Committee and up to 4 additional indi- in Chief, the Supplements Editor, three other ESA members recom-
o
viduals. mended by the Editorial Board and approved by the Board of
C
Directors, and the ESA President, Secretary and Treasurer.
Chairperson Paolo Pelosi
A Members Jennie Hunter Per Rosenberg Chairperson Alan Aitkenhead
Patrick Wouters Benedikt Pannen Members Brian Pollard T.A. Crozier
S
Phil Hopkins J. N. Cashman Hugo Van Aken
E
Basil Matta Andreas Hoeft
Education & Training Subcommittee
Peter Simpson Eberhard Kochs
The committee defines areas of education & training to be sup- Martin Tramèr
ported by the ESA, discusses/proposes/recommends issues/areas
related to education & training, CME and CPD in anaesthesia, crit-
Board of Editors
ical care medicine, emergency medicine and pain management in
Europe. It monitors and updates training guidelines in Europe, The Board of Editors deals with the day-to-day running of the
organizes/is responsible for the Joint Hospital Visiting Programme journal. Incomingmanuscripts are allocated to individual Editors
together with the UEMS/EBA, provides input into, and receives who deal with all aspects of consideration of the submission using
input from the UEMS/EBA, provides a pathway for input of the reports of independent reviews from external referees.
trainees, administers the ESA Fellowship and the Teaching Manuscripts are then transmitted to the Editor-in-Chief who takes
Recognition Award programmes and approves the Travel Grants thefinal decision and oversees the smooth running of the journal
proposed by the NASC Committee. The Chairperson reports to the in conjunction with the publishers. The Editorial Board appoints
Academic Affairs Committee. The members include the the editors. Certain Editors look after particular areas, e.g. book
Chairperson of the Examinations Committee, a representative of reviews or supplements.
theFEEA and the UEMS/EBA, and one additional expert in the field Editor in Chief Brian Pollard
ofeducation in trainingin Europe. Deputy Editor in Chief T.A. Crozier
Chairperson Philippe Scherpereel
Members Zeev Goldik Sean McDevitt Editors Craig Bailey Hans Tydén
Carmen Gomar* Jürgen Schüttler Adrian Gelb Robert Feneck
Basil Matta Jean Pierre Haberer
National Anaesthesia Societies Committee
Lajos Bogar Giorgio Capogna
(N.A.S.C.)
Martin Tramèr Martin Leuwer
Those European national societies of anaesthesiologists who Gisli Sigurdsson Chris Pomfrett
are ESA Society Members send representatives to the General JeremyCashman Nigel Harper
Assembly of the National Anaesthesia Societies Committee (NASC). On-Line Electronic Help for
TheNASC General Assembly elects all NASC members. Anaesthesiologists (O.L.E.H.) Committee
The aims of NASC are to establish close relationships between The OLEH Committee is responsible for the administration and
the ESA, the European National Societies of Anaesthesiology and promotion of the OLEH project including links with the companies
the World Federation of Anaesthesiologists (WFSA). The NASC that have adopted, or wish to adopt, the OLEH as part of their
encourages and assists in the formation of new national societies monitoring offering. Interfacing with the ESA Scientific
of anaesthesiologists in Europe, and it supports education and ProgrammeCommittee,theOLEH Committee is responsible for the
conduct of anaesthesia in less affluent European countries with content and future upgrades to the OLEH.
special needs. Educational programmes are encouraged in con- Chairperson Azriel Perel
junction with the Education & Training Subcommittee. Members Alan Aitkenhead Jennie Hunter
Michel De Bisschop
The NASC is responsible for reviewing applications received
Editors Jim Bovill George Baumgarten
under the ESA Travel Grants programme and selecting the winners
Haim Berkenstadt Jonathan Hardman
who are subject to approval by the Education and Training Paolo Pelosi David Livingstone
Subcommittee. Ezri Tiberiu Brian Pollard
Olivier Wenker Martin Tramèr
Goetz Wietasch
5
CONTINUED Media Committee Annual Meeting Committee
FROM
PAGE 5 The committee is responsible for the ESA web site con- The committee is responsible for all aspects of the annual
tent, the Newsletter and official communications (articles, Euroanaesthesia meetings with the exception of the content of the
. press releases etc.) to the public. The members include the scientific programme. There are several Annual Meeting
.
Newsletter Editors, the Industrial Liaison Officer, the ESA Committees running simultaneously, each dealing with their
.
Executive Director, the Website Editors and Administrator. respective meeting and in each instance includes the members of
s
e Chairperson Gordon Drummond the National Organising Committee from the country in which the
e Members Gordon Lyons David Robins Euroanaesthesia meeting will take place.
tt Francis Bonnet Andrea Kurz The three permanent committee members include the
i Alan Aitkenhead Alain Vuylsteke Chairperson of the Scientific Programme Committee, the Industrial
m Michel De BisschopRaf Kinnaer*
Liaison Officer, and the ESA Executive Director.
m Finance Committee
Chairperson Michel De Bisschop
o The committee is responsible for collating the annual budgets Members Alan Aitkenhead Jennie Hunter
C of the individual committees for presentation to the Board of Euroanaesthesia2006- Madrid
Directors and the General Assembly and oversees the financial and Hector Litvan Pablo Monedero
A investment policies of the Society. The Committee is chaired by Juan Navia Francisco Reinoso
S the acting Treasurer. Euroanaesthesia2007- Munich
E Chairperson Martin Tramèr Hugo Van Aken Klaus van Ackern
Members Klaus Olkkola Michel De Bisschop Eberhard Kochs Klaus Peter
Andreas Hoeft l
E x p l a i n i n g N A S C –
T h e Na t i o n a l A n a e s t h e s i a S o c i e t i e s C o m m i t t e e
Philippe Scherpereel, Chairman of the NASC and Olav FM Sellevold
A unique organization NASC at work Membership in the ESA
st The ESA is an organization of individu- The ESA has 7000 individual members,
Up to the 1 January, 2005, the
als, and the NASC is an organisation of but through the 45 national societies affil-
Confederation of European National
societies. Although it has committee sta- iated to the NASC, it can claim to repre-
Societies of Anaesthesiology was the
tus within the ESA it is unique in that it sent 35,000 registered members. If infor-
forum for the national societies in Europe.
follows a different set of rules, and holds mal members are taken into account, then
In contrast to the ESA and the European
its own annual general meeting. By main- this extends to approximately 100,000
Academy, CENSA had no individual mem-
taining the existing contacts of CENSA, it anaesthesiologists working in Europe! The
bers, and consequently was only known
links the ESA to the World Federation. It Europe in question is that defined by the
well to those involved in the running of
exists to encourage and assist in the for- World Health Organisation, and includes
their national society. The opportunity to
mation of new national societies of anaes- all of Russia, all the countries constituting
merge with the ESA and the EA into a sin-
thesiologists in Europe where none exist, the former Eastern bloc and Israel. The
gle organization to represent all anaesthe-
and it will support education and conduct 5000 delegates to Euroanaesthesia are a
siologists in Europe was something that
of anaesthesia in European countries with tinypercentageof the body as a whole.
was grasped with enthusiasm. Although
special needs. Those national societies
CENSAnolonger exists, its responsibilities The national societies pay through
that are well developed can share their
are now undertaken by the NASC, a com- NASC a fee for each registered member
knowledge and experience so that the
mittee within the new united organisa- that is smaller (0.86 euro) than the cost of
wheel does not have to be reinvented in
tion. The links that CENSA had with the an individual ESA membership, but it is
every country! The NASC has become the
World Federation of Anaesthesiology have only the latter that get to enjoy the
focus for any national society that might
been transferred. Through the NASC, the European Journal and can influence the
require a wider European co-operation.
ESA can claim to represent all European direction of the organization. The non-
One of the main goals of the NASC is to
anaesthesiologists, since the national members can still make their presence felt
contribute to the development of continu-
societies are composed mainly of ESA non- though, through the medium of their
ing medical education and to work towards
members. Three organizations cooperating national society. But not all anaesthesiol-
the harmonization of high standards of
together gives European anaesthesiology ogists choose to join their national socie-
anaesthesia across the continent. The link
new strength and energy, and the chal- ty, and this is largely a financial decision.
with the scientific arm of the ESA that the
lenge for the NASC is to harness this to the In countries where incomes are lower, rel-
new organization provides, offers the best
benefit ofthenational societies. atively fewer anaesthesiologists officially
chance ofsuccess.
sign up with their national society, creat-
ing a visible and an invisible membership.
6
CONTINUED Whilst the NASC is sympathetic to
FROM
PAGE 6 the problems of its member states,
the spirit of unity within European
anaesthesiology should work to make
.
. inaccurate membership returns a thing of
.
the past.
C
Election of the NASC and the
S Committee of Presidents
A
Every second year, the representatives
N
of the national societies meet at their
General Assembly, held during
g
Euroanaesthesia, to elect the NASC. The
n
number of registered members determines
i
n how many representatives a national soci-
i ety can send to vote on its behalf. The National Anaesthesia Societies Committee: From left: Giorgio Conti, Italy; Stefan Trenkler, Slovakia;
a
l National societies that fall behind with Olav FM Sellevold, Norway; Zeev Goldik, Israel, Lazlo Vimlati, Hungary; Philippe Scherpereel, France.
p their membership dues forfeit the right to Michael Ward, UK and Eberhard Kochs, Germany were not present.
x vote and lose the benefit of funds and
E awards, like ESA grants. Independent of
The Moldavian training programme, We seek to improve the practice of our
the General Assembly is the Advisory
which funds clinical training for ten resi- speciality in Europe and to provide a net-
Committee of Presidents that meets annu-
dents for six months in Cluj Napoca work for the education of ourselves, and
ally during Euroanaesthesia. The opportu-
inRomania, has been described in an earli- our colleagues, to benefit the recipients of
nity this provides for informal and formal
er Newsletter. This has proved to provide anaesthesia, intensive care, pain treat-
contacts maintains the network between
excellenttheoretical and practical training ment and emergency medicine. The great
the national societies and the ESA.
at relatively little cost to the ESA. number of countries working together in
The Chairman and eight members, all the new ESA is our main asset, providing
The NASC has taken advantage of the
from differentcountries, are elected by the us with a wide base enriched with the var-
larger organization to continue and devel-
General Assembly will serve for two years. ied and diverse of cultures of our conti-
op a venture with the Foundation for
The Chairman has an ex-officio seat on the nentfrom which to advance our aims.l
European Education in Anaesthesiology.
ESA Board, an important concession. The
FEEA began in the Netherlands, Belgium Further information:
ESAgives theNASC a budget and a signif-
and France in 1986, bringing a standard-
icant amount of independence in its activ- NASC policies and by-laws –
ized teaching programme based primarily
ities.
on local teachers, to specialists and www.euroanesthesia.org
The NASC programmes trainees worldwide. Under the direction of Grants for young teachers –
To further its educational aims, the theNASC, grants from the ESA are used to
www.Euroanesthesia.org/education/Tra
NASC offers to assist any national society create new Regional centres. Last year
velgrants.htm
that wishes to hold its own symposia dur- about 10,000 Euros were distributed to
ing the Euroanaesthesia meeting. All open new centres in Saint Petersburg and Foundation for European education in
applications should be presented at the Samarkand, and to send lecturers to Riga, Anaesthesiology (FEEA) –
Presidents meeting that takes place during Presov and Tashkent. In 2006, this effort www.euriviane.net
Euroanaesthesia. A decision regarding the will be continued and new centres will
symposiawill be taken as soon as possible open in Belgrade, Chisinau, Moscow, Kiev
after presentation. The programme is and advanced projects exist in Lithuania,
agreed between the NASC and the nation- Estonia. This programme will be presented
al society, and may combine clinical and in more detail at a later stage.
professional issues like nurse anaesthesia
andmanpower. Every year four to five suc-
cessful symposiaareheld,
Before the merger, CENSA supported
travel grants for young clinical teachers to
attend the Euroanaesthesia meeting, and
this continues.Ten fortunate applicants to
the ESA will be proposed by their national
society, supported by their academic insti-
tution, selected by NASC and invited to
Madrid.
7
Profile of the European Resuscitation Council
Kiss of life Pittsburgh hosted a World Association for tion, and in a particular a greater involve-
Disaster Medicine conference. European ment of cardiologists. He had been instru-
For most baby boomers the closest
delegates returned from this fired with the mental in the agreement by the European
exposure to resuscitation education was
need for action. In the United Kingdom, at Society of Cardiology to hold a symposium
the poster demonstrating the Holger-
the same time, the Ambulance Service on resuscitation in Brighton in 1985. in
Nielsen technique of artificial respira-
Association approached the British this he had the collaboration of Douglas
tion on the wall of the swimming pool.
Association for Immediate Care (BASICS) Chamberlain, a Brighton cardiologist and
In 1958 artificial respiration with
to ask if they could take the lead in devel- founding member of the UK movement. At
expired air was described and it was
oping public education in resuscitation. As this symposium the many controversies
christened the ‘kiss of life’. Whether it
aprelude to this, Asmund Laerdal, in 1981, and problems surrounding resuscitation
was the catchy name or the fact that it
was invited to be the guest speaker at the medicine were aired. This encouraged Lars
worked that was responsible for raising
BASICS conference in Brighton. His lecture Mogensen to suggest, in 1986, that the
the profile of resuscitation, neverthe-
“Our Brothers In Distress”, highlighted the European Society of Cardiology should
less something had changed. Although
paucity of public competence in basic life establish a permanent working group. The
it would take several years before the
support, and called for progress. ESC were generally supportive, and put the
change worked its way down to swim-
case to debate at their General Assembly
ming pool posters, resuscitation had In August 1981, a multi-disciplinary
in Vienna, in 1988. By this time the
become both a serious issue and a pop- group of interested clinicians met and
European Intensive Care Society and the
ular topic, and these two forces still formed The Community Resuscitation
European Academy of Anaesthesiology had
serve to drive resuscitation forward.
Advisory Committee. A year later the
already moved to set up their own working
Early organization American Heart Association invited council groups on resuscitation. Those who had
In the United States, Peter Safar, who members to Runnymede in the UK, to par- been involved in theprocess for Cardiology
originated from Vienna, was working at ticipate in an AHA Instructors Course in were hugely disappointed when the
the Baltimore City Hospital. His research Basic and Adult Life Support, and Assembly turned down the idea.
was responsible for the development of Stratified Emergency Cardiac Care Systems. Rejection as a catalyst
‘mouth to mouth’ artificial respiration and The group went on to develop a flip chart
it was his inspiration to combine this with for Basic Life Support which was launched After the rejection, a group of cardiol-
closed chest cardiac massage that is now at a British Heart Foundation conference ogists who had been strongly supportive
represented by ABC. He appreciated the in Brighton in October 1982.An optimistic met in a refreshment tent at the same
significance of delay in the re-establish- 8,000 copies wereproduced but these sold meeting in Vienna to discuss the outcome.
ment of cerebral oxygenation and support- out in the first few months and a further Almost immediately a strategy was agreed.
ed the training of paramedics and even 8,000 were printed. In 1983, the group There should be a group, but it should be
public bystanders. He helped found the becametheResuscitation Council (UK) and multidisciplinary and independent. Leo
American Heart Association’s committee gave the following as their objectives: Bossaert offered facilities at the University
of Antwerp to discuss the new organiza-
on cardiopulmonary resuscitation, which • Public Education in Life Saving Skills
tion, its objectives and membership. This
led to guidelines and new standards for • Education of Doctors, Nurses, Ambulance
meeting took place at the end of 1988
medical staff. personnel and other Health workers
under the chairmanship of Douglas
These developments were viewed with • Investigation and Encouragement of Chamberlain, and included representatives
interest from across the Atlantic, and dur- Research and Dissemination of Useful from several European countries. It was
Results ofResearch
ing the course of the 1970s, intense dis- agreed to set up an organization to be
European initiative
cussions took place at all levels whilst called theEuropean Resuscitation Council.
medical and ancillary staff speculated on A distinguished Swedish cardiologist, By 1989, the European Society of
when and what might happen in Europe. Dr Lars Mogensen, had been impressed by Cardiology, The European Academy of
the success of national resuscitation coun- Anaesthesiology and the European Society
At the end of that decade, Peter Safar’s
cils in the UK and Scandinavia, and ofIntensive care Medicine had official rep-
Resuscitation Research Centre in
favoured a more international collabora-
Current and past officials of the ERC: Bernd Boettiger, Leo Bossaert, Peter Baskett, Wolfgang Dick, Douglas Chamberlain, Pierre Carli, Petter Steen,
David Zideman. Leo Bossaert is the Executive Director and Bernd Bottiger is the President Elect.
8
CONTINUED resentation. An anaesthesiologist,
FROM ERC Mission Statement
PAGE 8 Peter Basket became the first elected
chairman, and the first General The Association’s objectives are as follows:
Assembly was held in Amsterdam in 1990.
. • to preserve life by improving standards of Resuscitation in Europe and
. Two years later, at the first major confer-
. • to co-ordinate the activities of European organisations with a major interest in
ence, once more in Brighton, American and
Resuscitation medicine and Emergency Medical Care.
f Australian colleagues were present The
o The Association shall pursue its objectives by :
move to wider international co-operation
• Producing guidelines and recommendations appropriate to Europe for the practice of
e proposed by the American Heart
Cardiopulmonary and Cerebral Resuscitation.
l Association in Dallas was strengthened,
i • Updating these guidelines in the light of critical review of Resuscitation practice.
f and a liaison committee that later became
o known as the International Liaison • Promoting the audit of Resuscitation practice including the standardisation of records
r Committee On Resuscitation (ILCOR), was of resuscitation attempts.
P • Designing standardised teaching programmes suitable for all trainees in Europe rang-
established.
ing from the lay public to the qualified physician.
The ERC today
• Promoting, organising and co-ordinating appropriate research.
The European Resuscitation is run from • Organising relevant congresses and other scientific meetings in Europe.
apermanent secretariat based in Antwerp, • Promoting political and public awareness of Resuscitation requirements and practice in
under the direction of Leo Bossaert. It has Europe.
four Working Groups respectively responsi- • Promoting exchanges amongst different disciplines
ble for Basic, Adult and Paediatric Life • Advising relevant European and other national and international bodies on all matters
Support, and Research. Membership is and problems relating to CPR.
open to medically qualified individuals.
Income is made up from membership sub-
scriptions, subsidies from national and are not confined to large centres, but are much the profile of resuscitation in the
local government, and from industry, and readily accessible to medical, nursing and community has increased. It has become
conference profits, educational meetings ancillary staff across the continent, and accepted that resuscitation guidelines for
and the sale of its publications and educa- areregularly oversubscribed.International Europe are the international standard,
tional materials. travellers may have noticed the arrival of something that many European organiza-
automated electronic defibrillators in air- tions can only dream about. In 20 years
The many doctors who are providers of
ports and major stations. These devices the European Resuscitation Council has
life support are witness to the impact it
that speak to instruct the user in their made its presence felt.l
has had on medical life. Provider courses
application are a manifestation of how
Vacancy in the ESA Education & Training Subcommittee
To accomplish the objectives of the 7) Administer the ESA Fellowship A new ESA Education & Training
Society, key activities are delegated to 8) Approve the Travel Grants proposed by Subcommittee member should: 1) be an
committees and subcommittees consist- theNASC Committee. active member of the ESA; 2) have a sig-
ing primarily of ESA members. The ESA The ESA Education & Training is com- nificant interest and involvement in edu-
Education & Training Subcommittee has posed of the Chairperson (Dr Jürgen cation and training at national level; 3)
recently been established within the Schuttler), the Chairperson of the include a statement and explanation of
European Society of Anaesthesiology. Examination Committee (Dr Zeev Goldik), her/his past, current and future involve-
The ESA Education & Training the UEMS/EBA representative (Dr Sean ment in education and training in anaes-
Subcommittee should: McDevitt), the FEEA representative (Dr thesia and critical care; 4) indicate how
Carmen Gomar) and one vacant position. their experience would contribute to the
1) Define areas of education & training to
The recommendations of the ESA Education work of the Education & Training
besupported by the ESA,
& Training Subcommittee must be Subcommittee; 5) have the willingness
2) Discuss/propose/recommend approved by the ESA Board to whom it and free time to support the overall activ-
issues/areas related to education and
reports through theChairperson. ities of the ESA Education & Training
training, CME and CPD in anaesthesia,
Subcommittee.
critical care medicine, emergency medi- Applicant sought
cineand pain management in Europe. ESA members who would like to partic-
Prof Philippe Scherpereel will resign
3) Monitor and update training guidelines ipate in one of the ESA committees should
his position with effect from December
in Europe, send their Curriculum Vitae for the atten-
2006 and Dr Jürgen Schuttler will take the
tion of the Nominations Committee to the
4) Organize/take responsibility for the
Chair with effect from January 2007.
Joint Hospital Visiting Programme ESA Secretariat.
together with the UEMS/EBA, We invite new applications for the Theappointment will be made by the ESA
vacancy on the ESA Education & Training
5) Provide input into, and receive input Board, and will be based on the recommen-
from the UEMS/EBA, Subcommittee from January 1st 2007 to dation of the Nominations Committee.l
December 2008.
6) Provide a pathway for input of trainees,
9
NSAIDs – can’t live with them…
can’t live without them
Michael Irwin
Willow bark to aspirin to improve anti-nociception. The time
when secondary injury starts and ends is
The Reverend Edward Stone published
unknown. We can only be sure that it will
the first report of the healing properties
extend into the post-operative period. A
of willow bark in England in 1763,
number of studies have used the chemical
although such preparations date back
markers of stress response in an attempt to
thousands of years. The active compo-
determine the onset and duration of early
nent of willow bark, later identified as
inflammation in different surgeries.
salicin, is metabolized to salicylate. The
Interleukin 6 is one of the most reliable
Bayer pharmaceutical company pro-
and important markers and levels give an Multimodal analgesia is a technique
duced the commercial preparation
indication of the duration and severity of that has been adopted by most anaes-
“aspirin” (they also made “heroin”) and
the inflammatory response. It is a multi- thetists as it improves efficacy through
by 1950 it was in the Guinness Book of
functional protein that is released early optimization of pharmacotherapy, whilst
Records as the world’s best-selling
during surgery, mediating the release of reducing side effects. Non-opioid anal-
painkiller. Other drugs with similar clin-
acute-phase proteins and causing inflam- gesics such as NSAIDs and paracetamol
ical effects were soon developed includ-
mation. In one study, interleukin 6 (acetaminophen) have proven efficacy
ing Non-Steroidal Anti-Inflammatory
increased after skin incision and achieved when used alone and as a component of a
Drugs. In 1982 Professor Sir John Vane,
a peak at around four hours. It then multimodal analgesic regime, where they
Sune Bergström and Bengt Samuelsson
decreased, returning to normal 72 hours generally reduce opioid consumption by
won the Nobel Prize for discovering the
after surgery [4]. around 30 – 40%.
role of aspirin in the inhibition of
prostaglandin production and in 1992 From this we may assume that the The peripheral and central activity of
the cyclo-oxygenase isoenzymes (COX 1 inflammatory response starts immediately COX-2 may help to explain the analgesic
and 2) were cloned [1,2]. after tissue injury and peaks four hours effects of conventional NSAIDs, which
after skin incision. There is also evidence reduce prostaglandin synthesis by inhibi-
Pain and inflammation
that this can occur even if somatic sensa- tion ofcyclo-oxygenase. However, conven-
Tissue injury, acute and chronic tion is blocked with local anaesthesia [5]. tional NSAIDs also inhibit COX-1, the
peripheral inflammation, interleukins and Any anti-nociceptive treatment, particu- isoenzyme that plays an important role in
spinal cord injury all increase the expres- larly those that inhibit inflammation, many homeostatic mechanisms, especially
sion of COX-2 and the release of neuro- given within 4 hours after skin incision, gastrointestinal mucosal protection and
transmitters. These include substance P could be considered as a preventive treat- maintenance of normal platelet function.
and glutamate, and result in increased ment, targeting the secondary phase of It was the preservation of COX-1 activity
local concentrations of arachidonic acid surgical injury. Long-term, painful seque- that prompted the development of selec-
metabolites (prostaglandins and lae following surgical procedures are more tive drugs. Since surgical patients are usu-
leukotrienes). These agents directly acti- common than generally appreciated and ally fasted, subjected to physiologic stress,
vate C pain fibres, degranulate mast cells even low-level pain can be associated with and have a potential for bleeding second-
(releasing histamine and cytokines), or decreased function. If central sensitisation ary to tissue trauma, the possibility of
lead to plasma extravasation and oedema. can be inhibited then there may be a COX-1 preservation was particularly attrac-
Prostaglandins increase the sensitivity of means to avoid this problem. tive. Subsequently the new generation of
nociceptive transduction mechanisms and coxibs were widely introduced into clinical
New generation of selective
enhance elicitation and synaptic transfer practice with promise of a reduction in
drugs
of pain signals in the spinal cord increas- upper gastrointestinal adverse events, no
ing the response to painful stimuli (hyper- Despite refinements in analgesia phar- effect on bleeding time, but still main-
algesia). Direct administration of macology like remifentanil and the intro- taining therapeutic anti-inflammatory and
prostaglandin to the spinal cord causes duction of COX-2 selective drugs (coxibs), analgesic efficacy.
hyperalgesia and allodynia, and the admin- there have been no major new pain drug
Recognition of
istration of cyclo-oxygenase inhibitors developments for many years. Ever
cardiovascular risk
reduces the development of both [3]. resourceful, anaesthetists have used exist-
ing drugs in novel ways, for example, Despite initial enthusiasm for these
Role in reducing injury
administering clonidine and neostigmine drugs, it was soon apparent that coxibs
I believe, also, that there is a role for by the intrathecal route. Opioid analgesics could increase the risk of adverse cardio-
COX-2 inhibition in the blockade of are commonly used for acute pain manage- vascular events in certain patients. Risk
prostaglandin synthesis in the first phase ment but, unfortunately, have a number of correlated with duration of administration
of inflammation. With the early adminis- undesirable and potentially dangerous side and dose, and some coxibs appeared to be
tration of a COX-2 inhibitor, peripheral and effects. more likely to cause problems than others
central sensitisation could be significantly [6], but it is generally accepted that the
reduced,andthis in turn has the potential latter is probably a class effect. Greatest
10