Anaesthesia practice in Europe

BACKGROUND Similar to other continents, Europe is experiencing a shortage of anaesthesia workforce, which profoundly impacts the national healthcare systems of affected countries. OBJECTIVE To assess the current landscape of the anaesthesia workforce, organisational practices, rules and responsibilities of anaesthesiologists and other anaesthesia providers in operating rooms. DESIGN Survey. SETTING Thirty-nine out of 41 European countries were surveyed between April 2022 and April 2023. PARTICIPANTS Delegates of the National Anaesthesiologists Societies Committee (NASC) of the European Society of Anaesthesiology and Intensive Care (ESAIC). INTERVENTION A faculty of experts from France, Germany and Italy, selected by the Chair of NASC, developed a survey consisting of 16 questions, which was sent to the NASC delegates of all European countries. MAIN OUTCOME MEASURES Responses from the NASC delegates. RESULTS The anaesthesia workforce, composition, roles and duties of anaesthesia teams vary significantly among European countries. The majority of respondents reported a workforce shortage, with variable trends, exacerbated in some cases by an increased loss of anaesthesiologists following the COVID-19 pandemic. Significant differences in anaesthesiologists’ salaries exist across countries. A one-to-one anaesthesiologist-to-patient ratio during general anaesthesia maintenance, neuraxial and peripheral blocks is the most common; however, in a notable number of cases, this ratio decreases to one-to-two or even less. In such instances, residents or nonphysician anaesthesia personnel (NPAs) play a crucial role, enabling anaesthesiologists to supervise more than one patient simultaneously. Differences in the training of anaesthesia team members, as well as rules regulating anaesthesia team composition and the autonomy of its members, were also evident. CONCLUSION The survey provides data on the current anaesthesia practice in Europe. The availability, composition and organisation of anaesthesia team members differ among European countries. The study highlights areas for further focus in operating room organisation and anaesthesia team composition, particularly regarding safety, efficacy and cost-effectiveness.