Tomobi Oluwakemi, Sampson John, Johnstone Robert, Hayanga Heather K
West Virginia University, Department of Anesthesiology, 1 Medical Center Drive, Morgantown, WV 26506, USA.
Johns Hopkins University School of Medicine, Anesthesiology & Critical Care Medicine, 600 Wolfe Street, Phipps Building, Rm 415, Baltimore, MD, 21287, USA.
J Natl Med Assoc. 2025 Sep 18. doi: 10.1016/j.jnma.2025.08.112.
For the first century of its practice, patients viewed anesthesiology with suspicion. Practitioners debated its professionalization as a medical field and their role in the operating room with the patient. This study looks at the debates around the development and incorporation of a pre-anesthesia evaluation into the patient experience and how these debates shape perceptions about current pre-anesthesia evaluation practices.
We conducted a qualitative descriptive analysis and a narrative synthesis was carried out on archival records of personal papers and paper documents at the Wood Library-Museum of Anesthesiology along with a content review on the history of anesthesia practice and the pre-anesthesia evaluation.
The search for pertinent documents yielded 259 records. Fifty-four additional records were identified manually at the Wood Library-Museum of Anesthesiology. After removing duplicates, excluding non-relevant records, and accessing articles for pertinence, 72 sources were included in the qualitative analysis. Three themes emerged from 72 sources as impacting the evolution of the pre-anesthesia evaluation: growth of the anesthesia workforce, changes in communication in the anesthesiologist-patient relationship, and the patient perspective.
This history is a small, focused look at a part of anesthesia practice today. It reviews some changes over time in the patient-anesthesiologist relationship and covers some of the debates and concerns that arose. Varying viewpoints regarding the practice of anesthesiology and the proper roles of anesthesiologists delayed the requirement for a pre-anesthetic evaluation until 1965, affected its perceived value, and slowed the development of the anesthesiologist-patient relationship. Lack of patient knowledge about the responsibilities of anesthesiologists and the processes for administering anesthesia limits patient understanding of the pre-anesthetic evaluation and the importance of the anesthesiologist-patient relationship. Patient education may improve patient and public understanding of the integral role of anesthesiologists in perioperative management to maintain patient safety.
在麻醉学实践的第一个世纪里，患者对其持怀疑态度。从业者们就其作为一个医学领域的专业化以及他们在手术室与患者之间的角色展开了辩论。本研究着眼于围绕将麻醉前评估纳入患者体验的发展及相关辩论，以及这些辩论如何塑造对当前麻醉前评估实践的看法。
我们进行了定性描述性分析，并对麻醉学伍德图书馆 - 博物馆的个人文件和纸质文档的档案记录进行了叙事性综合分析，同时对麻醉实践历史和麻醉前评估进行了内容回顾。
对相关文件的检索产生了259条记录。在麻醉学伍德图书馆 - 博物馆手动识别出另外54条记录。在去除重复项、排除不相关记录并评估文章的相关性后，72篇文献被纳入定性分析。72篇文献中出现了三个影响麻醉前评估演变的主题：麻醉工作人员的增长、麻醉医生与患者关系中沟通的变化以及患者视角。
这段历史是对当今麻醉实践一部分的小范围、聚焦式审视。它回顾了患者与麻醉医生关系随时间的一些变化，并涵盖了一些引发的辩论和担忧。关于麻醉学实践和麻醉医生恰当角色的不同观点，将麻醉前评估的要求推迟到了1965年，影响了其感知价值，并减缓了麻醉医生与患者关系的发展。患者对麻醉医生职责和麻醉实施过程缺乏了解，限制了患者对麻醉前评估以及麻醉医生与患者关系重要性的理解。患者教育可能会提高患者和公众对麻醉医生在围手术期管理中维持患者安全的不可或缺作用的理解。
