Preface| Volume 40, ISSUE 1, Pxxiii-xxv, December 2022

Anesthesiology in 2022: Ever in Demand and Ever Evolving

      Welcome to the 2022 Advances in Anesthesia! This year’s issue has 14 articles from all corners of our profession. As we do every year, the Editors have sought to find active and contentious topics to address, and we have invited the best experts we could find to discuss each topic. It’s a truism in anesthesia practice management that we don’t sit around and talk about everything that’s going well. As a profession, we have always been future oriented: what is the next threat? What has to change? And where are we headed next? This year’s collection of articles covers future-oriented anesthesia practice ranging from the clinically esoteric to the rough and tumble of health care professionalism in the modern era.
      In the first category, we have solicited reviews on robotic surgery, electroconvulsive therapy, and cardiac electrophysiology procedures. We have a new and updated review of anesthesia for obese obstetric patients, and a first summary of best practice for those with COVID-19. We review new anesthesia technology for intraoperative ventilation and current uses of dexmedetomidine. And for those interested in the cutting edge of translational resuscitation, we offer a pair of articles on management of vasoplegia and coagulation: two sides of the same basic science understanding of surgical inflammation, now beginning to influence evidence-based clinical management.
      We live in a challenging time for health care professionals, with both internal and external challenges to our daily existence. Articles on aspects of modern anesthesia practice include a review of advocacy and current political issues, guidance on opioid prescribing, an illustration of how anesthesiologists can influence end-of-life care, and a very specific example (the Josey Robertson Surgical Hospital in New York City) of how a perioperative process can be built from the ground up to promote a positive patient experience. While many of our professional articles are focused on US anesthesia practice, we have also included an important review of how anesthesiologists anywhere can contribute to positive patient outcomes in low- and middle-income countries.
      Demand for anesthesia services has never been higher, with close to half our work today outside of the traditional OR environment. More than ever, our profession needs innovative solutions for both clinical work and professional development; we hope this issue of Advances in Anesthesia will help you find both.