B30 ESRA history: important milestones

To effectively unfold a history, one needs to: know those inspired people, that paved the pathway and «wrote» the history, comprehend their backgrounds and motivations, delve into and understand their scientific or/and intellectual journeys, be one of them to identify and trace the history, or develop a deep connection with the history pioneers, aligning with their objectives and sharing their goals and vision, to authentically convey their perspectives. Since these criteria are met, the up to now history of the European Society of Regional Anaesthesia and Pain Therapy (ESRA) will be elaborated upon the lecture of Athina Vadalouka, during the 41st ESRA Annual Congress, held in Prague in September 2024, and will further be summarized in the following pages. ESRA was founded 44 years ago. Honouring its history and cherishing its heritage, nowadays, the society represents a dynamic organization that continues to share the passion for advancing education, scientific research and training in Regional Anaesthesia (RA), Perioperative Care and Pain Medicine. While its origins are rooted in Europe, ESRA has evolved into a global network, currently embracing more than 8.000 active voting members and an audience of more than 30.000 trainees, specialists, and nurses across the globe. As an international community, with a reputation for innovation, diversity and inclusion, its mission transcends geographical boundaries, offering invaluable opportunities to medical professionals worldwide, with the promise to support them during the transform of their professional journey. ESRA was founded by individuals, who shared the same mission, vision and talent to create the society. The idea originated from the first officers of ASRA Pain Medicine and from some brilliant minds who were well acquainted with many people in Europe, both professionally and personally. For instance, Ben Covino worked with Bruce Scott, the first President of ESRA, in Edinburg in 1976, and encouraged him to start establishing a European Society of Regional Anaesthesia. ESRA was officially founded by a Belgian Royal Decree on January 31, 1980, following intensive efforts and a pivotal meeting in Heidelberg, on September 24-25, 1979. The organization’s «Founding Fathers» were Albert Van Steenberge (Belgium), Hans Nolte (Germany), Arno Hollmén (Finland), Bruce Scott (UK), and Françoise Van Steenberge (Albert’s wife), who served as the group’s secretary. They established an administrative and scientific structure, accommodating Europe’s diverse countries, languages, and currencies. Under Bruce Scott’s leadership, two committees were created from the very first beginning: one to establish and set up the society across Europe and another to plan the first scientific meeting. This inaugural meeting was held in Edinburgh on September 16–18, 1982. ASRA Pain Medicine provided funding, and several UK companies (Astra Pharmaceuticals Ltd, Duncan Flockhart & Co Ltd, Dupont UK Ltd, and Roche Products Ltd) offered substantial sponsorship. The Edinburgh meeting marked the emergence of ESRA as a separate and distinct entity. The meeting lasted two days, with its scientific activities taking place in only one plenary hall, hosting one session at a time. Over the years, the ESRA scientific meetings grew and flourished, now expanding to four days and featuring multiple concurrent sessions, such as networking symposia, plenary experts’ panel discussions, instructional refresher course lectures, PRO–CON debates, «ask the expert» interactive sessions, «second opinion» discussions, «tips & tricks» sessions, problem based learning discussions (PBLD), free papers and video contests, electronic poster presentations with a poster competition, various hands–on clinical workshops on Ultrasound Guided Regional Anaesthesia (UGRA) and Pain Management, cadaver workshops, and exams for the acquisition of the ESRA Diplomas (ESRA–DRA and ESRA–DPM). Many other innovative sessions are introduced on an annual basis, including complex case discussions with audience–submitted content, trainees sessions, LIVE demonstrations on models and the 360 open space simulation courses. The annual congresses are pre–planned well in advance and take place in major European cities, each with unique social programs. ESRA’s first President was Bruce Scott, Albert Van Steenberge held the position of General Secretary, and Otto Schulte–Steinberg took charge of the finances as Treasurer. The initial zones created in 1980 were Benelux, France, Germany, Italy, Scandinavia, Spain, and the UK. Greece became a member in 1988, followed by Austria, Switzerland, and Portugal in 1990. The aim of ESRA was to attract all European countries, by offering educational, training and research opportunities, adhering to a philosophy of inclusivity and knowledge advancement beyond barriers. ESRA actively supported the establishment of national or regional groups or organisations of RA throughout Europe, inviting and encouraging them to join the society under its rules and regulations. ESRA Ambassadors such as Albert Van Steenberge (Belgium), Slobodan Gligorijevic (Switzerland), Marc Van De Velde (Belgium) and Patrick Narchi (France) have supported and represented Eastern European countries throughout these efforts. ESRA continuously updated its administrative structures with the primary goal of enhancing the dissemination of knowledge in RA and, more recently in Pain Management. We can trace the ESRA history step by step, throughout its significant milestones, that are presented below. · In 1984, during the Vienna meeting, ESRA established the Carl Koller Award, recognizing Dr John Alfred Lee (UK) as its first recipient. This award, originally sponsored by ASTRA, continues until today to honour, recognize and acknowledge scientific achievements and an outstanding lifetime contribution in the field of RA and/or Pain Medicine. · In 1989, ESRA launched its official publication, «The International Monitor of Regional Anaesthesia and Pain Therapy (IMRAPT)», with Mathieu Gielen (The Netherlands) serving as Editor–in–Chief. IMRAPT was initially supported by ASTRA, and later on by ASTRA/ZENECA, with its issues being published on a quarterly basis. Narinder Rawal (Sweden) succeeded Mathieu Gielen, and took over as Editor–in–Chief, holding the position from 1995 to 2005. · In 1992, André Van Zundert (Belgium) initiated the publication of the «Highlights» of Regional Anaesthesia and Pain Therapy, serving as Editor–in–Chief until 1999. From 2000 to 2003, he co–edited this edition with Narinder Rawal (Sweden), who then continued as Co–Editor alongside with the society Presidents, Slobodan Gligorijevic (Switzerland) and Giorgio Ivani (Italy), until 2009. In 2010, José de Andres (Spain) and Marc Van De Velde (Belgium) took over as Editors–in–Chief. The Highlights continue to be released as an online RAPM supplement every September. · On October 27, 1993, the ESRA Foundation was established, with its statutes being published on December 16, 1993. The foundation’s mission was to organize educational activities in RA and Pain Therapy for anaesthetists. Additionally, it was authorized and empowered to grant awards and prizes, to recognize excellence in the fields. · In 1995, the ESRA lecture was introduced, being delivered by JAW Wildsmith (UK), and becoming a prominent feature of the Annual Congresses. · The following year, in 1996, the ASRA lecture was added to the Annual Congress program, with the inaugural lecture being delivered by John Rowlingson (USA). · In order to showcase the diverse applications of RA, enhance the understanding and improve the knowledge in the field, as well as to attract new members to join the society, the ESRA Board of Directors planned an International Symposium on RA (ISRA). The inaugural ISRA congress took place in New Zealand from April 9–11, 1996, was supported by ESRA, ASRA, AOSRA, and LASRA, with JFW Wildsmith (UK) being at the helm of its scientific committee. · In 1998, during the Annual Congress in Geneva, from September 16–19, the ESRA Board of Directors approved and sanctioned the formation of several new committees. These were: a. Newsletter and Promotions Committee (Chair: A. Vadalouka, Greece) b. Research Grant Committee (Chair: A. Vadalouka, Greece) c. Education and Website Committee (Chair: B. Fischer, UK) d. Best Presentation Committee (Chair: M. Gielen, The Netherlands) e. Guidelines on Acute and Chronic Pain Committee (Chair: N. Rawal, Sweden) Three prizes for the best free papers and three for the best posters, sponsored by Becton–Dickinson, were awarded for the first time at this meeting. This event also marked the ESRA and EuroPain inaugural joint meeting, followed by another one in Istanbul in 1999. Concurrently, the first ESRA Cadaver Workshop in Innsbruck also started that year, with Slobodan Gligorijevic (Switzerland) serving as the chair of this event. This was a significant educational initiative, which was further improved and fine–tuned over the years, remaining one of the most popular ESRA activities until today. ESRA expanded its global presence and footprint by holding a fruitful international meeting in Jaipur, India, from February 9–13, 1998, with Narinder Rawal (Sweden) being the chair of the event. The society further engaged with and reached out to the Balkan countries, by organizing the 1st Mediterranean and Balkan Congress in Athens, Greece, from June 19-21, 1998, chaired by Athina Vadalouka (Greece), and attracting over 550 participants. At the Rome ESRA Annual Congress, in 2000, ESRA awarded its first Research Grant, being split between Spanish and Greek recipients. That year, meetings were also held in Quebec and Athens. In 2002, Barcelona hosted the 1st World Congress of Regional Anaesthesia, providing a global perspective on RA and Pain Therapy. The first Eastern European anatomy workshop on RA took place in Ljubljana also in 2002, whereas ESRA launched its first Winter Week course on RA in 2003. Both events were leaded by Slobodan Gligorijevic (Switzerland) and were welcome warmly by their audiences. The Eastern European Cadaver workshops keep being organized, with Paul Kessler (Germany) and Peter Merjavy (UK) serving as event chairs and following a venue rotation between Ljubljana, Prague, and Budapest. Additionally, Winter Week has evolved into an extremely successful activity over the years, being continued until today, under the leadership of Geert Jan Van Geffen (The Netherlands). The BBraun Award was established in 2005 and was presented to Alain Delbos (France), for his outstanding contribution in UGRA, via the introduction of a 3–D simulation training tool in the format of a DVD. The award kept being sponsored by BBraun until 2010. Afterwards, it was renamed «Recognition of Education in Regional Anaesthesia» Award, and is offered annually to support outstanding innovative activities or developments in the field of RA, as a reflection of excellence in teaching & clinical education. Similarly, the «Recognition of Education in Pain Medicine» Award was introduced in 2023, with Philip Peng (Canada) being its first recipient. In 2005, the ESRA Diploma of Regional Anaesthesia (EDRA) was launched, a project driven and spearheaded by André Van Zundert (Belgium), Giorgio Ivani (Italy), Narinder Rawal (Sweden), and Alain Borgeat (Switzerland), with the valuable assistance and substantial contribution from Chandra Kumar (UK). The first EDRA Diploma exams took place, in 2006, during the ESRA Annual Congress in Monte Carlo, Monaco. There were only a few candidates at first (4 in total), but the number has increased considerably since then, with ESRA nowadays counting more than 1000 diplomates. Recently this popular diploma has been renamed to ESRA–DRA (ESRA European Diploma of Regional Anaesthesia). Education and Excellence in the Provision of Care in Europe and beyond represent an integral part of the ESRA mission. The society is proud of the two jewels on its crown: Not only the ESRA–DRA, but also the ESRA–DPM (ESRA European Diploma of Pain Medicine), which was established in 2017, as an idea of Jose De Andres (Spain). Both aim to harmonize and improve quality standards for safe, independent practice in our fields, in Europe and elsewhere. The Diplomas assess the competencies of anaesthesiologists and pain physicians, acting within a multidisciplinary team and practicing as specialists. They also intend to complement national standards and enhance the competent, ethical, and professional care of RA and Pain Medicine. The ESRA Diplomas Exams, which are quite popular, are organized regularly on an annual basis, remotely and in person, within but also outside the European territory. Both of them, in 2023, during the 6th World Congress of Regional Anaesthesia and Pain Medicine, have been evaluated and received official accreditation by the Council for European Medical Specialists Assessment (CESMA), an advisory body of the European Union of Medical Specialists (UEMS). Pioneers in this endeavor were Morne Wolmarans (UK) and Sam Eldabe (UK), for the ESRA–DRA and ESRA–DPM respectively. The ESRA Academy was founded in 2010, was presented at the annual congress in Porto, and was further reformed from scratches in the coming years, being re–launched and presented in 2015 by Paolo Grossi (Italy). The Academy continues to be a valuable tool for all ESRA members, by hosting a variety of online educational content, including but not limited to recorded lectures, videos, and live demonstrations of RA/Pain techniques. The updated ESRA bylaws were also presented in 2010, and were approved by the Annual General Assembly, in addition to the «Albert Van Steenberge» Award, which was also launched that year. ESRA kept growing its membership and impact in RA and Pain Therapy in 2013. That year, the first publication on ESRA history by André Van Zundert (Belgium) and JAW Wildsmith (UK) was released and published in the journal RAPM. In 2014, PROSPECT (Procedure Specific Postoperative Pain Management) and ESRA formalized an agreement to strategize and plan their future partnership and to expand the group membership. PROSPECT, although an ESRA working group, still remains an independent academic body within the society academic umbrella. Currently, under the leadership of Marc Van De Velde (Belgium), continues to benefit from the academic endorsement and support of ESRA and develops some of the best available Consensus Recommendations in a clinically useful format. These are readily transferable in daily practice, serve as a clinical decision support service, and are designed to improve postoperative pain management on a procedure–specific basis. As such, they are translated into multiple languages to be readily available for clinicians across all corners of the world. In 2014, the 4th World Congress on RA and Pain Therapy (WCRAPT) took place in from being organized by ESRA, ASRA, LASRA, and In and under the leadership of Paul Kessler (Germany), ESRA expanded its workshops, featuring cadaver sessions and hands–on training across multiple European cities, Innsbruck and The cadaver workshops have also expanded in the field of pain and under the of (UK), and pain are regularly and In the of ESRA was a in with the and and has the of its educational to the new driven world. Since 2017, it its audience and into the a unique which the one needs with the knowledge of RA and Ultrasound in clinical who the tool take of its and format to improve their and care in the and At the of the ESRA introduced innovative online educational and is proud of its interactive which was first launched in by Alain Delbos (France) and This a unique educational a new of online education, for a learning an program, live all over the in and the of via live & with a of a to RA, Perioperative Care & Pain Medicine, has been 6th edition took place in April 2024, under the leadership of Jose (Switzerland), with the active of not only ESRA, but also ASRA Pain Medicine, LASRA, and more than online in one across all of videos, and were and are available for via the ESRA The represents a for standards and for international and the to knowledge for from Europe and in a and and a diverse and of geographical In and ESRA was in expanding its social presence and attracting of on and ESRA in the of Guidelines or Recommendations on RA and in with other The but are not limited to the Guidelines with the European Society of and Care on to on who RA, published in European of in the International Consensus Recommendations on published in The of and in the International Consensus on structures to identify on for the of in UGRA, published in RAPM in and the Guidelines on as a Consensus from a International published in RAPM and in ESRA for in training and across Europe and of its efforts to the the of our and the future of medical and to the for and excellence in our fields. experts’ ESRA the ESRA that was created in and their annual whereas a part of the ESRA educational is to Research and Education of up to and each are awarded regularly to worldwide, who are encouraged to of Excellence on RA or/and Pain Medicine in Europe are available to the new of physicians, with to applications from anaesthesiologists from countries the to in RA and Pain Medicine. The ESRA the new format of the ESRA initiated by the society by offering that is not only but also for the goal and objectives are to on ESRA events and training opportunities and the of our Since ESRA, also started offering a Diploma to its members in partnership with the of In and ESRA to the by many educational events to online training including free or meetings and the the society at the knowledge and became Currently, these continue to on an annual basis, the ESRA to RA and Pain Medicine education, and international In ESRA marked its since the organization of its first meeting, on its and achievements in the The first annual congress the took place in Greece, with over and more than under the leadership of Alain Delbos (France) and The event was both and In 2023, ESRA hosted its scientific event the 6th World Congress of RA and in as a joint event with its Annual efforts with all Pain Medicine, LASRA, and the of more than more than & from all and more than were Alain Delbos (France) and the scientific and the scientific was offered to all in with a with knowledge sharing and of new This congress was not another ESRA it in the of is the upon which can from each support and establish ESRA diversity within its and networking opportunities and that the globe. efforts with that share and are more than as they enhance the of discussions and providing a global on our fields. ESRA is its International established in to a to from all in RA and Pain Medicine. The unique and of all ESRA are not but In the the event of such was the European of RA, that was first organized in as an of Alain Delbos (France) and (France) and which continued to take place at the of each in until with the of RA and Pain Therapy, multiple in European countries every with a scientific program, at and of scientific between trainees and on to RA and Perioperative The primary goal was and with clinical and this ESRA kept the of and research in the of improved quality of medical European the of such and in the same of ESRA to expand this activity to to its mission Under the of (Greece), ESRA, with its ASRA Pain Medicine, and LASRA, launched the 1st World Week and the 1st World of RA and Pain Medicine in January 2024, more than from more than across all this in the of a RA and Chronic Pain the were to a on the of RA and Pain Medicine, under the for a Pain that transcends of all RA and the of shared and and the for our ESRA that have been to on the that has been and the that its ESRA expanded its and the to an international for who to standards and in RA, Perioperative Care and Pain Medicine. ESRA is a to the of inclusivity and in our of of and shared were and continue to be created by efforts. As on this that in and in inclusion, can the for and our have the to in the of scientific research and ESRA continues to the of partnership to that its vision, a future to global André Van John The European Society of Regional Anaesthesia and Pain Therapy Pain (The following to this on of the of the European Society of Regional Anaesthesia and Pain Alain José De Slobodan Giorgio Narinder Rawal, Athina Marc Van De ESRA September ESRA 1999. The International of Regional Anaesthesia and Pain Therapy, Highlights in Regional Anaesthesia and Pain Therapy, 2010. Wolmarans A. Regional in on General Recommendations from the of the International Consensus on Delbos Grant Merjavy Wolmarans International on structures to identify on for the of in regional Pain clinical practice on a from a international working Pain online of in Consensus Guidelines on from a International ESRA June

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