[Some methodological aspects of modern anesthesia]

The paper provides evidence for that it is necessity to introduce anesthesia standards (protocols). The anesthesia protocols (standards) are meant as a combination of the principles, rules, and provisions to be binding. The constituents of these protocols are all stages of anesthesia: preoperative examination of patients, choice of a method of anesthesia, a mode of provision of upper airways patency, the scope of monitoring, recording of the use of drugs. The minimum requirements below which an anesthesiologist cannot do his/her work are worked out for each constituent of the protocol. The wide introduction of anesthesia protocols in foreign countries could largely level differences in the quality of anesthesiological support and resulted in the emergence of a middle-leveled anesthesiologist. The paper considers the advantages and disadvantages of setting up of protocols above and their establishment in some clinical and clinical amalgamations. The author considers that there are so far two known ways to avoid the "parochiality", incompetence in determining local standards: (1) the use of the points of evidence-based medicine, i.e. the whole experience accumulated by the international anesthesiological community. To have such recommendations is not a problem if internet is available; (2) medical audit is a relatively new method for assessing the quality of anesthesia, which makes it possible through clinical analysis of the collected data to identify the areas that require developments and their introduction. It is local audit on whose basis the administration, the head of units, senior physicians generally develop and make amendments into different protocols and instructions that regulate the principles of clinical activities.