[Social media in anesthesiology: a systematic review on typology as well as opportunities and risks]

Social media have proliferated globally, with an estimated 5.1-5.5 billion active users and are gaining increasing relevance in anesthesiology. Social media are now firmly established as a medium for knowledge acquisition and information retrieval. In this context, "medfluencers" (individuals and institutions) play a growing role in disseminating health-related and discipline-specific information.

The aim of this article is firstly, to develop a clearer understanding of "medfluencers" in anesthesiology and secondly, to synthesize the opportunities and risks of social media for anesthesiology through a structured literature analysis.

Following specification of the two core research questions, a systematic literature search was conducted using predefined search strings in PubMed. Relevant contents from identified publications were synthesized into a typology of "medfluencers" and/or opportunities and risks of social media in anesthesiology. The literature search was performed in a systematic PRISMA-oriented manner and due to the heterogeneity of study designs and outcomes a narrative synthesis of the evidence was carried out.

A total of 1727 possible publications were identified and after the screening process 49 articles (original studies and reviews) were included. From the results five types of "medfluencers" in anesthesiology with distinct competencies, resources and aims were delineated. Social media activities in anesthesiology were synthesized into six opportunities and six risks for the respective "medfluencer" groups.

Virality is not a proxy for quality. Simultaneously, social media create a broad coverage and therefore entail content, ethical and legal responsibility. The use of social media offers novel possibilities for anesthesiology but requires a critical, evidence-based and legally compliant utilization. Concrete mitigation strategies to minimize risks are discussed, from which practical dos and don'ts for "medfluencers" are derived. Further studies are needed to be able to assess the effects on specific anesthesiological practices and the impacts on patient outcomes.