Instructions for Authors General | Anesthesiology | American Society of Anesthesiologists

Instructions for Authors

Before submitting a manuscript to Anesthesiology, please read these Instructions carefully. Each author on a manuscript submission is required to understand the material below.

Manuscripts must be submitted electronically via the Journal's online submission system. Authors should allow approximately 3-4 weeks for first decision. Authors will be notified if delays occur.

Due to the high volume of manuscripts we receive, we cannot provide status updates via telephone, fax, or e-mail. Authors can view the status of their submissions through the Editorial Manager submission site.

September 9, 2024: Authors may now run a pre-submission check on their manuscripts using Paperpal Preflight. This service evaluates a manuscript against technical compliance and language quality checks identified by the journal team. Please note that this service is completely optional, and the submission readiness report is free. Anesthesiology does not receive any money if authors choose to pay to download an edited manuscript file.

Highlights

New Version April 11, 2024
New Guidance: Authorship
New Guidance: Research Letters
New Guidance: References

Article Types At-A-Glance

General Editorial, Legal and Ethical Issues
Types of Articles and Content
Data Reporting and Statistics
Manuscript Preparation
Journal Style Considerations
Authors' General Checklist

General Editorial, Legal and Ethical Issues
1. Authorship
  Anesthesiology strongly endorses the practice of appropriately crediting contributions to research publications, towards the goals of providing proper recognition, fairness, and transparency for authors and readers; ensuring Journal best practices; and promoting clarity of communication. Appropriate credit for contributions to basic, clinical, and population research is an important aspect of scholarly publications.
  
  Anesthesiology authorship criteria are intended to denote the status of authorship for those who have made a substantial intellectual contribution to a manuscript, deserve credit for their contribution, and take responsibility for the work. Proper authorship is a matter of scholarly integrity and enhances confidence in the validity of published research. Criteria for authorship in Anesthesiology are based on elements from the World Association of Medical Editors, Committee on Publication Ethics, Council of Science Editors, and the International Committee of Medical Journal Editors. (see Authorship and Publication Matters: Credit and credibility. Anesthesiology 2021;135:1-8)
  
  Authors in Anesthesiology must satisfy all of the following 5 criteria:
  1. Scholarship: Substantial intellectual contributions to research conception or design, execution, data analysis, or interpretation of the results; AND
  2. Authorship: Drafting the manuscript or revising it critically for important intellectual content; AND
  3. Approval: Final approval of the version to be published; AND
  4. Ethics: Agreement to be accountable for all aspects of the research and manuscript; AND
  5. Integrity: Ensuring that questions related to the accuracy or integrity of any part of the research and manuscript, even ones in which the author was not personally involved, are appropriately investigated, resolved, and communicated (where needed).
  
  All authors should meet all five criteria, and all contributors who meet the five criteria should be authors. Those who do not meet all five criteria can be listed as Collaborators in an appendix or in the Acknowledgments section, as outlined in detail below. Each author should be able to identify the specific contributions of their co-authors and have confidence in the integrity of the contributions of their co-authors.
  
  It is not the role of Anesthesiology to determine who does or does not qualify for authorship or to arbitrate authorship conflicts. If agreement cannot be reached about who qualifies for authorship, the institution(s) where the work was performed, not the Journal, should be engaged. The order in which authors are listed on the byline must be decided collectively by the authors and not by the Journal. The list of authors and the order listed must be established at the time of original submission. Any change to authorship after submission is highly discouraged; however, if needed, see Changes to Authorship after Submission.
  
  Authors may indicate (no more than) two first authors in the byline (“#” next to their names and “# These authors contributed equally to the work” at the end of the Title Page). Please note, however, that this will not change how the authors appear in future citations to the article.
  
  Authors may also indicate two co-senior authors in the byline (“#” next to their names and “# These authors contributed equally as co-senior authors to the work” at the end of the Title Page).
  
  Please note that designating two or more corresponding authors is not permitted.
  
  There is no limit on the number of authors listed in the byline for an original investigation (provided each author meets all authorship criteria), however a long author list may not fit in the space for the author byline. In this case, other options include Group Authors (see below).
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  Non-Author Contributors
  Contributors who do not meet all 5 of the above authorship criteria should not be listed as authors but can be included in the Acknowledgments. Examples of activities that alone (without all five author qualifications) do not qualify a contributor for authorship are: acquisition of funding; general supervision of a research group; general administrative support; mentoring; providing patients, reagents, animals, or other study materials; collecting samples; writing assistance; technical editing; language editing; and proofreading. Those whose contributions do not justify authorship may be acknowledged individually or listed as collaborators. See the section below under Acknowledgements and the section on Non-Author Collaborators.
  
  Any participation by a professional writer in a manuscript must be disclosed for transparency. Professional writers meeting all authorship criteria must be listed authors. Those who only drafted or edited the manuscript but did not have a role in the study design, data analysis, or interpretation of results must be identified in the Acknowledgments section along with information about compensation (including which entity/entities) and potential conflicts of interest.
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  Unacceptable Forms of Authorship
  Authorship fraud is considered a type of research fraud (see Assessing the Perceived prevalence of research fraud among faculty at research-intensive universities in the USA. Account Res 2020;27:457-75). The following types of authorship are unacceptable:
  1. Gift authorship (honorary, courtesy): Offered from a sense of obligation, tribute, dependence or respect to an individual who has not contributed to the work, in return for anticipated benefit (e.g., Department Chair). Perceived to be the most prevalent type of authorship fraud.
  2. Guest authorship (celebrity, prestige, complementary): Granted in the belief that expert standing of the guest will increase the likelihood of publication, or the credibility of status of the work or the authors.
  3. Ghost authorship: Failure to identify someone who merited authorship (may range from uncredited authors-for-hire to major contributors not named as an author).
  1. Role of the Corresponding Author Anesthesiology takes very seriously the responsible conduct of research. Each manuscript must have a single Corresponding Author who takes primary responsibility for communication with Anesthesiology during the manuscript submission, peer review, and publication process, and ensures that all the journal’s policies and administrative requirements, such as providing details (if requested) of authorship (including that all authors meet all criteria for authorship, and all who meet the criteria should be identified as authors), ethics committee approval, clinical trial registration documentation, and listing of comprehensive conflict of interest statements, are met and properly completed. Manuscript submissions will be returned without assessment if more than one author is designated as the Corresponding Author. Upon submission, the Corresponding Author is required to attest to the validity and legitimacy of the data and interpretation, on behalf of all authors (who are also responsible for the validity and legitimacy of the data and interpretation). The Corresponding Author is responsible for ensuring that all authors meet the criteria for authorship, have reviewed and approved the manuscript and have completed the conflict of interest disclosures. If the manuscript is accepted, the same corresponding author is the primary contact during the production, publication, and post publication stages, including reviewing and approving the proof and for all other publication matters. The Corresponding Author must also be available after publication to respond to critiques of the work and to cooperate with any requests from the journal for data or additional information should questions about the manuscript arise after publication. This latter responsibility is an enduring one, as questions may arise years after the submission and publication of a manuscript. The Corresponding Author should have sufficient and ongoing accountability and availability for the research and publication. The role of the Corresponding Author is one of scholarly integrity, in which the Corresponding Author makes a number of statutory and ethical statements on behalf of all authors. Although there are certain administrative roles of the Corresponding Author, these cannot be separated from the other responsibilities, or delegated. Each manuscript should also have the same Corresponding Author throughout the submission, publication, and post-publication process. The designated Corresponding Author must be the person who submits the manuscript and is responsible for all communications for all iterations and all phases of the manuscript.
  2. Group Authorship When authorship is attributed to a group in the byline (known as group, corporate, organization, or collective names), all members of the group must meet all five criteria for authorship as described above. Group authorship requires the same level of participation as individually named (personal) authorship. Anyone listed as a Group author must meet all five criteria for authorship, and other contributors can be listed as collaborators or acknowledged. An explicit statement as to the exact nature of each Group author’s participation must be provided at the time a revised manuscript is submitted; upload this under the submission item Authorship Information. It is important to separately identify Group authors and non-author Collaborators. All members of the Group authors must be entered into Editorial Manager individually to verify their authorship and must complete the Copyright Transfer/Disclosure Form. Manuscripts may be held until all authors have verified authorship and confirmed that they have seen the submitted manuscript.
    
    a. Group authorship may be in the form of some named authors in the byline, in combination with a Research Group name. All members of the Research Group must be qualified authors, and all must meet authorship criteria. To indicate that all members of the group meet all authorship criteria, the byline must be in the format of Individual Authors Smith, Jones, Weiss, etc. “and” the Research Group (e.g., Smith A, Jones B, Weiss C; and the Generic Outcomes Group). Use of the connector “and” indicates that there are other individual authors who are not named in the byline. The name of the Research Group and the byline authors and the non-byline authors should be listed in an Appendix at the end of the manuscript, along with their affiliations, institutional position or title, contributions, and conflicts of interest disclosures. In PubMed, the authors named in the byline and the individual non-byline authors in the Research Group will be indexed as authors along with the Group Name.
    
    b. Group authorship may be in the form of a Research Group name alone in the byline and a list of the individual group authors in an Appendix along with their affiliations, institutional position or title, contributions, and conflict of interest disclosures. In PubMed, the Group name is listed, and all authors are indexed in the order they appear in the Appendix.
    
    Group author names must be listed in the full text of the article (in an Appendix), rather than in a supplementary online file.
  3. Non-Author Collaborators Individuals working with a Research Group who do not meet all five of the criteria for authorship may be listed as Collaborators provided that they substantially contributed to the work reported in the manuscript. If desired, Collaborators names can be listed as such in PubMed, in addition to the list of authors. They are listed in a separate Collaborators section in a paragraph below the author byline. If Collaborators are to be indexed in PubMed, they must be a part of a designated collaborator or corporate group, and that group name (“ABC Consortium”, “ABC Collaborators”, “ABC Investigators”, etc.) must appear in the author byline. In order to differentiate between a full author group and a non-author collaborator group, the article byline for the latter is Individual Authors Smith, Jones, Weiss, etc. “for” the Research Collaborators (e.g., Smith A, Jones B, Weiss C; for the Generic Outcomes Investigators). Use of the connector “for” indicates that the authors in the byline represent the group, which includes others who are not authors. Non-author Collaborator names, degrees, institutional affiliation, and institutional title or position should be listed in an Appendix, and not included in a supplementary online file. In this listing collaborator contributions should be specified (e.g., “served as scientific advisors,” “critically reviewed the study proposal,” “collected data,” “provided and cared for study patients,” “participated in writing or technical editing of the manuscript”).
    
    The Corresponding Author is responsible for completing the Collaborators statement for the manuscript and only including those members of the group who have substantially contributed and have provided written permission to be listed in the published article. Non-author Collaborators are not required to complete the Copyright Transfer/Disclosure form.
    
    Anesthesiology requires that authors provide their institutional affiliation, institutional title or position, and institutional email address upon manuscript submission. If the institution does not have an email system then a personal email address is acceptable. If an author is an unpaid employee, visiting scholar or visiting student, both the home institution and the institution at which the work was done should be listed as affiliations and each clearly identified as such. Collaborator institutional affiliation and institutional title or position must be listed in an Appendix to the full text of the article, rather than in a supplementary online file.
  4. Acknowledgements Other contributors may be thanked in an Acknowledgment section. Because acknowledgment may imply endorsement by acknowledged individuals of a study’s data and conclusions, Anesthesiology requires that the corresponding author obtain written permission to be acknowledged from all acknowledged individuals, prior to manuscript submission. This information does not need to be uploaded as part of the manuscript submission but must be available upon request. Acknowledged individuals are not indexed in PubMed.
    
    If relevant to your submission, contact the Editorial Office for further information about how to distinguish and mark group authorship and group collaborators.
  5. Changes to Authorship after Submission Authors on a work must be established before submission, and all authors must meet all the criteria for authorship. Any change in authorship (order, addition, removal, designated corresponding author) after the original submission should be requested in writing by the Corresponding Author. The request should provide a clear and thorough explanation for the change and define the contribution of every person listed as an author on the initial submission and the subsequent version(s). All authors must provide written approval of the change.
    
    Any changes (author order, addition, removal) to authors listed in a Research Group or as Group Collaborators made after manuscript submission must also be requested in writing by the Corresponding Author, as outlined previously, with the byline authors and the person(s) being added or removed providing written approval. Other members of the Research Group or Group Collaborators (i.e., those not listed on the byline), do not have to provide written approval. However, the Corresponding Author must provide a written statement to Anesthesiology confirming that all authors listed in the Research Group or as Group Collaborators have been informed of and approve the change.
    
    All requests should be submitted to the Editorial Office (editorial-office@asahq.org) for review and approval by the Editor-in-Chief.
2. Artificial Intelligence Authoring Tools
  Authors who use AI tools in the writing of a manuscript, production of images or graphical elements of the paper, or in the collection and analysis of data, must be transparent in disclosing in the Materials and Methods (or similar section) of the manuscript how the AI tool was used, and which tool was used. Authors are fully responsible for the content of their manuscript, even those parts produced by an AI tool, and are thus liable for any breach of publication ethics.
3. Copyright
  Each author must complete and submit the journal’s Copyright Transfer Agreement, which includes a section on the disclosure of potential conflicts of interest based on the recommendations of the International Committee of Medical Journal Editors, "Uniform Requirements for Manuscripts Submitted to Biomedical Journals." A copy of the form is made available to the submitting author within the Editorial Manager submission process. Co-authors will automatically receive an email with instructions on completing the form upon revision.
4. Open Access
  Anesthesiology is a subscription journal with hybrid (optional) open access. Authors of accepted peer-reviewed articles have the choice to pay a fee to allow perpetual unrestricted online access to their published article to readers globally, immediately upon publication. Please note that this choice has no influence on the peer review and acceptance process. These articles are subject to the journal's standard peer-review process and will be accepted or rejected based on their own merit.
  
  The article processing charge (APC) is charged on acceptance of the article and should be paid within 30 days by the author, funding agency or institution. Payment must be processed for the article to be published open access. For a list of journals and pricing, please visit our Wolters Kluwer Hybrid Open Access Journals page.
  
  Authors are responsible for disclosing the source of funding for APCs. This information will be published with the article.
5. Funder-mandated Open Access or Public Access Policies
  An author whose work is funded by an organization that mandates the use of the Creative Commons Attribution (CC BY) license is able to meet that requirement through the available open access license for approved funders. Information about the approved funders can be found here.
  
  A number of research funding agencies now require or request authors to submit the post-print version (the article after peer review and acceptance but not the final published article) to a repository that is accessible online by all without charge. As a service to ANESTHESIOLOGY authors, the publisher (Wolters Kluwer) will identify to the National Library of Medicine (NLM) articles that require deposit and will transmit the post-print version of an article based on research funded in whole or in part by the National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute, or other funding agencies to PubMed Central. The Copyright Transfer Agreement provides the mechanism.
6. Overlapping Publications
  1. Duplicate Submission or Prior Publication Manuscripts should be submitted solely to Anesthesiology and should not be under consideration with another scientific journal. If any of the material in the manuscript is submitted or planned for publication elsewhere in any form, or if the information appeared in a previous publication, identify the other publication in a cover letter and include a copy or link with your submission.
    
    Preliminary reports, such as an abstract or poster previously presented at a scientific meeting, are not considered prior publications. Submission of a full article for peer review reporting this information is encouraged, and information about the meeting (e.g., meeting title, location, and dates) should be disclosed on the title page.
  2. Preprints Anesthesiology will consider manuscripts that have been posted on a preprint server (e.g., medRxiv). Authors must disclose this information in a cover letter and on the title page of the submission and include a link to the preprint. Authors may not revise the posted preprint based on the journal reviewers’ feedback.
    
    If the manuscript is accepted for publication in Anesthesiology, it is the authors’ responsibility to update the preprint server record to include a link to the final, published article. The final version of the article may not be deposited to the preprint server.
  3. Plagiarism and Text Recycling Anesthesiology uses iThenticate software to screen submitted manuscripts for duplication of published or posted articles. Plagiarism is unacceptable and considered scientific misconduct. Rewording text just to disguise previously published material or avoid detection by plagiarism software is not acceptable. Authors are responsible for obtaining and uploading any needed permissions and for clearly and completely identifying any overlapping material and/or quoted or paraphrased passages with proper attribution in the text to avoid plagiarism.
    
    Occasionally authors may wish to replicate text from previously published articles when describing standard methods or models used often in their laboratory or in clinical trials protocols. In these instances, changing text simply to render it different from a prior article may result in diminished clarity, and it may be more appropriate to reuse small amounts of text. It is important to distinguish text recycling (sometimes but inappropriately called “self-plagiarism”) from plagiarism, which is scientific misconduct.
    
    Text recycling refers here to reuse of published textual material (prose or equations only, not figures) in a new document where the material is identical to the source (or substantively equivalent in both form and content), is not presented as a quotation (via quotation marks or block indentation), and at least one author of the submitted manuscript is also an author of the prior publication Anesthesiology will permit text recycling (as defined here), when restricted exclusively to a Methods section to describe a standard laboratory method or clinical protocol, and in limited amounts (sentences not multiple paragraphs), and with proper citation to its original publication, and provided it is the author’s own prior publication. A major tenet in text reuse is transparency.
7. Multiple Manuscripts from Single Investigation (segmented publication)
  Anesthesiology welcomes multiple manuscripts derived appropriately from a single investigation. Examples may include complex clinical trials with multiple aims or outcomes, longitudinal studies with initial results and long-term follow-up, prespecified interim analysis of clinical importance, planned or unplanned secondary analyses of original trials that are important enough to justify separate publication, reanalysis of data using a novel technique not available at the time of publication, or too much information to effectively communicate in a single manuscript. A practical test for appropriateness of segmentation is whether there are completely separate hypotheses or research questions; but not when there are the same or closely related hypotheses, research questions, population, methods, or results, or splitting purely by outcomes. The following applies to such manuscripts:
  
  Authors are encouraged to submit multiple manuscripts from the same investigation together at the same time (excepting interim analyses and long-term follow-up studies) with explanation in a cover letter. Authors must clearly disclose at submission if another manuscript derived from the same investigation or using the same database has been published previously, submitted elsewhere, or will be submitted to another journal.
  
  Authors may submit secondary outcomes, analyses, and long-term follow-up of clinical trials, and with explanation in a cover letter. These must be accompanied by the manuscript (published or unpublished) describing the primary outcome or analysis. Secondary outcomes and analyses and long-term follow-ups must explicitly state (in the Abstract, Introduction, Methods, Results, and Discussion) they are part of a larger whole or primary (or interim) analysis or previously reported database and cite that article and are usually only published after acceptance or publication of the primary outcome or analysis. Authors are encouraged to submit primary and secondary manuscripts together at the same time when appropriate.
  
  Inappropriate dividing of research that would form one meaningful manuscript into multiple different manuscripts is considered “salami” publication. Salami publication is unacceptable. Anesthesiology generally discourages authors from inappropriately dividing the results of a single study into multiple manuscripts. Anesthesiology does not allow salami publication, when a single comprehensive manuscript is appropriate. See Authorship and publication matters: Credit and credibility. Anesthesiology 2021;135:1-8.
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8. Scientific Misconduct
  Anesthesiology takes seriously the responsible conduct of research and ethical behavior in scholarly communications and recognizes its responsibility to appropriately address concerns of allegations of misconduct. Examples of misconduct include falsification of data, plagiarism, improper designations of authorship, duplicate publication, misappropriation of others’ research, failure to disclose conflict(s) of interest, and failure to comply with applicable legislative or regulatory requirements. Misconduct also includes failure to comply with any rules, policies, or procedures implemented by Anesthesiology. When Anesthesiology has concerns or receives allegations of scientific misconduct, Anesthesiology reserves the right to proceed according to the procedures described below.
  
  Process: In general, Anesthesiology follows the recommendations of the Committee on Publication Ethics (COPE) when working to address allegations of misconduct. When a concern or allegation is raised, involved parties will be contacted to provide an explanation of the situation. As needed, Anesthesiology may also contact the institution at which the study was conducted and any other involved journals. Anesthesiology will attempt to determine whether there was misconduct, and the Editor-in-Chief will respond with an appropriate action. Examples of action include: - Sending a letter of explanation only to the person(s) involved or against whom the allegation is made.
  - Sending a letter of reprimand to the same person(s), warning of the consequences of future, similar instances.
  - Sending a letter to the relevant head of the educational institution and/or financial sponsor of the person(s) involved, expressing the concerns and information collected.
  - Publishing in Anesthesiology a notice of duplicate publication, “salami” publishing, plagiarism, or other misconduct, if clearly documented. In cases of ghost-written manuscripts, the notice may include the names of the responsible companies as well as the submitting author(s).
  - Providing specific names to the media and/or government organizations, if contacted regarding the misconduct.
  - Formally withdrawing or retracting the article from Anesthesiology and informing readers and indexing authorities.
  - Banning an author or authors from publishing any manuscript in Anesthesiology for a specified time period, with notice to the author(s)’ institution.
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9. Human Studies
  Human experimentation must conform to ethical standards and be approved by the appropriate Institutional Review Board (IRB). A statement concerning IRB approval and consent procedures must appear at the beginning of the Methods section. Any systematic data gathering effort in patients or volunteers must be approved by an IRB or adhere to appropriate local/national regulations. The Editors of Anesthesiology are concerned about appropriate IRB review and informed consent. Authors may be questioned about the details of consent forms or the consent process. On occasion, the Editor-in-Chief may request a copy of the approved IRB application from the author. Lack of appropriate consent or documentation may be grounds for rejection. Local IRB approval does not guarantee acceptability; the final decision will be made by the Editor-in-Chief. A specific example is that of neuraxial or peri-neural administration of drugs because lack of toxicity from systemic administration does not exclude toxicity when injected near these neural structures. The Editor-in-Chief will consider appropriate study of drugs by these routes to include:
  - Drugs approved for intrathecal, epidural, or peri-neural administration by the United States Food and Drug Administration (FDA) or the equivalent regulatory agency for the country in which the study took place.
  - Drugs not approved by these routes, but which are widely used (e.g., fentanyl for intrathecal or epidural administration). The publication of dosing guidelines in multiple textbooks represents a reasonable demonstration that a drug is widely used and accepted.
  - Study performed under an Investigational New Drug (IND) application approved by the FDA or the equivalent agency in the investigator’s country.
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10. Animal Studies
  Experimental work on animals must conform to the Guide for the Care and Use of Laboratory Animals, which is available from the National Academy of Science. Adherence to all relevant regulations and/or approval of the appropriate Institutional Animal Care and Use Committee or governmental licensure of the investigator and/ or laboratory must be obtained. A statement of such approval must be included at the beginning of the Methods section. Anesthesiology is concerned about appropriate animal care. Authors may be questioned regarding the use of anesthetics, muscle relaxants, and postoperative analgesics. On occasion, the Editor-in-Chief may request a copy of the approved Animal Care and Use Committee application from the author. Major issues are a) the postoperative use of analgesics following surgical procedures and b) use of neuromuscular blocking drugs, particularly in minimally sedated animals. Local committee approval does not guarantee acceptability; the final decision will be made by the Editor-in-Chief. Investigators are encouraged to read: Drummond JC, Todd MM, Saidman LJ: Use of neuromuscular blocking drugs in scientific investigations involving animal subjects: The benefit of the doubt goes to the animal. Anesthesiology 1996; 85: 697-9.
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11. Conflicts of Interest and Sponsorship
  Anesthesiology is committed to integrity in the conduct and reporting of research. One component of scientific integrity is full disclosure of competing interests. Anesthesiology requires that all authors disclose all financial and non-financial relationships and activities, in accordance with International Committee of Medical Journal Editors “Uniform Requirements for Manuscripts Submitted to Biomedical Journals.” It is not sufficient to disclose only those activities which an author believes may be associated with the topic of the article. An author’s relationships or activities or competing interests are not per se a conflict. Individuals (readers, peer reviewers, editors, and authors) may disagree on whether an author’s relationships or activities represent conflicts. Although the presence of a relationship or activity does not always indicate a problematic influence on a paper’s content, perceptions of conflict may erode trust in science as much as actual conflicts of interest. Ultimately, readers must be able to make their own judgments regarding whether an author’s relationships and activities are pertinent to a paper’s content. These judgments require transparent disclosures. An author’s complete disclosure demonstrates a commitment to transparency and helps to maintain trust in the scientific process. Complete disclosures include declaring all funding sources supporting their work or its authors, even if support is indirect, e.g., to a local research foundation that funded the project. This includes departmental, hospital, or institutional funds. The authors must disclose all commercial associations, including consultancies, equity interests, or patent-licensing arrangements. An author’s relationships or activities or competing interests identified as conflicts during the peer review process are, in the opinion of the Editor-in-Chief, handled appropriately by Anesthesiology.
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12. Editorial Decisions and Appeals Process
  Decisions on submissions to this journal are final. Anesthesiology does not allow rejected manuscripts to be resubmitted as new manuscripts; resubmissions of rejected submissions will be returned without assessment. If an author wishes to appeal an editorial decision, the appeal must be based on evidence, provided by the corresponding author, that the reviewers have misunderstood the scientific content of the manuscript, that there is evidence of reviewer conflict of interest or bias, and/or that there are demonstrably incorrect statements of fact in the reviews. There are two phases to the appeals process; contact the Editorial Office for complete information if you wish to submit a formal appeal. Decisions whether to consider or accept an appeal are ultimately made by the Editor-in-Chief. Informal comments or complaints after decision that do not follow the appeals process will not be considered.
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13. Errata and Retractions
  The journal thoroughly investigates alerts of potential errors within a published article, following the COPE guidelines. If the journal deems there are errors within the published article that do not impact the main point, an erratum correcting the errors is published immediately online and in print in the next available issue. The pdf of the article is also corrected immediately. If it is determined that factual errors were made that affect the main point of the article, the article will be retracted.
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14. Reporting Requirements
  1. Laboratory Research
    Authors of laboratory research (experiments in animals, cells, molecules, or other biological foci) should consult Improving bioscience research reporting: the ARRIVE guidelines for reporting animal research. PLoS Biol 2010; 8: e1000412). Authors should report 4 specific elements of study design: a) adequate description of the methods used to allow replication; b) whether measures to reduce bias, including random allocation and blinding, were used and if so, how they were performed; c) how the sample size was determined; d) the data analysis plan. For details see the following editorial: Eisenach JC; Warner DS; Houle TT; Reporting of Preclinical Research in Anesthesiology: Transparency and Enforcement. Anesthesiology 2016.
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  2. Clinical Trials
    Authors of clinical trials (regardless of size) should consult the guidelines published by the CONSORT group [Moher D, et al. for the CONSORT Group: The CONSORT statement: Revised recommendations for improving the quality of reports of parallel-group randomized trials JAMA;2001; 285:1987-91 at Todd MM: Clinical research manuscripts in Anesthesiology. Anesthesiology 2001;95:1051-53. Authors should consult the CONSORT checklist for items required when reporting a randomized clinical trial.
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  3. Registration of Clinical Trials
    All clinical trials involving assignment of patients to treatment groups must be registered before patient enrollment, effective with trials beginning May 1, 2013. For trials that began enrollment before May 1, 2013, registration is strongly recommended and if the trial reported was not registered, please comment on this matter on the title page. The registry, registration number, principal investigator›s name, and registration date must be stated in the first paragraph of the Methods section of the manuscript. It must also be included on the title page of the manuscript. A number of registries have been approved by the International Committee of Medical Journal Editors, including http:// www.clinicaltrials.gov (the most commonly used registry in the United States), ISRCTN Registry, UMIN Clinical Trials Registry, EudraCT, Australian New Zealand Clinical Trials Registry, and the Netherlands Trial Register. Registries must be publicly available and written in English.
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  4. Observational Studies
    Anesthesiology requires explicit statement in manuscripts of whether a data analysis and statistical plan was defined before accessing the research data. See Kharasch ED: Observations and Observational Research. Anesthesiology. 2019;131:1-4. Authors are required to include one of the following sentences in the Methods section of the manuscript that describes this process: A data analysis and statistical plan was (1) written and posted on a publicly accessible server (Clinical Trials.gov or other) before data were accessed; (2) written and filed with a private entity (institutional review board or other) before data were accessed; (3) written, date-stamped (permanent dated electronic signature), and recorded in the investigators’ files before data were accessed; or (4) written after the data were accessed. If there was an a priori data analysis and statistical plan (numbers 1 to 3 above), authors are requested and strongly encouraged to include the plan as supplemental digital content at the time of initial manuscript submission. This is for peer review purposes only, not for publication.
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  5. Sex as a Biological Variable
    Laboratory, clinical, and epidemiologic data provide ample evidence for sex-specific differences in disease and drug response. Authors should review the NIH statement on sex as a biological variable (https://orwh.od.nih.gov/sex-gender/nih-policy-sex-biological-variable). It is the purview of funders to require inclusion of both vertebrate animal and human sexes in research. It is the purview of journals to review the inclusion and require adequate reporting. Consideration of sex as a biologic variable in reporting laboratory animal and human is required by Anesthesiology. Animal sex(es) should be included in the Abstract and Methods. If only one sex was studied, specification in the title may be appropriate. Discussion section should address potential implications of sex on results and conclusions, where appropriate. If research or data analysis by sex was not conducted, Discussion section should provide the rationale and discuss any implications for the interpretation. See Vutskits L, Clark JD, Kharasch ED: Reporting laboratory and animal research in Anesthesiology: The importance of sex as a biologic variable. Anesthesiology 2019;131:949-52.
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  6. Surveys
    Anesthesiology welcomes papers based on well done surveys. However, the quality of the survey methodology is often a factor in the Editor-in-Chief’s decision. Interested authors should review the material contained in the following editorial: Todd MM, Burmeister LF. Principles of Successful Sample Surveys. Anesthesiology 2003; 99: 1251-52.
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15. CME for Authors
  The first listed or last listed author of an accepted Anesthesiology manuscript can claim American Medical Association (AMA) PRA Category 1 Credit™ for their publication. The American Society of Anesthesiologists cannot award this credit, but these authors can apply directly to the AMA for 10 credits per article. Please also note that while the AMA charges a nominal amount for the credit application, authors can claim credit on a single application for multiple articles published within the past 6 years. More information about this opportunity can be found at https://www.ama-assn.org/education/claim-cme-credit-ama under the Direct Credit program or by calling the American Medical Association at 1-800-621-8335.
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Types of Articles and Content
1. Original Investigations
  The Original Investigation article type consists of the four central aspects of the medical specialty of anesthesiology:
  • Perioperative Medicine
  • Critical Care Medicine
  • Pain Medicine
  • Education
  Although there is overlap, authors will choose one of these areas as the article type during the submission process. Original investigations may include laboratory science, animal research, clinical investigations (including but not limited to clinical trials), observational research and meta-analysis (a quantitative statistical analysis of several combined separate but similar experiments or studies that measure the same outcome in order to test the pooled data for statistical significance). Consideration of a meta-analysis for peer review and publication requires a presubmission inquiry and approval for submission. See Presubmission Reviews and Proposals. Other types of Original Investigation submissions do not require presubmission approval. Original Investigation submissions range in length from 1500 to 4000 words. Abbreviated titles are required. All Original Investigations require a structured abstract (see Manuscript Preparation). Articles should be accompanied by no more than 50 references. Sources of compounds, reagents, and equipment should be identified by name and affiliation. Refer to drugs by their generic or chemical name, without abbreviation). Use a code number only when a generic name is not yet available. The identity and structure of novel research compounds, chemicals, biologics, and devices must be cited, or provided if not previously published. Report the source of cell lines, and, if known, their authentication and mycoplasma contamination status.
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2. Fast-Track Submissions
  Anesthesiology recognizes that manuscripts which communicate important clinical findings in perioperative, critical care, and pain medicine, with relevant implications for patient care, may have undergone prior external peer review by a highly regarded general medical journal but were not accepted for publication for reasons of priority. Such manuscripts may be more appropriate for a specialty journal such as Anesthesiology . To meet such needs, Anesthesiology created a new article type, Fast-Track, to evaluate such clinical manuscripts in an expeditious manner while considering the previously performed external peer review and any resulting manuscript revisions. Manuscripts that underwent a “desk review” only are not eligible for this program.
  
  Fast-Track articles must include:
  • Original decision letter received from the prior journal submission
  • All reviewer critiques received from the prior journal submission
  • Assurance that the information for items 1 and 2 is accurate, complete, and unedited
  • Assurance that the corresponding author is not subject to any confidentiality or nondisclosure obligation regarding the reviewer critiques
  • The manuscript. It is highly recommended, in order to facilitate the Anesthesiology evaluation process, that the authors submit a manuscript which has been revised to incorporate the concerns and suggestions of the prior external review. The submitted revised manuscript should be submitted in Track Changes mode (or use a different font color for revisions), along with the original manuscript which was not accepted. This is to enable rapid assessment of changes and revisions. The submitted manuscript need not be formatted according to the Anesthesiology Instructions for Authors.
  
  The goal of this process is to provide the corresponding author with an initial decision within one week. It is possible that such an initial Editor’s assessment may require additional peer review, or that such review may be required before a final decision can be rendered.
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3. Presubmission Reviews and Proposals
  Consideration of a Meta-analysis, Comprehensive Review (narrative or systematic), Clinical Focus Review, Understanding Research Methods, and Special Article for peer review and publication requires a presubmission inquiry and approval for submission. Individuals interested in writing these should submit a proposal through Editorial Manager by selecting “Submit New Manuscript” in the Author Main Menu and then selecting “Pre-submission proposal” from the list of article types.
  
  Authors will be asked to provide the following information during the submission of the proposal:
  - proposed article type;
  - list of the authors (and for reviews, their qualifications, including peer-reviewed manuscripts on the topic of a proposed article);
  - 250-word summary and outline of the proposed manuscript; do not send the full proposed manuscript.
  - for Clinical Focus Reviews, Narrative Reviews, Systematic Reviews, Meta-analysis, and Special Articles, authors are asked to identify the three most recent reviews, meta-analyses, or special articles on the topic (if existing) by providing the full citation and PMID number, and to identify objective difference(s) from those prior articles and the proposed article.
  
  NOTE: The person who submits the proposal is to be the same person who will be the designated corresponding author if the proposal is approved for submission; see Role of the Corresponding Author.
  
  Excepting these article types, Anesthesiology does not require presubmission approval. The journal editors do not provide presubmission or informal reviews of abstracts or any full manuscripts.
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4. Comprehensive Reviews
  Comprehensive Reviews (3,000 to 8,000 words) summarize and synthesize older and current ideas and publications and may suggest new concepts. They typically cover broad areas and with appropriate depth. They may be clinical, investigational, or basic science in nature and intended for one or more of these readerships. Comprehensive reviews may be Narrative Reviews or Systematic Reviews. Systematic Reviews without meta-analysis are published as Reviews, while those with meta-analysis are published as Original Investigations. Comprehensive Reviews should be written by recognized experts in the field, with requisite experience, as evidenced by substantial peer-reviewed publications in the topic area. Review articles are well-served by including summary figures and/or tables that help emphasize critical concepts. An unstructured abstract of 150 words maximum (one- or two-paragraph summary of the key points) is required. An Abbreviated Title and a Summary Statement is required on the Title Page. The Abbreviated Title should be limited to 50 characters maximum. The Summary Statement should be limited to 35 words maximum.
  
  Comprehensive Reviews are invited or require preapproval. Consideration of a Comprehensive Review for peer review and publication requires a presubmission inquiry and approval for submission. See Presubmission Reviews and Proposals for requirements and contact information.
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5. Clinical Focus Review
  Clinical Focus Review are brief reviews (2,000 to 3,000 words) focused on clinical topics. Clinical Focus Reviews are intended for the practicing clinician, should be written by individuals with substantial experience and expertise in the field, must be evidence-based, and emphasize the clinical aspects of the subject. An Abbreviated Title and a Summary Statement is required on the Title Page. The Abbreviated Title should be limited to 50 characters maximum. The Summary Statement should be limited to 35 words maximum. Articles should be accompanied by no more than 50 references. This article type has no abstract. If accepted for publication, we seek to include color illustrations (tables and/or figures) to enhance the effectiveness of the publication.
  
  Clinical Focus Reviews are invited or require pre-approval. Consideration of a Clinical Focus Review for peer review and publication requires a presubmission inquiry and approval for submission. See Presubmission Reviews and Proposals for requirements and contact information.
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6. Readers Toolbox
  Readers Toolbox articles are general educational overviews intended to increase comprehension among investigators and researchers. There is presently one type of Toolbox article, Understanding Research Methods.
  
  Understanding Research Methods: Introductory yet comprehensive articles (2,000 to 5,000 words) that present existing and emerging research methods which are, or will become, relevant to anesthesiology research. Articles are intended for non-experts, both clinicians and investigators, to help them keep abreast of new research techniques. Articles should enable readers to better read and understand the Original Investigations in Anesthesiology and make investigators aware of new tools and approaches to incorporate into their investigative armamentarium. Articles should be written by recognized experts, who have requisite experience with the new methodology as evidenced by relevant peer-reviewed publications. Articles should be approachable, clearly presented, understandable, and meaningful to a non-expert unfamiliar with the research technique. They should be attractive, readable and emphasize the use of visual and tabular information. A primer format, with gradually increasing detail as the reader gets farther into the article is a useful construct. Further information is available in (Kharasch ED: New Article Type: Understanding research methods and the readers toolbox. Anesthesiology 2019; 130:181-2).
  
  Consideration of an Understanding Research Methods article for peer review and publication requires a presubmission inquiry and approval for submission. See Presubmission Reviews and Proposals for Requirements and contact information.
  
  Articles should include the following:
  • A brief 150-word unstructured summary, figure legends and references.
  • An infographic (see Infographics in Anesthesiology -- Complex Information for Anesthesiologists Presented Quickly and Clearly) which should be numbered as figure 1.
  • An introduction which frames the general topic and general application area (basic science, clinical research, outcomes, health services, statistics, etc.); limitations of current or older methods related to the newer approach; motivation for the development of the new approach; description of the new methodology; technology; or approach (provide a working understanding not an exhaustive technical review); specific advantages and limitations of the new methods.
  • Examples of how the new method is used to address a research question might be provided; how the method is used in laboratory, clinical, or population research; ideally providing one or two “working examples.” References to seminal articles using the method would be valuable.
  • Descriptions of any specialized equipment and/or training and other practical issues, with focus on generic technology not on specific manufacturers or vendors. A brief discussion of general costs may be appropriate. Describe pertinent variations of the method and likely future evolution and application of the new method.
  • Three to six display elements (tables, text boxes, or up to 4 additional figures) which help highlight and explain the text and enhance the effectiveness of communication. Figures, tables and text boxes must be cited in the text in consecutive number order. Boxes can be used for explaining and highlighting basic concepts. Boxes must have a short title, contain up to 300 words and may include a table or equations. Text presentation in boxes may be used sparingly. Two of the boxes must be titled (1) “What to look for in research using this method” and (2) “Where to find more information on this topic.” Figures can be drawings, schematics, photographs, and/or graphs. Use of color is encouraged. Redrawing rather than reproduction of published figures is preferred. Draft figures may be included in the initial manuscript submission. Final figures should be submitted as a separate field, clearly labeled with the figure number. Each figure must have a short title and a focused legend that guides the reader through each element of the figure.
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7. Special Articles
  Anesthesiology occasionally publishes Special Articles (e.g., history, education, demography, contemporary issues, etc.). Consideration of a Special Article for peer review and publication requires a presubmission inquiry and approval for submission. See Presubmission Reviews and Proposals for requirements and contact information. An unstructured abstract of 150 word maximum (one- or two-paragraph summary of the key points) is required. An Abbreviated Title and a Summary Statement is required on the Title Page. The Abbreviated Title should be limited to 50 characters maximum. The Summary Statement should be limited to 35 words maximum.
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8. Research Letters
  Research Letters are short, focused reports on original research with important circumscribed results, but not enough for a full manuscript. They are published in the Correspondence section of Anesthesiology and are indexed in PubMed and searchable and citable. Research Letters should be in unstructured essay format (no abstract, brief summary, or key points). If needed, use separate paragraphs for background, methods, results, discussion, but do not add these as headers or separators. The text is limited to 1,000 words (excluding title, authors, references) and 10 references. The text should include the full name, academic degrees, and a single institutional affiliation for each author and the email address for the corresponding author. Authors must disclose competing interests, all funding sources (includes departmental, hospital, or institutional funds), and regulatory approval (trial registration, IRB, IACUC). Acknowledgements are not allowed. Figures and tables are limited to 2 total, and figures must be single-paneled, not multi-paneled. Online Supplemental materials may be submitted and must be numbered and cited consecutively. Examples of Supplemental material include brief additional and necessary methods or illustrative short video files. Research Letters undergo standard Journal peer review, and all Journal policies apply to Research Letters.
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9. Images in Anesthesiology
  Images in Anesthesiology (IiA) are succinct submissions that couple an interesting, novel, or highly educational image with brief text designed to highlight the pertinent information closely related to anesthesia, critical care, and pain medicine displayed by the image. Supplemental video content can be included to expand the visual learning. The focus of an IiA submission is the image itself, and key educational points raised in the body of the text should be directly related to the observation of the image. The IiA section of the Journal is not to be used as a forum for case reports. IiA manuscripts are intended to educate medical students, residents, fellows, anesthesiology practitioners, and interested physicians and scientists. IiA manuscripts are limited to 350 words, should include 3 references, and must not have more than 4 authors. The image should be one frame that on occasion might have two coupled panels. Labeling of the image should focus attention to the intended educational message. A brief figure legend (no more than 150 characters, including spaces) must be included with the submission.
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10. Mind to Mind
  Mind to Mind is a creative writing section devoted to exploring the abstract realm of our profession and our lives. Submitted works can be poetry, fiction, or creative nonfiction. Limit submissions to 1,200 words or less. Authors can be students or a current or emeritus member of the anesthesia, perioperative, critical care, or pain teams. Patients may submit writing about their medical experience. Provide a Title Page (see Title Page). The piece may be published anonymously at the author’s request, however, authors’ names, conflicts of interest, and other information are required during submission on the title page. Pieces must respect confidentiality as needed.
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11. Letters to the Editor
  The peer-review process does not necessarily stop with the publication of research articles. Letters to the Editors may offer commentary on published articles or be “freestanding.” Letters may raise issues in the conduct, reporting or interpretation of original research reported in Anesthesiology, request additional information or offer alternative interpretations and conclusions. “Freestanding” Letters to the Editor also may discuss matters of general interest to anesthesiologists, without specific linkage to recently published articles. Letters are not a venue for reporting original research findings or case reports, and authors must attest during the submission process that a case description is not included in the submission. Letters to the Editor should be brief (250 to 750 words). A few references, a small table, or a pertinent illustration may be used. For Letters commenting on a published article, the original article should be the first reference in the Letter. Supply an original title for the Letter on the Title Page. Do not submit Abbreviated Titles, Summary Statements, and Abstracts. Letters may offer criticism of published material. They must be objective and constructive.
  
  NOTE: Letters commenting on published articles will be sent to the corresponding author of that article, with an invitation to reply. Letters commenting on published articles must be received in the Editorial Office no later than two months after the first of the month of the original article print publication date.
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12. Other Article Types
  Anesthesiology also publishes 1) Editorials, 2) Classic Papers Revisited, and 3) Review of Educational Materials (book reviews). These are typically solicited. Please contact the Editorial Office for further information.
  
  NOTE: Case reports, case series, case scenarios, and correspondence/Letters to the Editors describing cases are not published by Anesthesiology and are not accepted for review (see Eisenach JC: Case reports are leaving Anesthesiology, but not the specialty. Anesthesiology 2013; 118:479).
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Data Reporting and Statistics
Detailed statistical methods must be reported for every submission. An authors’ account of findings should present an accurate report of all analyses performed as an objective interpretation and be accompanied by a considerable descriptive statistical analysis. Underlying data should be represented accurately in the manuscript. Several elements are necessary so that reviewers and readers can correctly understand and interpret your manuscript. These items and considerations are below.
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1. Identify the Study Design
  The study or research design must be clearly noted in the Title or Abstract, and Methods section of your manuscript. Be sure that the stated aims of the study can be addressed by the design of the study. Ensure there is no mismatch between the type of design and the hypotheses you wish to investigate. Describe in the Methods the type of analyses that are needed in your study design and the limitations of that design.
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2. Use the Appropriate Reporting Checklist
  Follow the appropriate reporting guidelines for your study type. To ensure that all necessary information is included, Anesthesiology recommends using the EQUATOR Network collection of reporting guidelines. The network contains guidelines and checklists for all study designs. Deviating considerably from the standard reporting guidelines may adversely impact the statistical review. Each of the guidelines has 2 major publications: a checklist identifying all necessary reporting items and how to satisfy them, and an elaboration and extension document explaining the thinking behind each reporting item. Be sure all reporting items in the checklist are addressed in your Methods section.
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3. Statistical Analysis Section
  This subsection should be included for all manuscripts that utilize any statistical methods and should appear at the end of the Materials and Methods section. There are several elements to include in this subsection:
  1. Sufficient Detail:
    Authors should include enough detail to allow replication of the analyses if given access to the data. Considerations include:
    • Tests: Describe each specific test used to examine each variable; do not simply list a series of tests. Describe how the test was applied to the data, and include the consideration of the assumptions underlying the tests (e.g., normality, independence of observations). Many tests have multiple versions (e.g., independent versus paired t-tests) so ensure that enough detail is provided to allow proper evaluation.
    • Statistical software: Clearly report the software used for the analysis. Provide links to any statistical code used to conduct bespoke analyses.
    • Hypothesis testing: Identify the nature of the hypothesis and type of testing (e.g., two-tailed).
    • Descriptive statistics: Introduce the descriptive statistics including the measures of central tendency (e.g., mean, median, etc.) and variability (e.g., standard deviation, 25th to 75th quartiles).
    • Criterion for statistical significance: If null hypothesis testing is used, define the criterion for statistical significance (e.g., p < 0.05). If appropriate, note any adjustments for multiple comparisons.
  2. Type of Measurements:
    Describe the type and nature of the measurements (e.g., categorical, ordinal, etc.). Report how the measurements are treated or coded for the analysis. If variables are transformed (e.g., log), scaled (e.g., Z-score, mean centered), or recoded (e.g., effect coding, dummy coding), report this to the reader.
  3. Statistical Power Analysis:
    A priori power analyses are important for guiding sample size during study planning and are helpful when interpreting findings. Without a power calculation, readers cannot distinguish between the lack of a “true” effect versus the mere lack of power to detect one. Authors are strongly encouraged to conduct and report an a priori statistical power calculation when utilizing null hypothesis testing. At the very least, authors should provide a rationale for why the research question(s) can be meaningfully addressed with the collected sample size. Avoid all post hoc power calculations based on p values or observed effect sizes.
  4. Clinically Significant or Practically Significant Difference:
    For many analyses, it may not be clear what effect size represents a clinically significant difference, association, or effect. In such instances it is easy for readers to confuse statistical significance with clinical significance. To assist your readers in interpreting the findings, authors are strongly encouraged to define clinical or practical significance prior to conducting the analysis. This definition should be reported to the reader.
4. Reporting Results
  1. Numerical precision:
    All prespecified outcomes should be reported, and primary outcomes treated as primary in the writing and analysis. Do not solely focus on statistically significant findings while excluding non-significant findings. Anesthesiology requires that authors do not engage in selective reporting of analyses. If an analysis was performed during the course of the study it must be included in the manuscript (placing some analyses in supplemental data files is acceptable).
  2. Missing or Lost Data:
    All missing or lost data should be reported in the Methods or Results sections. Include a description of the missing data using frequency counts. Where appropriate, report the use of missing value analyses and the consideration of bias resulting from missing data using relevant methods such as multiple imputation.
  3. Effect Size:
    Focus on descriptive statistics and effect estimates rather than dichotomous significance judgements represented by p values. Focus the results presentation on the magnitude and uncertainty of the effects. Manuscripts should heavily rely on descriptive statistics to communicate sample characteristics, which provide the context for statistical inferences. Effect estimates, corresponding 95% confidence intervals, and exact p-values should also be used to communicate the effects under study. Communicating the size of the effect and any uncertainty in it are essential for proper results reporting.
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5. Numerical Reporting
  1. Numerical precision:
    • In summarizing data using original measurements, do not report more significant digits or decimal places for central tendency (e.g., mean, median, mode) and variability (e.g., SD, IQR) than contained in the original measurements.
    • In reporting model-based estimates, contrasts, and 95%CI that are scaled according to original measurements (e.g., linear regression parameters), do not report more significant digits or decimal places than contained in the original measurements.
    • When reporting percentages (%), it is advisable to round to the nearest whole number when the sample size is N < 100. When reporting percentages for larger sample sizes, rounding to the nearest tenth is often advisable (e.g., 25.6%) unless very small differences are of interest or for percentage is close to 0% or 100%.
    • When reporting relative risks such as odds ratio (OR), hazard ratio (HR), or risk ratio (RR) and corresponding 95%CI, use the ‘rule of fours’: OR<0.400 (use three digits); OR>0.40 to OR <4.00 (use two digits); OR>4.0 (use one digit).
    • When reporting test statistics such as t, F, ꭓ², r, etc., use two decimal places (e.g., r = 0.32, t (24) = 3.45).
  2. P-values:
    Report exact p-values throughout the manuscript (e.g., p = 0.004). This is the case even for statistically non-significant values (e.g., p = 0.545). It is acceptable to round very small p-values to a convenient quantity (e.g., p < 0.001).
  3. Reporting style:
    When reporting standard deviation, use ± SD; when reporting interquartile range (IQR), use [25th, 75th]]; when separating a range of values, use “to” or “,” instead of a dash, e.g., (4 to 7); Separate decimal places with a period (e.g., 9.5); when reporting a percentage of a population that a number represents use (%) after that number.
  4. Numerator and Denominator for Percentages:
    When reporting percentages, ensure that the frequency counts for the numerator and denominator are available to the reader. This can be accomplished in line with the text, e.g., 26/100 (26%), or can be reported in relevant tables.
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Manuscript Preparation

All manuscripts should be submitted via the journal’s online submission and review system; do not submit a manuscript via e-mail. Make sure your submission is complete and correct before completing the steps to submit it to the journal office. Manuscripts that do not satisfy minimum submission requirements will be returned to authors to correct. You will have an opportunity to review the constructed PDF file before approving the submission. Review this document carefully; after it is sent to the editors and reviewers, no changes can be made until an editorial decision is reached.

All submissions require a Title Page. Manuscripts must be double-spaced. Fonts should be 10 point or larger. All four margins should be at least 2.5 cm (1 in). If a manuscript is formatted for A4 paper, leave at least a 5 cm (2 in) margin at the bottom of the page. Number pages consecutively, preferably the upper right corners.

At first submission, manuscripts may be submitted as single Word document files, including title page, references, figure legends, figures, and tables. All manuscript components need to be included to allow for evaluation of your manuscript. If the editors request a revision, however, source files of the manuscript, figures, and tables will be required as well as other submission and publication elements.

ALL articles should be arranged in the following order.
• Cover letter (optional)
• Manuscript, as a single file in word processing format (eg, .doc), consisting of Title Page, Abstract (if required for the article type; see relevant section), Body Text, References, Figure Legends, if any (in numerical order, on the same page, at the end of the manuscript file); be sure to number all pages of the manuscript file
• Tables (each Table should be a separate file in word processing file format, eg, .doc)
• Appendices (each Appendix should be a separate word processing file format, eg, .doc)
• Figures (each Figure should be a separate file in figure file format, eg, EPS, TIFF, JPG, PDF; minimum resolution 300 dpi)
• Other submission elements (Supplemental Digital Content, etc.)

PAGE NUMBERING: Number all pages in the manuscript file.
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1. Title Page
  All submissions require a Title Page with the following information on the first page(s) of the manuscript file.
  1. Article Title: (do not use abbreviations in the title).
  2. Author Information: First name, middle initial, and last name of each author, with their highest academic degree(s) (M.D., Ph.D., etc.), and institutional affiliations, institutional title or position, and institutional email address; make sure the names of and the order of authors as they appear on the Title Page and entered in the system match exactly.
  3. Corresponding Author: Name, mailing address, phone number, and e-mail address of the corresponding author; only one corresponding author may be designated for the entirety of the review and publication process; see Authorship.
  4. Clinical trial number and registry URL, if applicable. The registry, registration number, principal investigator’s name, and date of registration must be stated on the title page and in the first paragraph of the Methods section of the manuscript.
  5. Prior Presentations: Note any presentation/s of the work at conferences for meetings; include name, exact date, location.
  6. Acknowledgments: List individuals or organizations to be acknowledged, if any. Provide complete name, degrees, academic rank, department, institutional affiliation, city, state, country, and a brief description of their contribution.
  7. Word and Element Counts: Number of words in the Abstract, Introduction, and Discussion; number of Figures; number of Tables; number of Appendices, if any; number of Supplementary Digital Files, if any. Make sure all elements are submitted.
  8. Abbreviated Title (Running Head): State the essence of the article (50 characters maximum) for all article types except Images in Anesthesiology, Letters to the Editor, and Mind to Mind.
  9. Summary Statement: Brief statement (35 words maximum) to be printed in the Table of Contents for Review Article, Clinical Focus Review, and Special Article submissions.
  10. Funding Statement: Disclosure of all financial support for the work, including departmental or institutional funding/ support. Comments such as “No Funding Received” are not acceptable. If only institutional/hospital/departmental funds were used, add the following statement: “Support was provided solely from institutional and/or departmental sources.” Be sure to specify funding from any of the following organizations: National Institutes of Health (NIH), Wellcome Trust, Howard Hughes Medical Institute (HHMI) (see the section Compliance with NIH and Other Research Funding Agency Accessibility Requirements). Provide both the name and location of each funding agency/source.
  11. Conflicts of Interest: Authors must disclose all financial and non-financial relationships and activities within 36 months of manuscript submission, in accordance with International Committee of Medical Journal Editors “Uniform Requirements for Manuscripts Submitted to Biomedical Journals.” If no competing interests, please add the following statement: “The authors declare no competing interests.” Refer also to the Conflicts of Interest and Sponsorship section of the Instructions for Authors. If any of these elements are not applicable to your submission, write “not applicable” after the number and topic; for example, “5. Prior Presentations: Not applicable.”
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2. Abbreviations
  Do not use any nonstandard abbreviations. This includes in the title, abstract, text, figures, figure legends, tables, and table legends. Refer to the List of Standard Abbreviations.
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3. Abstract
  Original Investigations (Perioperative Medicine, Critical Care Medicine, Pain Medicine, and Education) require a structured abstract. It should be limited to 300 words. The structured abstract should contain four labeled paragraphs: Background, Methods, Results, and Conclusions. The abstract may be the only part of an article that is read and must stand alone and effectively convey the key elements within an article. Please ensure that the abstract communicates the research context, purpose and a hypothesis; the key methods, the most important findings (including the primary outcome, at minimum) described using numerical results (and statistical significance), and clear conclusions which are supported by those results. An Abstract with narrative results and p values is not acceptable. Any data in the Abstract must also be provided in the main Results. In order to enhance comprehension, the use of nonstandard abbreviations or acronyms in the Abstract is not allowed. Refer to the List of Standard Abbreviations. Review Articles and Special Articles require an unstructured, one- or two-paragraph summary of the key points of the article of 150 words or fewer.
  
  Make sure the text of the Abstract in the manuscript file and in the manuscript submission system match exactly.
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4. Body Text
  1. Introduction (new page).
  2. Materials and Methods (new page): A subsection entitled “Statistical Analysis” should appear at the end of the Materials and Methods section when appropriate (for comments re. Statistics). Include, as relevant, statements about informed consent, animal care, IRB approval, and/or clinical trial registration.
  3. Results (new page).
  4. Discussion (new page): The discussion should focus on the findings in the current work.
  
  The Introduction and Discussion sections should not exceed 2,000 words combined. It is recommended that the Introduction be no longer than 500 words and the Discussion section no more than 1,500 words. Manuscripts that do not meet these word limits may be sent back to the authors.
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5. References
  The following guidelines should be followed when citing other materials in your manuscript:
  
  • Number the references (as superscripts) in the sequence they appear in the text.
  
  • Use abbreviated titles of the medical journals as they appear in Index Medicus.
  
  • Include only references accessible to all readers.
  
  o Do not include material appearing in programs of meetings
  or in organizational publications.
  
  o Preprints may be cited parenthetically, in running text,
  but should not be cited in the reference list.
  
  o Sites on the World Wide Web (URLs) may be used as
  references, provided the citation includes the last accessed date.
  
  o Abstracts are acceptable as references only if published within
  the previous 3 years.
  
  o Manuscripts in preparation or submitted for publication are
  never acceptable as references.
  
  o If you cite accepted manuscripts “In Press” as references,
  please provide one electronic copy (e.g., Word, PDF) when you
  submit the new manuscript and mark them as “In Press, Reference # .”
  
  • If there are 7 or more authors in a reference, list the first 3 authors’ names, followed by et al.” When there are 6 or fewer authors in a reference, all names should be listed.
  
  Please confirm the accuracy of your references by comparison with original sources, not with someone else’s reference lists, and examine your citations for typographical errors. Supply complete publication information for all references.
  
  Anesthesiology style is that references in legends to tables and figures are cited in the order in which they occur (as if they were cited in the text). This includes references that appear only in a table or figure legend and not in the text. Because authors may use software to format references, and to ensure that references are cited in the proper order, references cited in a table or figure legend should also be cited in the text at the first (but not necessarily subsequent) callout to that figure or table; a reference should not be cited only in a table or figure legend. If references are cited only in a table or figure legend, this will require renumbering of references during composition of the manuscript and possibly delay publication.
  
  Use the following reference formats:
  
  1. Journal (article with 6 authors): Carli F, Mayo N, Klubien K, Schricker T, Trudel J, Belliveau P: Epidural analgesia enhances functional exercise capacity and health-related quality of life after colonic surgery: Results of a randomized trial. Anesthesiology 2002;97:540-9
  
  2. Journal (article with 7+ authors): Martin KT, Xin Y, Gaulton TG, et al.: Electrical impedance tomography identifies evolution of regional perfusion in a porcine model of acute respiratory distress syndrome. Anesthesiology 2023;139:815-26
  
  3. Book: Barash PG, Cullen BF, Stoelting RK: Clinical Anesthesia, 3rd edition. Philadelphia, Lippincott-Raven Publishers, 1997, pp 23-4
  
  4. Chapter: Blitt C: Monitoring the anesthetized patient, Clinical Anesthesia, 3rd edition. Edited by Barash PG, Cullen BF, Stoelting RK. Philadelphia, Lippincott-Raven Publishers, 1997, pp 563-85
  
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6. Tables
  Number tables consecutively in order of appearance (Table 1, etc.). Make sure tables are cited/called-out in the text in the correct order. Each table must have a title and include footnotes when appropriate. Make sure any symbols and abbreviations used in the tables are defined. Tables must be a word processing document. Do not submit tables as image or spreadsheet files. Tables meant to appear as online supplementary materials must be uploaded separately with the Supplemental Digital Content item type.
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7. Appendices
  Upload each appendix as a separate file. Number each appendix. Each appendix must be cited within the text, in consecutive order. Appendices will appear in the print and PDF version of the article.
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8. Figure Legends
  Supply a legend for each figure, preferably on the last page of the manuscript file. For review purposes, figures and their accompanying legends can be included as a group at the end of the manuscript file. If a revision is requested, authors are asked to supply figures as separate original source files with textual legends grouped on a single page in the manuscript file.
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9. Figures
  Figures should be prepared according to the professional standards of this Journal in appropriate file format with sufficient resolution for publication. If a single figure contains more than one panel, each panel must be identified alphabetically (e.g., A, B, etc.) and should read left to right in presentation. Figures must be cited in the text in the same consecutive numeric order. Each Figure should be submitted as a separate file, clearly labeled with the figure number (e.g., Figure1.tif, Figure2.eps, etc.). Make sure that any special symbols used in a figure (e.g., asterisk, double asterisk) are explained in the legend/caption.
  
  Format: Acceptable graphics formats are .tif, .eps, .jpg, or .pdf.
  
  Resolution: Photographic or halftone figures should be saved at 300 ppi resolution, with image sizes no smaller than 4 x 6 inches, approximately 1200 to 1800 pixels wide. Line-art, graphs, charts, diagrams must be 1200 ppi, approximately 4800 pixels wide, minimum. If images are submitted with resolutions lower than these specifications, we may be unable to publish them, even if we accept the submission. Therefore, make sure that the images submitted with your manuscript comply with these specifications.
  
  Additional detailed information about digital art for publication can be found at http://links.lww.com/ES/A42
  
  If a revision is requested, do not paste graphics into word processing documents; submit them as separate files in figure file format. NOTE: Before approving your submission, view the PDF that is created by the system to make sure images are easily legible for the editors and reviewers.
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10. Supplemental Digital Content
  Authors may submit Supplemental Digital Content to enhance article text and for consideration as online-only posting. Supplemental Digital Content may include the following types of material: text documents, graphs, tables, figures, audio, and video.
  
  Number and cite all Supplemental Digital Content consecutively in the text. In-manuscript citations (other than biographical sketches) should include the type of material submitted, should be clearly labeled as “Supplemental Digital Content,” should include a sequential number, and should provide a brief description of the supplemental content. For example: “See table, Supplemental Digital Content 1, listing all medications used in this study.” Each Supplemental Digital Content file must be composed to stand alone. For example, tables and figures must include titles, legends, and/or footnotes, following journal style, so the viewer can fully understand the supplemental content on its own. Production will not make any edits to the supplemental files; they will be presented as submitted.
  
  For text documents, graphs, tables, and figures, upload these files as PDFs in Editorial Manager. For audio and video files, enter the author’s name, videographer, participants, length (minutes), and size (MB) of file in Editorial Manager. Authors should de-identify patients and remove patients’ names from Supplemental Digital Content, obtain written consent from the patients or legal guardians, and submit written consent with the manuscript. Copyright for video or audio supplemental digital content will be required upon acceptance. For a list of acceptable file types and size limits, please review the publisher’s requirements for submitting Supplemental Digital Content.
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11. Permissions
  Permission is needed to publish any figure, abstract, portion of text, or table that has been previously published or copyrighted. Written permission must be obtained from the copyright holder. Authors are responsible for obtaining and uploading any needed permissions from the copyright holder upon submission of their manuscript and for providing proper attribution in the text of the manuscript. The following link may also be helpful: Rights and Permissions
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Journal Style Considerations
1. Claims of Primacy
  Do not make any ordinal/primacy claims, e.g., “this is the first study”; “this is the only study”; “we are the first to demonstrate.”
2. Units of Measurement
  Use metric units. The units for pressures are mmHg or cmH₂O. Diagonal slashes are acceptable for simple units, e.g., mg/kg; when more than two items are present, negative exponents should be used, i.e., ml · kg^-1 · min^-1 instead of ml/kg/min.
3. Drug Names and Equipment
  Use generic names. If a brand name must be used, insert it in parentheses after the generic name. Provide manufacturer's name, city, state, and country. Be careful about the use of trademarked terms (e.g., Thrombelastography™, TEG™, etc.).
4. Sources of Compounds
  Sources of compounds, reagents, and equipment should be identified by name and affiliation. Refer to drugs by their generic or chemical name, without abbreviation. Use a code number only when a generic name is not yet available. The identity and structure of novel research compounds, chemicals, and biologics must be cited, or provided if not previously published. Report the source of cell lines, and, if known, their authentication and mycoplasma contamination status.
5. Patient Identification
  Do not use patients' names, initials, or hospital numbers. An individual (other than an author) must not be recognizable in photographs unless written consent of the patient or legal guardian has been obtained and is provided at the time of submission. Authors should obtain consent forms from the relevant institution(s).
6. Language Editing Services
  Articles submitted to the journal must be written with a solid basis of English language. If you need assistance in this area, language editing services are available through Editage.
  
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Authors' General Checklist

Refer to specifics of article types as needed.

_____ COVER LETTER (optional)

_____ TITLE PAGE (required for all submissions):

_____ Title

_____ Authors’ Information: First name, middle initial, last name, academic degree/s, institutional affiliation/s for each author, institutional title(s)/position for each author

_____ Corresponding Author: Name, complete mailing address, phone and institutional email address (Noninstitutional email addresses are not acceptable unless there is no institutional email address)

_____ Clinical trial number and registry URL, if applicable. The registry, registration number, principal investigator's name, and date of registration for the clinical trial must be stated on the title page as well as in the first paragraph of the Methods section of the manuscript

_____ Prior Presentations: Meetings at which the work has been presented (name, exact date, location), if relevant

_____ Preprint Server: URL, author list, title, and name of preprint server, if previously posted on a preprint server

_____ Acknowledgments: Complete information about individuals or organizations whose assistance is acknowledged (note: describe any author or collaborator Groups in an Appendix)

_____ Word and Element Counts: Number of words in Abstract, in Introduction, and in Discussion; number of figures; number of tables; number of appendices, if any; and number of supplementary files, if any.

_____ Abbreviated Title (Running Head): State the essence of the article (50 characters maximum) for all article types except Images in Anesthesiology, Letters to the Editor, Editorials, and Mind to Mind

_____ Summary Statement: A brief statement (35 words maximum) to be printed in the Table of Contents for Review Article, Clinical Focus Review, and Special Article submissions

_____ Funding Statement: Sources of financial support for the work (including institutional support--do not leave blank); provide both the name and location of each funding agency/source.

_____ Conflicts of Interest

_____ STRUCTURED ABSTRACT (300 words or fewer) as relevant to article type:

_____ Background

_____ Methods

_____ Results

_____ Conclusions

_____ BODY OF MANUSCRIPT:

_____ Page Numbers (consecutive, upper right corner)

_____ Introduction

_____ Materials & Methods

_____ Statistics, if applicable

_____ Results

_____ Discussion

_____ References

_____ Figure Legends

_____ TABLES

_____ APPENDICES, if any (e.g., author or collaborator Groups, and individual members, thereof)

_____ FIGURES

_____ SUPPLEMENTAL DIGITAL CONTENT, if any

_____ COPIES OF LISTED IN-PRESS PAPERS, if any

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