The bibliometrics of the anesthesiology literature has shifted substantially during the past 3 decades. The present authors analyzed the Journal of Cardiothoracic and Vascular Anesthesia (JCVA) at selected time intervals from 1990 to 2011 to quantify temporal variations in geographic publication patterns. The authors also determined whether previously described reductions in North American research productivity were accompanied by similar decreases in the number of other forms of publication in JCVA.