Automated anesthesia.
OBJECTIVE
Anesthesiologists are overloaded with information and multitasking necessities in an extremely complex work environment. The purpose of this review is to present recent developments toward automated anesthesia and present future technologies for everyday clinical practice.


RESULTS
Decision support systems integrate different parameters, clinical scenarios and assessments by (non)-trained personnel into algorithms, which lead to diagnostic suggestions, triage evaluations or treatment options. Target-controlled anesthesia infusion systems reduce the anesthesiologist's workload; target-controlled analgesia systems have the potential to provide more stable hemodynamic control. Closed-loop delivery of anesthesia is feasible and provides anesthetic control as good as or better than human delivery. Teleanesthesia offers the possibility of distant preoperative assessment of the patient's fitness for anesthesia, aid of trained personnel to perform anesthetic tasks and the control of anesthesia delivery in a distant location.


CONCLUSIONS
Decision support systems help to make reliable and standardized decisions in complex environments. Target-controlled infusion systems reduce the anesthetic workload. Closed-loop systems will automate anesthesia care in the near future. Teleanesthesia offers the opportunity to provide safe anesthetic care whenever trained personnel are not available or need support.
Hemmerling
Thomas M
TM
Department of Anesthesiology, McGill University, Canada. thomas.hemmerling@mcgill.ca
D000758:Anesthesia / Q000379:methods*; D000764:Anesthesia, Closed-Circuit; D000777:Anesthetics / Q000008:administration & dosage; D001331:Automation; D003243:Consciousness / Q000187:drug effects; D020000:Decision Support Systems, Clinical; D006801:Humans; D007262:Infusions, Intravenous; D010146:Pain / Q000517:prevention & control; D017216:Telemedicine
D000777:Anesthetics