title: A pilot study of tele-anaesthesia by virtual private network between an island hospital and a mainland hospital in Japan.
abstract: We studied the use of tele-anaesthesia between Sado General Hospital (SGH) located on Sado Island and Yokohama City University Hospital (YCUH) located in mainland Japan. The two sites were connected via a virtual private network (VPN). We investigated the relationship between the bandwidth of the VPN and both the frame rate and the delay time of the tele-anaesthesia monitoring system. The tool used for communication between the two hospitals was free videoconferencing software (FaceTime), which can be used over Wi-Fi connections. We also investigated the accuracy of the commands given during teleanaesthesia: any commands from the anaesthetist at the YCUH that were not carried out for any reason, were recorded in the anaesthetic records at the SGH. The original frame rate and data rate at the SGH were 5 fps and approximately 18 Mbit/s, respectively. The frame rate at the transmission speeds of 1, 5 and 20 Mbit/s was 0.6, 1.6 and 5.0 fps, respectively. The corresponding delay time was 12.2, 4.9 and 0.7 s. Twenty-five adult patients were enrolled in the study and tele-anaesthesia was performed. The total duration of anaesthesia was 37 hours. All 888 anaesthetic commands were completed. There were 7 FaceTime disconnections, which lasted for 10 min altogether. Because no commands needed to be given during the FaceTime disconnection, the telephone was not used. The anaesthesia assistance system might form part of the solution to medical resource shortages.
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan yushukyo@gmail.com.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Miyashita
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Mizuno
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Yo
authors.initials: Y
authors.lastname: Sugawara
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Yusuka
authors.initials: Y
authors.lastname: Nagamine
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Yukihide
authors.initials: Y
authors.lastname: Koyama
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Miyazaki
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Uchimoto
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Iketani
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Tojo
authors.affiliation: Department of Anesthesiology, Yokohama City University Hospital, Japan.
authors.forename: Takahisa
authors.initials: T
authors.lastname: Goto
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D000758:Anesthesia / Q000379:methods*; D005260:Female; D006769:Hospitals, General / Q000706:statistics & numerical data; D006801:Humans; D007564:Japan; D008297:Male; D016343:Monitoring, Intraoperative / Q000379:methods; D010865:Pilot Projects; D012984:Software; D017216:Telemedicine / Q000379:methods*; D049269:Videoconferencing / Q000295:instrumentation / Q000592:standards