First Fully Automated Anesthesia System

A totally automated anesthetic system administers drugs for general anesthesia (GA) and monitors their separate effects completely automatically, with no manual intervention.

A team of anesthesiologists, biomedical scientists, and engineers at McGill University Health Center (MUHC, Montreal, Canada) who form a group called ITAG (Intelligent Technology in Anesthesia research group), developed the automated system, which measures three separate parameters displayed on an integrated monitor of anesthesia (IMATM): depth of hypnosis via electroencephalogram (EEG) analysis, pain via a new pain score called Analgoscore, and muscle relaxation via phonomyography, all developed by ITAG. The system then administers the appropriate drugs using conventional infusion pumps, controlled by a laptop computer on which the system, which has been nicknamed "McSleepy,” is installed. Using these three separate parameters and complex algorithms, the automated system calculates faster and more precisely than a human can, the appropriate drug doses for any given moment of anesthesia. This allows anesthesiologists to focus more on other aspects of direct patient care.

The system interface resembles current displays and provides a detailed clinical picture of what is going on and what has happened. The system can also communicate with personal digital assistants (PDAs), making distant monitoring, and anesthetic control possible. In addition, the technology can be easily incorporated into modern medical teaching programs such as simulation centers and web-based learning platforms. The anesthetic technique was used for the first time on a patient who underwent a partial nephrectomy, a procedure that removes a kidney tumor while leaving the non-cancerous part of the kidney intact, over a period of 3 hours and 30 minutes. A commercial version of the totally automated anesthetic system might be available within the next five years.

"We have been working on closed-loop systems, where drugs are administered, their effects continuously monitored, and the doses are adjusted accordingly, for the last 5 years,” said Thomas Hemmerling, M.D., of the MUHC department of anesthesia and the head of ITAG. "Think of ‘McSleepy' as a sort of humanoid anesthesiologist that thinks like an anesthesiologist, analyses biological information and constantly adapts its own behavior, even recognizing monitoring malfunction.”

"It will probably take two years to perfect the system,” added Dr. Hemmerling. "Many people are reluctant to rely on automated systems, especially when they are not visible--it is not clear what they are actually doing or how; [it is] the fear of a ‘black box' which suddenly takes over.”


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McGill University Health Centre