Autonomous Systems in Anesthesia: Where Do We Stand in 2020? A Narrative Review.

Abstract:

:As most of us are aware, almost every facet of our society is becoming, for better or worse, progressively more technology-dependent. Technological advancement has made autonomous systems, also known as robots, an integral part of our life in several fields, including medicine. The application of robots in anesthesia could be classified into 3 types of robots. The first ones are pharmacological robots. These robots are based on closed-loop systems that allow better-individualized anesthetic drug titration for optimal homeostasis during general anesthesia and sedation. Recent evidence also demonstrates that autonomous systems could control hemodynamic parameters proficiently outperforming manual control in the operating room. The second type of robot is mechanical. They enable automated motorized reproduction of tasks requiring high manual dexterity level. Such robots have been advocated to be more accurate than humans and, thus, could be safer for the patient. The third type is a cognitive robot also known as decision support system. This type of robot is able to recognize crucial clinical situation that requires human intervention. When these events occur, the system notifies the attending clinician, describes relevant related clinical observations, proposes pertinent therapeutic options and, when allowed by the attending clinician, may even administer treatment. It seems that cognitive robots could increase patients' safety. Robots in anesthesia offer not only the possibility to free the attending clinicians from repetitive tasks but can also reduce mental workload allowing them to focus on tasks that require human intelligence such as analytical and clinical approach, lifesaving decision-making capacity, and interpersonal interaction. Nevertheless, further studies have yet to be done to test the combination of these 3 types of robots to maintain simultaneously the homeostasis of multiple biological variables and to test the safety of such combination on a large-scale population.

journal_name

Anesth Analg

journal_title

Anesthesia and analgesia

authors

Zaouter C,Joosten A,Rinehart J,Struys MMRF,Hemmerling TM

doi

10.1213/ANE.0000000000004646

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

1120-1132

issue

5

eissn

0003-2999

issn

1526-7598

pii

00000539-202005000-00006

journal_volume

130

pub_type

杂志文章,评审
  • The use of a laryngeal mask airway after a prolonged suspension laryngoscopy to preserve a vocal cord fat graft.

    abstract::A 62-yr-old man presented for a microdirect laryngoscopy and vocal cord fat grafting under jet ventilation. After a prolonged laryngoscopy, the patient developed hypercapnea and upper airway obstruction secondary to traumatic epiglottitis. The placement of a laryngeal mask airway provided ventilation and allowed for d...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000286322.04940.a5

    authors: Kidani DC,Shah NK

    更新日期:2007-12-01 00:00:00

  • Continuous gastric decompression for postoperative nausea and vomiting after coronary revascularization surgery.

    abstract::Postoperative nausea and vomiting is common after cardiac surgery and may contribute to significant morbidity. Gastric decompression during anesthesia has been used for postoperative nausea and vomiting prophylaxis in shorter duration noncardiac surgery with conflicting results. We tested the hypothesis that gastric d...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/01.ANE.0000143567.51304.1A

    authors: Burlacu CL,Healy D,Buggy DJ,Twomey C,Veerasingam D,Tierney A,Moriarty DC

    更新日期:2005-02-01 00:00:00

  • Experimental neuropathy in mice is associated with delayed behavioral changes related to anxiety and depression.

    abstract:BACKGROUND:Patients with chronic pain frequently suffer affective disorders, particularly anxiety and depression. Although clinical research on the relationship between pain and depressive symptoms has been done, it is not clear whether pain causes depression or depression exaggerates pain. To investigate the relation ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000261514.19946.66

    authors: Suzuki T,Amata M,Sakaue G,Nishimura S,Inoue T,Shibata M,Mashimo T

    更新日期:2007-06-01 00:00:00

  • Sorptive loss of volatile and gaseous anesthetics from in vitro drug application systems.

    abstract::In in vitro pharmacological experiments, determination of effective concentration values for various anesthetics depends on understanding the exact concentration of the drugs dissolved in physiological solutions. Actual anesthetic concentration may differ from expectations because of drug adsorption, absorption or oth...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ANE.0000142112.30807.5C

    authors: Suzuki T,Uchida I,Mashimo T

    更新日期:2005-02-01 00:00:00

  • Comparison of intramuscular dexmedetomidine and midazolam premedication for elective abdominal hysterectomy.

    abstract::The purpose of this study was to compare the perioperative effects of the intramuscular (i.m.) alpha 2 agonist, dexmedetomidine (DEX), and midazolam (MID) premedication. The study comprised 192 women (64 per group) scheduled for abdominal hysterectomy. The doses of the study drugs were chosen to obtain equal sedative ...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1213/00000539-199410000-00006

    authors: Erkola O,Korttila K,Aho M,Haasio J,Aantaa R,Kallio A

    更新日期:1994-10-01 00:00:00

  • Effect of local anesthetic dilution on the onset time and duration of double-injection sciatic nerve block: a prospective, randomized, blinded evaluation.

    abstract:BACKGROUND:Among the various factors influencing the success rate, onset time, and duration of peripheral nerve blocks, the role of local anesthetics concentration remains uncertain. In this prospective, randomized, single-blinded study, we evaluated whether varying the dilution of a fixed dose of mepivacaine solution ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000000293

    authors: Cappelleri G,Ambrosoli AL,Turconi S,Gemma M,Ricci EB,Cornaggia G

    更新日期:2014-08-01 00:00:00

  • Barbiturate-benzodiazepine interactions at the gamma-aminobutyric acidA receptor in rat cerebral cortical synaptoneurosomes.

    abstract::Combinations of benzodiazepines (midazolam and diazepam) with barbiturates (pentobarbital and phenobarbital) exhibit synergistic (supra-additive) hypnotic interactions in rats. Because both benzodiazepines and barbiturates interact with the gamma-aminobutyric acidA (GABAA) receptor complex, we have tested the hypothes...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-199309000-00030

    authors: DeLorey TM,Kissin I,Brown P,Brown GB

    更新日期:1993-09-01 00:00:00

  • Ventilatory support using bilevel positive airway pressure during neuraxial blockade in a patient with severe respiratory compromise.

    abstract::In pregnant patients with myasthenia gravis and respiratory compromise, neuraxial anesthesia for lower abdominal surgery can risk further respiratory depression. We report the use of epidural anesthesia for dilation and curettage and tubal ligation in a 26-yr-old woman with a 12-wk intrauterine pregnancy with severe m...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000198335.89760.ed

    authors: Warren J,Sharma SK

    更新日期:2006-03-01 00:00:00

  • Distribution of Extreme Vital Signs and Complete Blood Count Values of Healthy Parturients: A Retrospective Database Analysis and Review of the Literature.

    abstract:BACKGROUND:The impact of physiological adjustments throughout pregnancy on maternal vital signs and laboratory values has yet to be fully defined. The present study was designed to determine the normal range of these parameters among healthy pregnant women during the peripartum period. METHODS:This is a retrospective ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000003866

    authors: Gat R,Hadar E,Orbach-Zinger S,Shochat T,Kushnir S,Einav S

    更新日期:2019-12-01 00:00:00

  • Preserved CO(2) reactivity and increase in middle cerebral arterial blood flow velocity during laparoscopic surgery in children.

    abstract:UNLABELLED:In adult patients, the creation of pneumoperitoneum (PP) by means of carbon dioxide (CO(2)) insufflation leads to an increase in cerebral blood flow velocity (CBFV), which is thought to be caused by hypercapnia. We evaluated whether PP leads to an increase of CBFV in children, and whether this increase is di...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-200202000-00005

    authors: Huettemann E,Terborg C,Sakka SG,Petrat G,Schier F,Reinhart K

    更新日期:2002-02-01 00:00:00

  • Postoperative Cognitive Dysfunction and the Change of Regional Cerebral Oxygen Saturation in Elderly Patients Undergoing Spinal Surgery.

    abstract:BACKGROUND:In this study, we examined the relationship between postoperative cognitive dysfunction (POCD) and intraoperative regional cerebral oxygen saturation (rSO2) in elderly patients undergoing spinal surgery. METHODS:We enrolled 87 patients older than 65 years. All patients were tested using a battery of cogniti...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000001352

    authors: Kim J,Shim JK,Song JW,Kim EK,Kwak YL

    更新日期:2016-08-01 00:00:00

  • The Cognitive Science of Learning: Concepts and Strategies for the Educator and Learner.

    abstract::Education is the fundamental process used to develop and maintain the professional skills of physicians. Medical students, residents, and fellows are expected to learn considerable amounts of information as they progress toward board certification. Established practitioners must continue to learn in an effort to remai...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,评审

    doi:10.1213/ANE.0000000000000890

    authors: Weidman J,Baker K

    更新日期:2015-12-01 00:00:00

  • Aromatherapy as treatment for postoperative nausea: a randomized trial.

    abstract:BACKGROUND:Postoperative nausea (PON) is a common complication of anesthesia and surgery. Antiemetic medication for higher-risk patients may reduce but does not reliably prevent PON. We examined aromatherapy as a treatment for patients experiencing PON after ambulatory surgery. Our primary hypothesis was that in compar...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e31824a0b1c

    authors: Hunt R,Dienemann J,Norton HJ,Hartley W,Hudgens A,Stern T,Divine G

    更新日期:2013-09-01 00:00:00

  • Different responses of ear and finger pulse oximeter wave form to cold pressor test.

    abstract::The cold pressor test is often used to assess vasoconstrictive responses because it simulates the vasoconstrictive challenges commonly encountered in the clinical setting. With IRB approval, 12 healthy volunteers, aged 25--50 yr, underwent baseline plethysmographic monitoring on the finger and ear. The contralateral h...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200106000-00026

    authors: Awad AA,Ghobashy MA,Ouda W,Stout RG,Silverman DG,Shelley KH

    更新日期:2001-06-01 00:00:00

  • Identification of the correct cervical level by palpation of spinous processes.

    abstract:BACKGROUND:The ability to identify the correct vertebral level through examination is an important skill for clinicians who are performing nerve blocks without fluoroscopy. The conventional palpation method, which identifies the most prominent cervical spinous process as the seventh cervical (C7) spinous process is unr...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0b013e3182110f9f

    authors: Shin S,Yoon DM,Yoon KB

    更新日期:2011-05-01 00:00:00

  • A preplanned treatment for malignant hyperpyrexia.

    abstract::Although a rare complication of general anesthesia, unanticipated malignant hyperpyrexia requires a rapid, organized treatment plan. With the aid of a treatment protocol sheet and a compact drug and cooling package, treatment can be implemented quickly in each operating room. ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/00000539-197609000-00022

    authors: Fraser JG,Crumrine RS,Izant RJ Jr

    更新日期:1976-09-01 00:00:00

  • Effect of halothane, enflurane, and nitrous oxide on tracheal ciliary activity in vitro.

    abstract::Effects of halothane, enflurane, and nitrous oxide on ciliary beats were evaluated using a photoelectric system in dissected rabbit tracheal segments. Dose-dependent suppression of the frequency of ciliary beats of moderate degrees was observed after exposure of tracheal segments to warmed and humidified vapors of hal...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: Lee KS,Park SS

    更新日期:1980-06-01 00:00:00

  • Cerebrovascular cytokine responses during coronary artery bypass surgery: specific production of interleukin-8 and its attenuation by hypothermic cardiopulmonary bypass.

    abstract:UNLABELLED:Brain dysfunction after cardiopulmonary bypass (CPB) is common, and it has been hypothesized that this injury might be due partly to activation of inflammatory processes in the brain. We measured juguloarterial gradients for interleukin-1beta, interleukin-6, and interleukin-8 (IL-8) as indices of local proin...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199910000-00003

    authors: Nandate K,Vuylsteke A,Crosbie AE,Messahel S,Oduro-Dominah A,Menon DK

    更新日期:1999-10-01 00:00:00

  • Continuous Transversus Abdominis Plane Nerve Blocks: Does Varying Local Anesthetic Delivery Method-Automatic Repeated Bolus Versus Continuous Basal Infusion-Influence the Extent of Sensation to Cold?: A Randomized, Triple-Masked, Crossover Study in Volunt

    abstract:BACKGROUND:It remains unknown whether continuous or scheduled intermittent bolus local anesthetic administration is preferable for transversus abdominis plane (TAP) catheters. We therefore tested the hypothesis that when using TAP catheters, providing local anesthetic in repeated bolus doses increases the cephalad-caud...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ANE.0000000000001939

    authors: Khatibi B,Said ET,Sztain JF,Monahan AM,Gabriel RA,Furnish TJ,Tran JT,Donohue MC,Ilfeld BM

    更新日期:2017-04-01 00:00:00

  • A comparison of general anesthesia and lumbar epidural analgesia for elective cesarean section.

    abstract::Controversy exists concerning the choice of anesthetic technic for elective cesarean section. Several maternal and newborn parameters were compared during general anesthesia (GA) and lumbar epidural analgesia (LEA). High inspired maternal O2 levels were achieved with both technics. Vigorous, well-oxygenated infants wi...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:

    authors: James FM 3rd,Crawford JS,Hopkinson R,Davies P,Naiem H

    更新日期:1977-03-01 00:00:00

  • Dexamethasone added to lidocaine prolongs axillary brachial plexus blockade.

    abstract::Different additives have been used to prolong regional blockade. We designed a prospective, randomized, double-blind study to evaluate the effect of dexamethasone added to lidocaine on the onset and duration of axillary brachial plexus block. Sixty patients scheduled for elective hand and forearm surgery under axillar...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/01.ane.0000189055.06729.0a

    authors: Movafegh A,Razazian M,Hajimaohamadi F,Meysamie A

    更新日期:2006-01-01 00:00:00

  • Assessing cognitive and psychomotor performance under long-term treatment with transdermal buprenorphine in chronic noncancer pain patients.

    abstract:BACKGROUND:The therapeutic use of opioids has been associated with altered cognition and impaired psychomotor function. Several studies have demonstrated the impact of opioid therapy on psychomotor performance and cognition, but there are no data about the effect of long-term treatment with transdermal buprenorphine on...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/01.ane.0000281078.65585.1e

    authors: Dagtekin O,Gerbershagen HJ,Wagner W,Petzke F,Radbruch L,Sabatowski R

    更新日期:2007-11-01 00:00:00

  • Comparison of Thrombelastography-Derived Fibrinogen Values at Rewarming and Following Cardiopulmonary Bypass in Cardiac Surgery Patients.

    abstract:BACKGROUND:The inflated costs and documented deleterious effects of excess perioperative transfusion have led to the investigation of targeted coagulation factor replacement strategies. One particular coagulation factor of interest is factor I (fibrinogen). Hypofibrinogenemia is typically tested for using time-consumin...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/ANE.0000000000001465

    authors: Fabbro M 2nd,Gutsche JT,Miano TA,Augoustides JG,Patel PA

    更新日期:2016-09-01 00:00:00

  • Intraoperative patient-controlled analgesia: an alternative to physician administration during outpatient monitored anesthesia care.

    abstract::Outpatients undergoing minor diagnostic and therapeutic procedures associated with intermittent discomfort are frequently given bolus injections of intravenous opioid analgesics. In a group of 80 healthy women undergoing vaginal ovum pickup procedures, we evaluated patient-controlled administration of alfentanil using...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1213/00000539-199207000-00008

    authors: Zelcer J,White PF,Chester S,Paull JD,Molnar R

    更新日期:1992-07-01 00:00:00

  • Transdermal nicotine for analgesia after radical retropubic prostatectomy.

    abstract:BACKGROUND:Previous animal and human studies suggested that nicotine might have an antinociceptive effect. We hypothesized that the preoperative application of a 7 mg nicotine patch would result in reduced postoperative analgesic requirements in patients undergoing radical retropubic prostatectomy (RRP) under general a...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章,随机对照试验

    doi:10.1213/ane.0b013e31816f2616

    authors: Habib AS,White WD,El Gasim MA,Saleh G,Polascik TJ,Moul JW,Gan TJ

    更新日期:2008-09-01 00:00:00

  • The effects of general anesthesia and surgery on basal and interferon stimulated natural killer cell activity of humans.

    abstract:UNLABELLED:Natural killer (NK) cells can lyse certain tumor cells as well as virally infected cells without prior sensitization. Animal studies have shown that general anesthesia (GA) alone or GA followed by surgery decreases both basal NK cytotoxicity and enhancement of NK activity by interferon (IFN). The purpose of ...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199710000-00037

    authors: Kutza J,Gratz I,Afshar M,Murasko DM

    更新日期:1997-10-01 00:00:00

  • Ultrasound-guided peripheral nerve stimulator placement in two soldiers with acute battlefield neuropathic pain.

    abstract::Acute peripheral neuropathic pain after combat-related polytrauma is a common occurrence in the United States military that is often refractory to current drugs and regional anesthesia. Both spinal cord and peripheral nerve stimulation are successfully used for chronic neuropathic pain states, but are not reported for...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0b013e318247f6b2

    authors: Kent M,Upp J,Spevak C,Shannon C,Buckenmaier C 3rd

    更新日期:2012-04-01 00:00:00

  • Antinociceptive potentiation and attenuation of tolerance by intrathecal co-infusion of magnesium sulfate and morphine in rats.

    abstract:UNLABELLED:N-methyl-D-aspartate (NMDA) antagonists, such as MK801, delay the development of morphine tolerance. Magnesium, a noncompetitive NMDA antagonist, reduces postoperative morphine requirements. The present study was designed to evaluate the effects of intrathecal co-administration of magnesium sulfate with morp...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1097/00000539-199804000-00028

    authors: McCarthy RJ,Kroin JS,Tuman KJ,Penn RD,Ivankovich AD

    更新日期:1998-04-01 00:00:00

  • The effects of sevoflurane and halothane anesthesia on cerebral blood flow velocity in children.

    abstract:UNLABELLED:We compared cerebral blood flow velocity during anesthesia with sevoflurane and halothane in 23 children admitted for elective surgery (age, 0.4-9.7 yr; median age, 1.9 yr; ASA physical status I-II). Inhaled induction was performed in a randomized sequence with sevoflurane or halothane. Under steady-state co...

    journal_title:Anesthesia and analgesia

    pub_type: 临床试验,杂志文章

    doi:10.1097/00000539-200104000-00017

    authors: Mönkhoff M,Schwarz U,Gerber A,Fanconi S,Bänziger O

    更新日期:2001-04-01 00:00:00

  • Ryanodine Receptor to Mitochondrial Reactive Oxygen Species Pathway Plays an Important Role in Chronic Human Immunodeficiency Virus gp120MN-Induced Neuropathic Pain in Rats.

    abstract:BACKGROUND:Chronic pain is one of the most common complaints in patients with human immunodeficiency virus (HIV)-associated sensory neuropathy. Ryanodine receptor (RyR) and mitochondrial oxidative stress are involved in neuropathic pain induced by nerve injury. Here, we investigated the role of RyR and mitochondrial su...

    journal_title:Anesthesia and analgesia

    pub_type: 杂志文章

    doi:10.1213/ANE.0000000000003916

    authors: Godai K,Takahashi K,Kashiwagi Y,Liu CH,Yi H,Liu S,Dong C,Lubarsky DA,Hao S

    更新日期:2019-07-01 00:00:00