There are autopilots to help fly airplanes, automatic cruise control in our cars, and soon, thanks to work from Canadian researchers, there could be automatic anesthesia delivery machines in surgical wards.
Anesthesia is a tricky field of medicine. Decades ago, doctors thought that when it came to sedation, the more, the better. Keeping patients in adeep sleep was better than risking them waking on the operating table.
But now, doctors know that too much anesthesia can hinder recovery. It can also lead to brain development problems in children who have to go through surgery.
So doctors have worked to keep the dose low by calculating anesthesia based on a patient’s weight and age. But over the course of a long surgery, it can be difficult to maintain just the right amount of sedation.
But now, a new device being tested by University of British Columbia researchers, called iControl-RP, takes out some of the guess work of anesthesia. It’s an automatic dosing machine that monitors a patient’s brainwave activity along with their blood oxygen levels to determine how much anesthesia to deliver, minute by minute.
If a patient’s EEG shows she is awakening or feeling pain, it delivers more propofol or fentanyl to keep her sedated. If the device detects the patient is slipping too deeply into sleep, it dials back the dose.
Guy Dumont, a professor of electrical and computer engineering at the University of British Columbia who helped develop the device, says it allows for personalized anesthesia.
“With such a system, we give exactly the amount of drug required… which means we personalize anesthesia to the personal needs of the patient -- something that is very difficult to do without technology,” he says.
Dr. Mark Ansermino, a pediatric anesthesiologist at B.C. Children's Hospital who has helped test the device, says that because it continuously monitors the patient, it will cut the risk of human error.
“I think there are many tasks that can be done much better by a machine than can be manually done by an anesthesiologist,” he says.
While the iControl-RP is not meant to replace an anesthesiologist in the operating room, it provides them with a better tool to achieve the right level of anesthesia.
“This is the innovation that will take us to the next level in improved safety to patients under anesthesia,” he says.
The iControl-RP has already been tested in 400 surgical procedures, with early data showing it's as safe as standard human-delivered anesthesia.
The U.S. Navy is now planning to evaluate the automated system in emergency surgeries of soldiers injured on the field, where an anesthesiologist is often unavailable.
With a report from CTV medical specialist Avis Favaro and producer Elizabeth St. Philip
