Towards automation in anaesthesia: A review

Surgeries represent a risk for patients and a big cost for the hospital. Anaesthesia represents a complex part of surgery also carries risks for patients. The most known are awareness (with deep psychological consequences); increased risk of morbidity and mortality; adverse reactions and long post-op recovery. The complexity of anaesthesia management can be reduced by studying the patients´ responses and developing indicators of the patient state. To assess the level of depth of anaesthesia, the anaesthetist needs to be aware of the patient physiological responses to the drugs and to surgical stimuli. A system that could advise on the patient state considering all clinical signs being measured, the patient individual response and the amount of drugs, will have a big impact on patient overall safety and future health, post-op recovery and hospital resources. This paper does a review of different systems and methods applied to several aspects of the anaesthesia field. All with the goal of working towards automation in this very complex area, that involves high risks for patients. This paper covers advisor systems; signal processing; new monitors and devices; mathematical modelling; and control algorithms; all focused on practical clinical implementation. The objective is to have an overview of the work done so far and the steps taken towards automation in anaesthesia.