Advances in Medicine-Engineering Crossover in Automated Anesthesia

doi:10.1007/s12204-021-2329-x

摘要/Abstract

Abstract: Medicine-engineering crossover refers to the cross-fertilization of multiple disciplines to meet clinical needs through various means, including engineering, which greatly promotes medical development. In the development of anesthesiology, improvements in anesthesia equipment and continuous innovation of anesthesia technology are all closely related to the integration of medicine and engineering. In recent years, the exploration and development of automated anesthesia equipment has led to closer integration of medicine, engineering, and other disciplines, including the development of robots in anesthesia, automated monitoring and alarm technology,automated perioperative management, and remote anesthesia. Herein, the current status of applications and development of medicine-engineering crossover in the field of automated anesthesia are discussed.

Key words: medicine-engineering crossover, automation, anesthesia, robotics

中图分类号:

R 4
R 197.39

. [J]. J Shanghai Jiaotong Univ Sci, 2022, 27(2): 137-143.

XU Tianyi (徐天意), XIA Ming (夏明), JIANG Hong (姜虹). Advances in Medicine-Engineering Crossover in Automated Anesthesia[J]. J Shanghai Jiaotong Univ Sci, 2022, 27(2): 137-143.

参考文献 62

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[44]	WINTERS B D, CVACH M M, BONAFIDE C P, et
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	al. Technological distractions (part 2): A summary of approaches to manage clinical alarms with intent to reduce alarm fatigue [J]. Critical Care Medicine, 2018,46(1): 130-137.
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	epidural catheter localization using ultrasound guid ance [J]. Pediatric Anesthesia, 2020, 30(2): 194-195.
[48]	MIRZA M, GHOLAMHOSSEINI H, HARRISON M J. A fuzzy logic-based system for anaesthesia monitor ing [C]//2010 Annual International Conference of the IEEE Engineering in Medicine and Biology. Buenos Aires, Argentina: IEEE, 2010: 3974-3977.
[32]	QU B, CHEN L Y, ZHANG Y L, et al. Landmark guided versus modified ultrasound-assisted Parame dian techniques in combined spinal-epidural anesthesia for elderly patients with hip fractures: A randomized controlled trial [J]. BMC Anesthesiology, 2020, 20(1): 248.
[49]	EAPEN Z J, PETERSON E D. Can mobile health
[33]	ELSHARKAWY H, SAASOUH W, BABAZADE R, et al. Real-time ultrasound-guided lumbar epidural with transverse interlaminar view: Evaluation of an in plane technique [J]. Pain Medicine, 2019, 20(9): 1750-1755.
	applications facilitate meaningful behavior change?:Time for answers [J]. JAMA, 2015, 314(12): 1236-1237.
[34]	MORIMOTO Y, IHARA Y, SHIMAMOTO Y, et al.
[50]	MICHARD F, BARRACHINA B, SCHOETTKER P.
	Use of ultrasound for spinal anesthesia in a super mor bidly obese patient [J]. Journal of Clinical Anesthesia,2017, 36: 88-89.
	Is your smartphone the future of physiologic monitor ing? [J]. Intensive Care Medicine, 2019, 45(6): 869-871.
[35]	LI M Z, NI X, XU Z D, et al. Ultrasound-assisted
[51]	WHITE S M. Automated electronic anaesthesia
	technology versus the conventional landmark location method in spinal anesthesia for cesarean delivery in obese parturients: A randomized controlled trial [J].Anesthesia and Analgesia, 2019, 129(1): 155-161.
	records [J]. Anaesthesia, 2016, 71(7): 850-851.
[36]	PARK S K, YOO S, KIM W H, et al.Ultrasound assisted vs. landmark-guided paramedian spinal anaes thesia in the elderly: A randomised controlled trial [J].European Journal of Anaesthesiology, 2019, 36(10):763-771.
[52]	NAIR B G, NEWMAN S F, PETERSON G N, et al.
[37]	CONROY P H, LUYET C, MCCARTNEY C J, et
	Automated electronic reminders to improve redosing of antibiotics during surgical cases: Comparison of two approaches [J]. Surgical Infections, 2011, 12(1): 57-63.
	al. Real-time ultrasound-guided spinal anaesthesia: A prospective observational study of a new approach [J]. Anesthesiology Research and Practice, 2013, 2013:525818.
[53]	YEOH C, MASCARENHAS J, TAN K S, et
[38]	KARMAKAR M K, LI X, HO A M H, et al. Real-time ultrasound-guided paramedian epidural access: Evalu ation of a novel in-plane technique [J]. British Journal of Anaesthesia, 2009, 102(6): 845-854.
	al. Automated notifications improve time to anes thesia induction: Integrating health information technology systems to enhance perioperative ef ficiency [J]. Anaesthesia and Anaesthetics, 2018.
[39]	LENG Y S, YU S, TAN K K, et al. Development of a real-time lumbar ultrasound image processing system for epidural needle entry site localization [C]//2016 38th Annual International Conference of the IEEE En gineering in Medicine and Biology Society (EMBC ).Orlando, FL, USA: IEEE, 2016: 4093-4096.
	https://doi.org/10.15761/jaa.1000116.
[40]	BEIGI P, MALENFANT P, RASOULIAN A, et
[54]	MARSH-FEILEY G, EADIE L, WILSON P.
	al. Three-dimensional ultrasound-guided real-time
	Telesonography in emergency medicine: A systematic review [J]. PLoS One, 2018, 13(5): e0194840.
	midline epidural needle placement with epiguide:
[55]	KAMATA K, HAYASHI M, NAGATA O, et al. Initial experience with the use of remote control monitoring and general anesthesia during radiosurgery for pedi atric patients [J]. Pediatric Neurosurgery, 2011, 47(2):
	A prospective feasibility study [J]. Ultrasound in
15	8-166.
	Medicine & Biology, 2017, 43(1): 375-379.
[56]	GOODRIDGE D, MARCINIUK D. Rural and re mote care: Overcoming the challenges of distance [J].Chronic Respiratory Disease, 2016, 13(2): 192-203.
[41]	PESTEIE M, LESSOWAY V, ABOLMAESUMI P,
[57]	CONE S W, GEHR L, HUMMEL R, et al. Remote
	et al. Automatic localization of the needle target for ultrasound-guided epidural injections [J]. IEEE Trans actions on Medical Imaging, 2018, 37(1): 81-92.
	anesthetic monitoring using satellite telecommunica tions and the Internet [J]. Anesthesia and Analgesia,2006, 102(5): 1463-1467.
[42]	LI H, ZUO M, GELB A W, et al. Chinese anesthe siologists have high burnout and low job satisfaction:A cross-sectional survey [J]. Anesthesia and Analgesia,2018, 126(3): 1004-1012.
[58]	MACAIRE P, NADHARI M, GREISS H, et al. Inter net remote control of pump settings for postoperative continuous peripheral nerve blocks: A feasibility study in 59 patients [J]. Annales Fran?caises d’Anesth′esie et De R′eanimation, 2014, 33(1): e1-e7.
[59]	RAHMAN Q A, JANMOHAMED T, PIRBAGLOU
[43]	PANDYA A N, MAJID S Z, DESAI M S. The origins,evolution, and spread of anesthesia monitoring stan dards: From Boston to across the world [J]. Anesthesia and Analgesia, 2021, 132(3): 890-898.
[44]	WINTERS B D, CVACH M M, BONAFIDE C P, et
	M, et al. Patterns of user engagement with the mobile app, manage my pain: Results of a data mining inves tigation [J]. JMIR MHealth and UHealth, 2017, 5(7):e96.
[60]	HEMMERLING T M. Robots will perform anesthesia in the near future [J]. Anesthesiology, 2020, 132(2):219-220.
	al. Technological distractions (part 2): A summary of approaches to manage clinical alarms with intent to reduce alarm fatigue [J]. Critical Care Medicine, 2018,46(1): 130-137.
[61]	LOEB R G, CANNESSON M. Closed-loop anesthesia:Ready for prime time? [J]. Anesthesia & Analgesia,2017, 124(2): 381-382.
[45]	FERNANDES C, MILES S, LUCENA C J P. Detect ing false alarms by analyzing alarm-context informa tion: Algorithm development and validation [J]. JMIR Medical Informatics, 2020, 8(5): e15407.
[62]	RUSKIN K J, RUSKIN A C, O’CONNOR M. Automa tion failures and patient safety [J]. Current Opinion in Anaesthesiology, 2020, 33(6): 788-792.[1] LANE T. A short history of robotic surgery [J]. Annals of the Royal College of Surgeons of England, 2018,100(6 sup): 5-7.
[46]	IMHOFF M, KUHLS S, GATHER U, et al. Smart
[2]	OSMAN N I, DE MANGIR N, MIRONSKA E, et al.Robotic surgery as applied to functional and reconstructive urology [J]. European Urology Focus, 2019,5(3): 322-328.
	alarms from medical devices in the OR and ICU [J].
[3]	ASHRAFIAN H, CLANCY O, GROVER V, et al.The evolution of robotic surgery: Surgical and anaesthetic aspects [J]. British Journal of Anaesthesia, 2017,119(Sup 1): i72-i84.
	Best Practice & Research Clinical Anaesthesiology,
[4]	ZAOUTER C, JOOSTEN A, RINEHART J, et al.Autonomous systems in anesthesia [J]. Anesthesia & Analgesia, 2020, 130(5): 1120-1132.
20	09, 23(1): 39-50.
[5]	SCHWILDEN H, SCHUTTLER J. The determination of an effective therapeutic infusion rate for intravenous anesthetics using feedback-controlled dosages [J]. Der Anaesthesist, 1990, 39(11): 603-606.
[47]	GOHIL B, GHOLAMHHOSSEINI H, HARRISON M J, et al. Intelligent monitoring of critical pathologi cal events during anesthesia [C]//2007 29th Annual International Conference of the IEEE Engineering in Medicine and Biology Society. Lyon, France: IEEE,2007: 4343-4346.
[6]	ENGBERS F H M, DAHAN A. Anomalies in targetcontrolled infusion: An analysis after 20 years of clinical use [J]. Anaesthesia, 2018, 73(5): 619-630.
[48]	MIRZA M, GHOLAMHOSSEINI H, HARRISON M J. A fuzzy logic-based system for anaesthesia monitor ing [C]//2010 Annual International Conference of the IEEE Engineering in Medicine and Biology. Buenos Aires, Argentina: IEEE, 2010: 3974-3977.
[7]	KUCK K, JOHNSON K B. The three laws of autonomous and closed-loop systems in anesthesia [J].Anesthesia and Analgesia, 2017, 124(2): 377-380.
[49]	EAPEN Z J, PETERSON E D. Can mobile health
	applications facilitate meaningful behavior change?:Time for answers [J]. JAMA, 2015, 314(12): 1236-1237.
[8]	MAHAJAN V, SAMRA T, PURI G D, et al. Anaesthetic depth control using closed loop anaesthesia delivery system vs. target controlled infusion in patients with moderate to severe left ventricular systolic dysfunction[J]. Journal of Clinical Anesthesia, 2017, 42:106-113.
[50]	MICHARD F, BARRACHINA B, SCHOETTKER P.
[9]	PASIN L, NARDELLI P, PINTAUDI M, et al. Closedloop delivery systems versus manually controlled administration of total IV anesthesia: A meta-analysis of randomized clinical trials [J]. Anesthesia and Analgesia,2017, 124(2): 456-464.
	Is your smartphone the future of physiologic monitor ing? [J]. Intensive Care Medicine, 2019, 45(6): 869-871.
[10]	BROGI E, CYR S, KAZAN R, et al. Clinical performance and safety of closed-loop systems: A systematic review and meta-analysis of randomized controlled trials[J]. Anesthesia and Analgesia, 2017, 124(2): 446-455.
[51]	WHITE S M. Automated electronic anaesthesia
[11]	SETHI N, DUTTA A, PURI G D, et al. Evaluation of automated delivery of propofol using a closed-loop anesthesia delivery system in patients undergoing thoracic surgery: A randomized controlled study [J]. Journal of Cardiothoracic and Vascular Anesthesia, 2021,35(4): 1089-1095.
	records [J]. Anaesthesia, 2016, 71(7): 850-851.
[12]	KONG E, NICOLAOU N, VIZCAYCHIPIMP. Hemodynamic stability of closed-loop anesthesia systems: A systematic review [J]. Minerva Anestesiologica, 2020,86(1): 76-87.
[52]	NAIR B G, NEWMAN S F, PETERSON G N, et al.
[13]	ELEVELD D J, PROOST J H, WIERDA J M. Evaluation of a closed-loop muscle relaxation control system[J]. Anesthesia and Analgesia, 2005, 101(3): 758-764.
	Automated electronic reminders to improve redosing of antibiotics during surgical cases: Comparison of two approaches [J]. Surgical Infections, 2011, 12(1): 57-63.
[53]	YEOH C, MASCARENHAS J, TAN K S, et
	al. Automated notifications improve time to anes thesia induction: Integrating health information technology systems to enhance perioperative ef ficiency [J]. Anaesthesia and Anaesthetics, 2018.
[14]	HEMMERLING T M, ARBEID E, WEHBE M, et al. Evaluation of a novel closed-loop total intravenous anaesthesia drug delivery system: A randomized controlledtrial [J]. British Journal of Anaesthesia, 2013,110(6): 1031-1039.
	https://doi.org/10.15761/jaa.1000116.
[15]	WEHBE M, ARBEID E, CYR S, et al. A technical description of a novel pharmacological anesthesia robot[J]. Journal of Clinical Monitoring and Computing,2014, 28(1): 27-34.
[54]	MARSH-FEILEY G, EADIE L, WILSON P.
[16]	ZAOUTER C, HEMMERLING T M, LANCHON R,et al. The feasibility of a completely automated totalIV anesthesia drug delivery system for cardiac surgery[J]. Anesthesia and Analgesia, 2016, 123(4): 885-893.
	Telesonography in emergency medicine: A systematic review [J]. PLoS One, 2018, 13(5): e0194840.
[17]	ZAOUTER C, HEMMERLING T M, MION S, et al.Feasibility of automated propofol sedation for transcatheter aortic valve implantation: A pilot study [J].Anesthesia and Analgesia, 2017, 125(5): 1505-1512.
[55]	KAMATA K, HAYASHI M, NAGATA O, et al. Initial experience with the use of remote control monitoring and general anesthesia during radiosurgery for pedi atric patients [J]. Pediatric Neurosurgery, 2011, 47(2):
[18]	SCH¨A DLER D, MIESTINGER G, BECHER T, et al.Automated control of mechanical ventilation during general anaesthesia: Study protocol of a bicentric observational study (AVAS) [J]. BMJ Open, 2017, 7(5):e014742.
15	8-166.
[19]	JOOSTEN A, COECKELENBERGH S,DELAPORTE A, et al. Implementation of closed-loopassisted intra-operative goal-directed fluid therapy during major abdominal surgery [J]. European Journal of Anaesthesiology, 2018, 35(9): 650-658.
[56]	GOODRIDGE D, MARCINIUK D. Rural and re mote care: Overcoming the challenges of distance [J].Chronic Respiratory Disease, 2016, 13(2): 192-203.
[20]	GREEN D, JONAS M, MILLS E. Implementation of closed-loop-assisted intra-operative goal-directed fluid therapy during surgery [J]. European Journal of Anaesthesiology,2019, 36(4): 303-304.
[57]	CONE S W, GEHR L, HUMMEL R, et al. Remote
[21]	DI L L, WANG Y X, MA S X, et al. The effect of goaldirected fluid therapy combines closed-loop anesthesia management on postoperative rehabilitation of patients undergoing laparoscopic pancreaticoduodenectomy[J]. Journal of Clinical Anesthesia, 2020, 60:115-117.
	anesthetic monitoring using satellite telecommunica tions and the Internet [J]. Anesthesia and Analgesia,2006, 102(5): 1463-1467.
[58]	MACAIRE P, NADHARI M, GREISS H, et al. Inter net remote control of pump settings for postoperative continuous peripheral nerve blocks: A feasibility study in 59 patients [J]. Annales Fran?caises d’Anesth′esie et De R′eanimation, 2014, 33(1): e1-e7.
[59]	RAHMAN Q A, JANMOHAMED T, PIRBAGLOU
	M, et al. Patterns of user engagement with the mobile app, manage my pain: Results of a data mining inves tigation [J]. JMIR MHealth and UHealth, 2017, 5(7):e96.
[60]	HEMMERLING T M. Robots will perform anesthesia in the near future [J]. Anesthesiology, 2020, 132(2):219-220.
[22]	HEMMERLING T M, WEHBE M, ZAOUTER C, et al. The Kepler intubation system [J]. Anesthesia and Analgesia, 2012, 114(3): 590-594.
[61]	LOEB R G, CANNESSON M. Closed-loop anesthesia:Ready for prime time? [J]. Anesthesia & Analgesia,2017, 124(2): 381-382.
[23]	HEMMERLING T M, TADDEI R, WEHBE M, et al.First robotic tracheal intubations in humans using the Kepler intubation system [J]. British Journal of Anaes thesia, 2012, 108(6): 1011-1016.
[62]	RUSKIN K J, RUSKIN A C, O’CONNOR M. Automa tion failures and patient safety [J]. Current Opinion in Anaesthesiology, 2020, 33(6): 788-792.[1] LANE T. A short history of robotic surgery [J]. Annals of the Royal College of Surgeons of England, 2018,100(6 sup): 5-7.
[24]	WANG X, TAO Y, TAO X, et al. An original design of remote robot-assisted intubation system [J]. Scientific Reports, 2018, 8(1): 13403.
[2]	OSMAN N I, DE MANGIR N, MIRONSKA E, et al.Robotic surgery as applied to functional and reconstructive urology [J]. European Urology Focus, 2019,5(3): 322-328.
[3]	ASHRAFIAN H, CLANCY O, GROVER V, et al.The evolution of robotic surgery: Surgical and anaesthetic aspects [J]. British Journal of Anaesthesia, 2017,119(Sup 1): i72-i84.
[4]	ZAOUTER C, JOOSTEN A, RINEHART J, et al.Autonomous systems in anesthesia [J]. Anesthesia & Analgesia, 2020, 130(5): 1120-1132.
[5]	SCHWILDEN H, SCHUTTLER J. The determination of an effective therapeutic infusion rate for intravenous anesthetics using feedback-controlled dosages [J]. Der Anaesthesist, 1990, 39(11): 603-606.
[6]	ENGBERS F H M, DAHAN A. Anomalies in targetcontrolled infusion: An analysis after 20 years of clinical use [J]. Anaesthesia, 2018, 73(5): 619-630.
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