Teletherapeutic drug administration by long distance closed-loop control of propofol †

High-order sliding-mode control for anesthesia

Depth of anesthesia can be indirectly measured by Bispectral Index (BIS), therefore it is possible to administer propofol in a closed loop to maintain the optimal level of anesthesia while minimizing the dose to improve the postanesthesia recovery. High-Order Sliding-Mode control can be used to individualize drug dosing. In this study, the controller is tested with four in silico patients.

Telemedicine and anaesthesia

Telemedicine is the use of electronic information and communication technology to provide and support healthcare when distance separates the participants. India is characterised by low penetration of healthcare services where primary healthcare facilities for rural population are highly inadequate. The majority of doctors practice in urban and semi-urban areas, whereas the major proportion of population lives in rural areas. This calls for the innovative methods for utilisation of science and technology for the benefit of our society. There are few reports in the literature which support the use of telemedicine technology for pre-operative assessment, intra-operative consultation, monitoring and post-operative follow-up, which is discussed in this article.

Modernization of traditional acupuncture using multimodal computer-based high-tech methods-recent results of blue laser and teleacupuncture from the Medical University of Graz

Basic and clinical research in traditional Chinese and Korean acupuncture has been performed at the Research Unit of Biomedical Engineering in Anesthesia and Intensive Care Medicine and the Traditional Chinese Medicine Research Center at the Medical University of Graz since 1997. This publication focuses on the latest innovative aspects that underline the further enhancement and development of acupuncture. In this context, novel biomedical and neuroscientific methods are of paramount importance for the fast and efficient modernization of the ancient Asian healing method. Traditional and future oriented acupuncture stimulation methods can be divided into manual needle, laser needle (blue, red and infrared laser light) and electrical punctual stimulation at the body, hand and ear. Special emphasis in this research article is given to totally new technical and methodological investigations, e.g. the first data published worldwide in medicine obtained with new blue laser acupuncture equipment. In this regard, critical summary and recent results from peripheral and central measurements during acupuncture stimulation using high-tech bioengineering assessment are given. In addition, we describe the first teleacupuncture performed between Asia and Europe.

Automated anesthesia

PURPOSE OF REVIEW

Anesthesiologists are overloaded with information and multitasking necessities in an extremely complex work environment. The purpose of this review is to present recent developments toward automated anesthesia and present future technologies for everyday clinical practice.

RECENT FINDINGS

Decision support systems integrate different parameters, clinical scenarios and assessments by (non)-trained personnel into algorithms, which lead to diagnostic suggestions, triage evaluations or treatment options. Target-controlled anesthesia infusion systems reduce the anesthesiologist's workload; target-controlled analgesia systems have the potential to provide more stable hemodynamic control. Closed-loop delivery of anesthesia is feasible and provides anesthetic control as good as or better than human delivery. Teleanesthesia offers the possibility of distant preoperative assessment of the patient's fitness for anesthesia, aid of trained personnel to perform anesthetic tasks and the control of anesthesia delivery in a distant location.

SUMMARY

Decision support systems help to make reliable and standardized decisions in complex environments. Target-controlled infusion systems reduce the anesthetic workload. Closed-loop systems will automate anesthesia care in the near future. Teleanesthesia offers the opportunity to provide safe anesthetic care whenever trained personnel are not available or need support.