Researchers at McGill University and the McGill University Health Centre (MUHC) have performed the world’s first totally automated administration of an anaesthetic using a system they created called ‘McSleepy’.
The new system administers drugs for general anaesthesia and monitors their separate effects completely automatically with no manual intervention.
‘We have been working on closed-loop systems, where drugs are administered, their effects continuously monitored, and the doses are adjusted accordingly, for the last five years,’ said Dr Thomas M. Hemmerling of McGill’s Department of Anaesthesia and the Montreal General Hospital, who heads ITAG (Intelligent Technology in Anaesthesia research group).
‘Think of McSleepy as a sort of humanoid anaesthesiologist that thinks like an anaesthesiologist, analyses biological information and constantly adapts its own behaviour, even recognising monitoring malfunction,’ he said.
The anaesthetic technique was used on a patient who underwent a partial nephrectomy, a procedure that removes a kidney tumour while leaving the non-cancerous part of the kidney intact, over a period of three hours and 30 minutes.
To manipulate the various components of general anaesthesia, the automated system measures three separate parameters displayed on a new integrated monitor of anaesthesia (IMATM): depth of hypnosis via EEG analysis; pain via a new pain score called Analgoscore; and muscle relaxation via phonomyography, all developed by ITAG.
The system then administers the appropriate drugs using conventional infusion pumps, controlled by a laptop computer on which McSleepy is installed.
Using these three separate parameters and complex algorithms, the automated system calculates the appropriate drug doses for any given moment of anaesthesia faster and more precisely than a human. An additional feature is that the system can communicate with personal digital assistants (PDAs), making distant monitoring and anaesthetic control possible.
Dr. Hemmerling hopes that a commercial system might be available within the next five years.