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A safer way to “go under”

November 07, 2013
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A CFRI-led team has reported the first clinical trial of an automated anesthesia drug delivery system for children, a major step towards more personalized anesthesia.

"The implications of this project are huge," says CFRI researcher Dr. Mark Ansermino, who co-authored the study. "The outcomes will be improved safety and efficiency in the OR and improved drug safety for patients."

Last year, there were approximately 8750 pediatric surgeries with anesthesia at BC Children’s Hospital. Presently, anesthesiologists make a few anesthetic dosing adjustments per hour in response to a patient’s physiological conditions such as heart rate and blood pressure.

The new CFRI-developed automated anesthesia system continuously monitors a patient’s brain activity and adjusts dosing second-by-second to induce or maintain an anesthetized state.

"By conducting continual measurement of the effect of these drugs on the brain, we are able to automate these adjustments based on experience with the actual patient rather than on experience from previous patients, as is currently the case," says CFRI’s Nicholas West, the study’s first author.

The automated system is thus ideal for delivering only as much anesthetic as a child needs, which the study found varied by as much as ten times between similar children.
The study evaluated 108 pediatric patients, ages six to 17, who underwent gastrointestinal endoscopy procedures at BC Children’s Hospital between August 2011 and September 2012.

In 85 per cent of the procedures, the automated system worked seamlessly with no need for manual intervention. 

This pioneering research, with CFRI researcher and UBC Engineering professor and Dr. Guy Dumont as the engineering lead, paves the way for trials to evaluate the autopilot system’s clinical benefits.

The multi-authored paper "Robust closed-loop control of induction and maintenance of propofol anesthesia in children" was published in the August 2013 issue of Pediatric Anesthesia.

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