Remote and Automated Anesthesia: Telemedicine, Closed-Loop Systems, and the Future of Procedural Sedation
Abstract
Background: The fields of telemedicine and artificial intelligence (AI) are converging with clinical anesthesia, promising to reshape the delivery of procedural sedation and perioperative care. Remote monitoring technologies and closed-loop drug delivery systems offer potential solutions to pressing challenges, including geographic disparities in access to anesthesia expertise, workforce shortages, and the pursuit of heightened precision in drug administration. Aim: This narrative review synthesizes contemporary evidence (2015-2024) to critically evaluate the technological foundations, clinical efficacy, and broader implications of remote anesthesia monitoring and automated sedation systems. Methods: A comprehensive search of PubMed, IEEE Xplore, Scopus, and CINAHL databases was conducted. Results: Evidence indicates that tele-anesthesia platforms can safely extend specialist oversight to non-operating room anesthesia (NORA) sites and remote locations, improving compliance with monitoring standards. Closed-loop systems for propofol sedation demonstrate superior maintenance of target depth compared to manual control, with potential benefits in hemodynamic stability. However, successful integration is contingent on robust connectivity, intuitive human-machine interfaces, and clear liability frameworks. These technologies necessitate a redefinition of the anesthesiologist’s role toward system supervision and management of complex exceptions. Conclusion: Remote and automated anesthesia represents a paradigm shift toward a hybrid model of care. Its responsible adoption requires co-evolution of technology, validation through pragmatic clinical trials, updated training curricula, and proactive policy development to ensure these tools augment rather than replace clinical judgment, ultimately expanding safe access to high-quality sedation.
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References
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Authors
Copyright (c) 2024 Mohammed Khalid Alyahya, Waleed Mualla Almukhlifi, Abdullah Mohammed S Albalawi, Mordi Nasser Al Dosari, Mordy Abdullah Al Talasat, Almohanad Mohammed Alqarni, Abdullah Mushari Alshahrani, Waleed Ghalib Alotaibi, Talal Fawaz Saeid Aleidyani, Ahmad A. Sonbol, Awatif Hamoud Najem Alsolmi
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