Archive Hot Technology 2018

What's New in Anesthesia and Pain Control

The quest for speedier and safer fast-on, fast-off.

Dan O

Dan O'Connor, Editor-in-Chief

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Jay Horowitz
FAST-ON, FAST-OFF Jay Horowitz, CRNA, ARNP, of Quality Anesthesia Care in Sarasota, Fla., predicts that integrated anesthesia machine technology that automates anesthesia delivery could take hold.

What will the practice of anesthesia look like in 2020? To find out, we asked a few providers to share their vision of what new drugs and devices lie ahead for those at the head of the table to deliver better anesthesia and pain control for your patients. Here's what they saw when they peered into the future.

1. Anesthesia providers on autopilot

It's always been the Holy Grail in anesthesia to have Star Trek-like medications and technologies to rapidly put a patient to sleep and just as rapidly wake him up. "Fast-on, fast-off without any of the common side effects like dropping blood pressure or nausea," says Jay Horowitz, CRNA, ARNP, of Quality Anesthesia Care in Sarasota, Fla. Yes, the effects of modern anesthetic drugs wear off fast and new drugs are in the pipeline. But Mr. Horowitz says maybe the future of anesthesia lies in non-pharmacologic methods that could greatly reduce the need for anesthesia providers so that "eventually an anesthesia provider functions much more like a pilot of 747 that mostly flies on autopilot."

While the Sedasys computer-assisted personalized sedation (CAPS) system didn't catch on, Mr. Horowitz thinks integrated anesthesia machine technology that automates anesthesia delivery could take hold. What would that look like? "It would incorporate the usual vaporizers and gas flows, but also a syringe pump and an integrated array of sensors to monitor vital signs and brain activity that adjust anesthetic depth — all while keeping a clear record of the anesthetic," says Mr. Horowitz.

2. More ambulatory procedures under sedation

Just as a cardiologist can perform heart valve procedures in a catheterization lab, anesthesiologist Peter J. Papadakos, MD, FCCM, FAARC, envisions a time when an orthopedic surgeon can "micro" repair joints in his office rather than replacing them in the OR. "As more surgery becomes noninvasive, we don't need the operation anymore," says Dr. Papadakos, a professor in the department of anesthesiology & perioperative medicine at the University of Rochester (N.Y.) Medical Center.

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