Jordan W S, Jaklitch R R, Heining M P
Int J Clin Monit Comput. 1986;3(4):269-78. doi: 10.1007/BF01724395.
The place of computerization in intravenous anaesthesia delivery: Although total intravenous anaesthesia may have advantages over inhalational anaesthesia in certain circumstances, it has drawbacks from the point of view of feedback control. The ideal agent is not available, although di-isopropylphenol holds promise. There is an undefinable end-point. Inadequate dosage produces the extremely unpleasant phenomenon of intra-operative awareness. Future developments, it seems, should include the development of suitable intravenous agents and transducers of anaesthetic depth, rather than increasingly complicated control systems. It is extremely unlikely that a computer will replace the anaesthetist in the foreseeable future. The anaesthetist is still required for, amongst other things, specifying the desired depth of anaesthesia and varying it during the operation, and for responding to unforeseen crises. It may be hoped that, by liberating the anaesthetist from those tasks which can be automated, more time can be devoted to patient monitoring and other aspects of anaesthetic care, thereby improving patient safety. There is an undoubted place for computerized delivery of anaesthesia in teaching (particularly teaching pharmacokinetic principles) and in research (for standardization of anaesthetic depth).
尽管全静脉麻醉在某些情况下可能优于吸入麻醉，但从反馈控制的角度来看，它也有缺点。理想的麻醉药尚未出现，尽管异丙酚有一定前景。存在一个难以确定的终点。剂量不足会产生术中知晓这种极其令人不适的现象。未来的发展似乎应包括开发合适的静脉麻醉药和麻醉深度传感器，而不是越来越复杂的控制系统。在可预见的未来，计算机极不可能取代麻醉医生。麻醉医生仍然不可或缺，例如确定所需的麻醉深度并在手术过程中进行调整，以及应对不可预见的危机。或许可以期望，通过将麻醉医生从可自动化的任务中解放出来，能有更多时间用于患者监测和麻醉护理的其他方面，从而提高患者安全性。计算机化麻醉给药在教学（尤其是药代动力学原理教学）和研究（用于麻醉深度标准化）方面无疑有其用武之地。
