招聘講演（18）

TECHNOLOGY - FRIEND OR FOE?

Gavin NC Kenny, BSc(Hons), MD, FRCA, FANZCA

There is increasing complexity within anaesthesia caused by increased amount and complexity of monitoring, greater number of alarms and more complex anaesthetic machines. In addition, the available drugs and monitoring equipment have changed markedly in thirty years.

Successful Application of New Technology

There are two rules which apply to any proposed new development. It must either undertake a task which would be impossible without the technology or else it must perform the task better than with present technologies

Infusion Systems

Infusion systems have developed from simple drips through manually controlled pumps to target-controlled infusion systems which can target either blood or effect site drug concentrations. The benefits and limitations will be described.

Closed-Loop Control Systems

Closed loop systems have been assessed for use in controlling blood pressure, neuromuscular blockade, postoperative analgesia and general anaesthesia. The fundamental tests are whether these can:

1. achieve better control than with a manual system?

2. is the better control clinically valuable?

Anaesthetic Information Management Systems

These have developed over the past two decades and any system must work effectively with both long major and short minor cases. Studies have shown that those who use automatic record systems would not go back to a manual version. Development is not linear from initial specification to final implementation but is circular with each version being re-assessed to improve to the next.

Future Of New Technology

Development of new technology must be controlled and directed by anaesthetists. It must be used with as much skill as we practice the art of anaesthesia.