Remote anaesthesia using surgical robot
3 Sept 2010
A surgical robot could be used to perform complex regional
anaesthesia procedures remotely — teleanaesthesia, according to
researchers who carried out a simulation at the University of Florida
College of Medicine.
The researchers performed a series of simulations to evaluate the
feasibility of performing robot-assisted regional anaesthesia
procedures. The simulations used a da Vinci surgical robot system
consisting of four robotic arms with a high-definition stereoscopic
The procedures were performed using an ultrasound "phantom" that
simulated what the anaesthesiologist would see when performing
ultrasound-guided procedures. The anaesthesiologist was in the
operating room but facing away from the robotic arms and simulated
patient, as the procedure was carried out using the da Vinci
system's operator console.
After initial placement of the ultrasound probe, the
anaesthesiologist was able to successfully carry out a simulated
nerve block procedure, including identifying nerve structures,
picking up the needle and positioning it at targeted nerve, and
performing the injection.
The robotic system was then used to attempt a more technically
advanced regional anaesthesia procedure: placing a perineural
catheter for continuous nerve block. Although some steps had to be
performed manually, most of steps of this complex catheter placement
procedure were successfully performed by the da Vinci operator.
There were some important limitations in performing the simulated
procedures, including the fact that some steps had to be performed
manually. The cost of the da Vinci system is another practical
obstacle, if not already present in the hospital.
Although robot-assisted regional anaesthesia is strictly
experimental for now, "This study demonstrated that a multipurpose
surgical robot could be adapted for simulated nerve block
placement," according to the report by Dr Patrick J Tighe and
colleagues of University of Florida College of Medicine,
Nevertheless, "The simulation proved that robotic-assisted
regional anesthesia is feasible using existing clinical equipment,"
Dr Tighe and colleagues write. Further research will be needed to
advance this concept, including studies to "optimize robotic
interfaces with other nerve block equipment."
In the future, robot technology might be used to perform
procedures remotely — teleanesthesia. "There are too few skilled
regional anesthesiologists to meet the demand," comments Dr Steven
L. Shafer of Columbia University, Editor-in-Chief of Anesthesia
& Analgesia. "This technology is in its infancy. If future
studies show that it is practical, one highly trained
anesthesiologist could provide dozens of specialized nerve blocks to
patients around the world in a single day. There would still be a
requirement for a local anesthesiologist to look after the patient,
handle any complications, and provide backup anesthesia in case the
Read the full study in Anesthesia & Analgesia at: