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This book aims to provide the modern anaesthesiologist and interested clinician with the tools to understand how anaesthesia and surgery influence human physiology, how information about the anaesthetic state and the different homeostatic systems of the human body is collected and processed, and how this information can be integrated to optimize and individualize care to the patient by helping us to swiftly respond to changes: personalized anaesthesia.
Because there is no disease condition that can be treated with the administration of anaesthetic medications, the specialty of anaesthesiology does not possess a curative effect in itself. Nevertheless, achieving the state of anaesthesia or the anaesthetic state relies completely on the use of drugs. Drugs used in anaesthesia are very powerful and able to transiently break the most deeply rooted physiological defence mechanisms. Some of the effects induced include lack of consciousness, absence of response to pain, absence of muscle tone, immobility, lack of breathing and dysfunction of the autonomic nervous system, to name just a few. Some of these effects might be considered target or ‘therapeutic effects’, such as unconsciousness, analgesia or immobility, but others are ‘side effects’ that are induced because of the relative low specificity of currently used anaesthetic drugs.
With the advances in computational technology, artificial intelligence (AI) systems have been growing exponentially and promise to become tools that are able to overcome some of the most difficult issues of medical research and patient care. Current progress in AI systems offers significant advantages in healthcare, with the potential to minimize the gap between data, knowledge and patient care. The purpose of this chapter is to examine how AI methods might affect data analysis in biomedicine and more specifically in anaesthesia. By the time this book has been published, the anaesthesia and critical care literature will be abound with manuscripts that use AI methods. It will therefore become crucial for the clinician to understand what AI is all about. A detailed understanding of AI requires an extensive knowledge of computational science and complex mathematical concepts. This chapter will provide the reader with the main insights needed to understand the basic concepts of the underlying modelling framework used by AI and will briefly review the different AI methods, their applications and limitations.
Personalized Anaesthesia presents a modern vision of anaesthesia. Integrating technology and knowledge from leading experts in the field, this book will change the way anaesthesia is both taught and practiced. Modern practice requires the anaesthetist to provide patient-specific management. This is the first resource to be organised by the desired physiological effect, rather than by drug groupings, explaining how physiological changes can be produced and controlled according to the characteristics of each patient and the particular surgical context. The book integrates physiology, pharmacology and technology, and applies these concepts in a systematic manner to each homeostatic system. This will optimise drug titration, effect quantification and decision making in anaesthesia practice to match the needs of the individual patient. Complex mathematical and scientific concepts are explained using accessible text, colour illustrations throughout and graphs. This is an essential text for any consultant or trainee working in anaesthesia.
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