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Faster recovery? Some hospitals turn to computer-assisted anesthesia

by Linda Carroll / / Source: TODAY

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Just before Penny Gilliatt’s colonoscopy she met the team that would be performing her procedure: the nurse, the doctor—and the robot that would be handling her anesthesia.

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The robot is a machine called Sedasys. It’s currently approved by the Food and Drug Administration to act as the anesthesiologist for healthy patients getting one of two procedures, colonoscopies and upper endoscopies. At many medical centers those procedures aren’t currently monitored by an anesthesiologist.

That’s the case at Virginia Mason Medical Center where Gilliatt is a nurse.

She says she isn’t worried that a machine is controlling her anesthesia. “There are people also in the room that are trained and they are also monitoring me,” she told NBC's Joe Fryer. “To me, this is just an extra layer of safety.”

Perhaps more important to Gilliatt, the machine allows her doctor to use a drug, called propofol, that kicks in quickly and also wears off quickly. When doctors don’t have an anesthesiologist — or a Sedasys — present they have to use sedatives that wear off a lot more slowly, often leaving patients in a fog for hours.

Because Gilliatt will get propofol, she’ll be alert when she comes out of anesthesia and will be better able to understand and remember what her doctor tells her after the procedure. In the past, Gilliatt’s doctor said, “we would try to tell [patients] what we found during the colonoscopy, and most of the time they wouldn’t be able to remember.”

The type of anesthesia given to Gilliatt is called conscious sedation, in which the patient is unaware of what is going on around them, but can respond to simple directions given by doctors and nurses.

When the nurse says, “big, deep breaths,” Gilliatt complies.

Periodically Gilliatt is instructed to squeeze a handset so the machine can monitor her response time and determine whether she needs more or less medication. If there is a problem the machine can shrink the dose or cut off the medication altogether.

The new technology might make some a little worried when they first hear about it, said NBC medical correspondent Dr. Natalie Azar.

“The reaction I had as both a doctor and a patientis that I would want a doctor administering anesthesias,” she explained. “But I think it’s important for people to remember what this is for and what this is not for. It has a very, very narrow indication, that is, for these endoscopy and colonoscopy procedures for a very, very select group of patients. You need to be over the age of 18 and relatively healthy.”

Beyond that, she said, “this is not for deep anesthesia or procedures lengthy procedures lasting more than 45 minutes.”

And what happens if something goes wrong with the anesthesia?

“The doctor doing the colonoscopy is not the one monitoring the anesthesia,” Azar said. “There is a designated person in the room [to do that] and everybody in the room has to be trained in terms of the whole process of anesthesia. And there has to be an MD or nurse anesthetist on call should there be a complication so they could respond immediately.”

Anesthesiologists aren't worried about being replace by machines like Sedasys yet.

Before the use of Sedasys expands, “we need to do more studies to absolutely determine its safety for other procedures,” said anesthesiologist Dr. Jeffrey Appelbaum from the University of Chicago.

Linda Carroll is a regular contributor to and She is co-author of "The Concussion Crisis: Anatomy of a Silent Epidemic” and the recently published “Duel for the Crown: Affirmed, Alydar, and Racing’s Greatest Rivalry.”

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