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Anesthesia in the Future Steven L. Shafer Palo Alto VA Health Care System Stanford
2010
Typical American Hospital 1985 - 25 years ago Typical American Hospital
Therapeutic Armamentarium ,[object Object],[object Object],[object Object],[object Object]
Routine Monitors ,[object Object],[object Object],[object Object],[object Object],[object Object]
Special Monitors ,[object Object],[object Object],[object Object],[object Object]
Airway Control ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
MAC M onitored   A nesthesia  C are M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic M ostly   A pneic and  C yanotic
Patient Care ,[object Object],[object Object],[object Object],[object Object],        surgical technique
Patient Care Issues ,[object Object],[object Object],[object Object]
Anesthesia 1998 12 years ago
Basics of Anesthesia ,[object Object],Patient Comfort ,[object Object],[object Object]
Therapeutic Armamentarium ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
TIVA Total IntraVenous Anesthesia Total IntraVenous Awareness TIVAE Total IntraVenous Anesthesia with Ephedrine
Propofol
Desflurane, Sevoflurane
Fentanyl Family Tree
Remifentanil
Routine Monitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],   Finger on the pulse    Finger on the pulse
Special Monitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Bispectral Index ,[object Object],[object Object],[object Object],[object Object],[object Object]
Airway Control ,[object Object],[object Object],[object Object],Laryngeal Mask Airway
MAC M onitored   A nesthesia  C are M idazolam,  A lfentanil, and  C onversation
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Patient Care Patient Controlled Analgesia Patient Controlled Apnea
2010 Today
New Therapeutics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Anesthesiology 76:327-330, 1992
New Therapeutics ,[object Object],[object Object],[object Object],[object Object],[object Object]
New Therapeutics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New Therapeutics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New Therapeutics ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
New Therapeutics ,[object Object],[object Object],[object Object],[object Object],Suxuronium
MAC M onitored   A nesthesia  C are M adam,  A re you  C omfortable?
New Therapeutic Modes ,[object Object]
New Monitoring ,[object Object],[object Object],[object Object],EGADS
EGADS
Patient Care ,[object Object],[object Object],[object Object],[object Object]
 
Anesthesia in 2020?
Plausible vs. Implausible ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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