Henry Street Anesthesia prepares anesthesia providers for our automated future.
Anesthesia may be defined as hypnosis, paralysis, analgesia, and hemodynamic control.
If these components can be automated, anesthesia can be automated.
Automation technologies don’t just help us do things, they do things for us.
Automated, closed-loop systems in anesthesia have long been shown to equal or surpass manual performance of human providers.
Closed-loop systems for automated hypnotic drug delivery during general anaesthesia: a systematic review and meta-analysis. Felippe et al., Br J Anaesth 2026.
Methods: Meta-analysis of 17 RCTs (n=1,898) comparing BIS-guided closed-loop propofol delivery with manual titration.
Results: Closed-loop control increased time within target BIS range by 17.6%, reduced time with BIS <40, and shortened time to extubation.
Rocuronium: automatic infusion versus manual administration with TOF monitorisation. Ozturk Arikan et al., J Clin Monit Comput 2016.
Methods: RCT comparing automatic TOF-guided rocuronium infusion with routine manual administration during elective abdominal surgery.
Results: No significant difference between groups in intubation quality, extubation time, or recovery.
Clinical efficacy and safety of automatic remifentanil administration based on Analgesia Nociception Index monitoring during burn surgery under propofol anesthesia: a randomized controlled clinical trial. Hureau et al., PLOS ONE 2025.
Methods: RCT (n=52) of manual vs. automatic (ANI-REMI-LOOP) remifentanil infusion during BIS-guided propofol anesthesia for burn surgery.
Results: Automatic group used 17.8% less remifentanil and spent less time in hemodynamic reactivity, hypotension, or bradycardia (4.2% vs. 19.4% of anesthesia time); post-op pain and analgesic use were similar.
Automated closed-loop versus manually controlled norepinephrine infusion in patients undergoing intermediate- to high-risk abdominal surgery: a randomised controlled trial. Joosten et al., Br J Anaesth 2021.
Methods: RCT (n=30) of closed-loop norepinephrine, titrated to the patient's own baseline MAP ±5 mmHg via FloTrac/EV1000, vs. manual titration.
Results: Time spent hypotensive (MAP <90% of baseline) was roughly tenfold lower with closed-loop control (1.6% vs. 15.4% of case time).
The Development of an Automated Fluid Infusion Management System to Prevent Hypotension During General Anesthesia: A Randomized Clinical Trial. Matsuki et al., J Clin Med 2025.
Methods: 79 randomized (71 analyzed); automated esSVI-triggered fluid bolus system vs. manual fluid management, both with phenylephrine backup.
Results: Automated system was non-inferior to manual management for maintaining MAP ≥65 mmHg (82.0% vs. 79.9% of case time); no difference in fluid volume, phenylephrine dose, or blood loss.
Design, build, or study closed-loop simulations in virtual reality.
Open to learners in nurse anesthesia (CRNA) and anesthesiology (MDA) residency programs.
Available for talks, workshops, panels and grand rounds on anesthesia automation, closed-loop systems, and simulation.
New York State Association of Nurse Anesthetists (NYSANA) Fall Meeting
Saratoga Springs, NYSeptember 2026
Oregon Association of Nurse Anesthetists (ORANA) Annual Conference
Portland, ORNovember 2019
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