A flight simulator for general anesthesia training

https://doi.org/10.1016/0010-4809(87)90019-XGet rights and content

Abstract

A simulator of general anesthesia is described. It consists of an integrated set of physiologic computer models and a graphics display. The model predicts many of the physiologic and pharmacodynamic changes associated with general anesthesia. It is a multiple model consisting of circulatory, respiratory, pharmacokinetic, and pharmacodynamic models and their interactions. The model can account for many pathologic states of the cardiorespiratory system plus poor renal and hepatic function. Both intravenous and inhalation agents are included. Examples of its capabilities are presented, including pharmacokinetic changes associated with thiopental administration to a hypovolemic subject, administration of oxygen in several pulmonary pathologic conditions, and a simulation of an induction using fentanyl or thiopental. The model, combined with the graphics interface, becomes a realtime simulator useful for training students and residents.

References (22)

  • A. Zwart et al.

    Multiple model approach to uptake and distribution of halothane: The use of an analog computer

    Comput. Biomed. Res.

    (1972)
  • K.B. Bischoff et al.

    Thiopental pharmacokinetics

    J. Pharm. Sci.

    (1968)
  • R.M. Epstein

    Morbidity and mortality from anesthesia

    Anesthesiology

    (1978)
  • O.C. Philips et al.

    Anethesia mortality

    Clin. Anesth.

    (1974)
  • J.B. Cooper

    Anesthesia can be safer: The role of engineering and technology

    Med. Inst.

    (1985)
  • J.N. Lunn et al.
  • Special Committee Investigating Deaths Under Anesthesia

    1970: Report on 745 classified cases, 1960–1968

    Med. J. Aust.

    (1970)
  • W.K. Hamilton

    Unexpected deaths during anesthesia: Wherein lies the cause?

    Anesthesiology

    (1979)
  • J.E.W. Beneken et al.

    The use of multiple models in cardivascular system studies: Transport and perturbation methods

    IEEE Trans. Biomed. Eng.

    (1968)
  • Y. Fukui et al.

    Interactions among ventilation, the circulation, and the uptake and distribution of halothane

    Anesthesiology

    (1981)
  • F.S. Grodins

    Integrative cardiovascular physiology: A mathematical synthesis of cardiac and blood vessel hemodynamics

    Quart. Rev. Biol.

    (1959)
  • Cited by (44)

    • The history of medical simulation

      2008, Journal of Critical Care
      Citation Excerpt :

      It was the precursor of the current BodySim software [25,59-61]. A fellow at the University of California–San Diego laboratory, Howard Schwid, simplified the models to run on a laptop and added critical event management [62,63]. The Anesthesia Simulator Recorder became a commercial product in 1989.

    • Simulation in Obstetrics and Gynecology

      2008, Obstetrics and Gynecology Clinics of North America
      Citation Excerpt :

      The Comprehensive Anesthesia Simulation Environment (CASE) was designed to facilitate assessment of anesthesiologists' technical and behavioral skills. Gaba, Schwid, Howard and colleagues [8–10] appreciated the role of simulation-based training in non–health care industries and likened human patient simulation to cockpit simulation, an experiential learning environment used in aviation for professional education and training. Medical simulation was seen as a means to augment didactic instruction, providing an out-of-the-chair and hands-on experience in a safe environment without harming real patients.

    View all citing articles on Scopus
    1

    Current address: Anesthesiology Service, Veterans Administration Hospital, 1660 South Columbian Way, Seattle, WA 98108.

    View full text