Meet The Machine That Could Replace Anesthesiologists

It can only be used for simple procedures for now, but that's changing quickly

Sedasys

The machine sedated this patient before her colonoscopy at the ProMedica Toledo Hospital in Toledo.Dustin Franz for The Washington Post

Say hello to the hunk of plastic that could replace your anesthesiologist.

Right now, only four U.S. hospitals are using the Sedasys anesthesiology machine to sedate patients before surgery. Johnson & Johnson has been cautiously rolling out the machine after winning approval from the Food and Drug Administration in 2013. The FDA originally rejected the machine in 2010, but later approved after Johnson & Johnson agreed it would only be used for simple screenings--like colonoscopies or endoscopies--and only when an anesthesiology doctor or nurse was on-call.

The machine administers a measured dose of propofol to the patient, and the drug acts quickly. To keep patients safe, the machine is programmed with conservative parameters. Even the slightest problem--for example, if the patient has low blood oxygen or a slow heart rate--slows or stops the drug's infusion. According to the Washington Post, the machine has stricter limits than a human anesthesiologist would have.

For a colonoscopy, patients who choose to be sedated could pay as much as $2,000 to be put to sleep, which is more than the cost of the colonoscopy itself. Sedasys, on the other hand, costs between $150 and $200.

Anesthesiologists, who train for four years after medical school, are paid an average of $277,000 a year. Many argued that a machine couldn’t achieve the delicate balance between too much sedation, which can kill a patient, and too little, which doesn’t block out the pain.

Members of the American College of Anesthesiologists used to strongly oppose the machine, but as its approval became inevitable, they lobbied for restrictive guidelines instead. The co-chairs of the group’s Sedasys committee don’t see the machine taking over their profession though.

"Clearly this is an example of disruptive innovation," Rebecca Twersky told the Washington Post. "But we're not going away."

Others say they wouldn’t be so sure--more complex devices are in the works. At the University of British Columbia in Vancouver, researchers are testing a machine that can administer anesthesia for brain and heart surgeries, even in children.

“I dream about using it in bigger areas than endoscopy units,” said Joseph Sferra, the vice president of surgical services at ProMedica Toledo Hospital. “I’m sure this is very disconcerting to anesthesiologists.”