Historic First: Transcontinental Anesthesia Successfully Performed
Author: McGill University
Published: 2010/09/10 - Updated: 2025/12/18
Publication Details: Peer-Reviewed, Announcement
Category Topic: Medical Research - Related Publications
Page Content: Synopsis - Introduction - Main - Insights, Updates
Synopsis: This peer-reviewed research from McGill University documents a landmark achievement in telemedicine where anesthesia was remotely controlled during surgery for the first time. Dr. Thomas Hemmerling's team managed patient care from Montreal while patients underwent thyroid surgery in Pisa, Italy, using real-time video monitoring of vital signs and an automated drug delivery system. The advancement addresses a critical healthcare gap, particularly for patients in remote areas where anesthesiologists aren't available on-site, and offers practical benefits for preoperative consultations conducted via video conference, potentially reducing travel burdens and preoperative anxiety for patients. The system also promises educational applications, allowing medical residents to develop skills and confidence while working remotely with experienced tutors - Disabled World (DW).
- Definition: Teleanesthesia
Teleanesthesia is the remote administration of anesthesia by an anesthesiologist or trained clinician who is physically located away from the patient, typically communicating through videoconferencing and controlling anesthetic delivery systems in real time. It represents an extension of telemedicine into the operating room, allowing qualified practitioners to manage sedation, regional anesthesia, or general anesthesia for patients at distant surgical sites - particularly valuable in rural or underserved areas where local anesthetic expertise may be limited. The practice relies on high-speed, secure digital infrastructure and specialized monitoring equipment that transmits vital signs and other patient data to the remote provider, who then adjusts medications and techniques accordingly. While teleanesthesia shows promise for improving access to specialized anesthetic care and optimizing resource allocation in healthcare systems, it remains an emerging field with evolving regulatory frameworks and ongoing debates about the appropriateness of remote administration for complex surgical cases and the liability implications for practitioners working across state or international lines.
Introduction
Video-conferences may be known for putting people to sleep, but never like this.
Dr. Thomas Hemmerling and his team of McGill's Department of Anesthesia achieved a world first on August 30, 2010, when they treated patients undergoing thyroid gland surgery in Italy remotely from Montreal. The approach is part of new technological advancements, known as 'Teleanesthesia', and it involves a team of engineers, researchers and anesthesiologists who will ultimately apply the drugs intravenously which are then controlled remotely through an automated system.
Main Content
This achievement is a product of an on-going scientific collaboration between Dr. Hemmerling's team and the Italian team of Dr. Zaouter of the Department of Anesthesia of Pisa University (Chairman Prof. Giunta).
"The practice has obvious applications in countries with a significant number of people living in remote areas, like Canada, where specialists may not be available on site," Hemmerling said. "It could also be used for teaching purposes, allowing the resident to perform tasks without the physical presence of a tutor, thus increasing his or her confidence level."
Four strategically placed video cameras monitored every aspect of patient care in Pisa, Italy, in real time. Ventilation parameters (such as the patient's breathing rate), vital signs (ECG, heart rate, oxygen saturation) and live images of the surgery are monitored by each camera, with the fourth used for special purposes. A remote computer station ('anesthesia cockpit') is required, as is a workstation that handles the audio-video link between the two centers.
"Obviously, local anesthesiologists can override the process at any time," Hemmerling explained.
Prior to the operation, an assessment of the patient's airway and medical history is also performed via video-conferencing.
The researchers are also looking at the possibility of preoperative assessment of patients at home. It used to be that invasive blood tests or other tests were required in preparation for many surgeries, but that's no longer the case.
Many patients take very long journeys and often wait hours to see an anesthesiologist who will ask them specific questions, but video-conferencing could eliminate these logistical problems and probably reduce the preoperative stress of the patients coming into the hospital before surgery.
"The next steps will be to confirm the results of this pilot experience with further studies," Hemmerling said.
Insights, Analysis, and Developments
Editorial Note: The development of teleanesthesia signals a meaningful shift in how medical care can be extended to underserved populations, though questions remain about standardization and the specific training required for remote anesthesia delivery across international borders. While the pilot proved technically feasible, the long-term success of this approach will depend on rigorous follow-up studies and clear protocols that maintain the safety standards patients deserve, particularly when the anesthesiologist and surgical team cannot respond instantaneously to unexpected complications - Disabled World (DW).Attribution/Source(s): This peer reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its relevance to the disability community. Originally authored by McGill University and published on 2010/09/10, this content may have been edited for style, clarity, or brevity.