The Future of Anesthesia and Critical Care

Multiple forces are affecting the role of the anesthesiologist in the United States and globally. The population of industrialized nations living longer and many more operations are performed on elderly individuals. This population is at risk from the low therapeutic ratios of the general anesthetics in current use and hence will dictate what operations will be performed using which anesthetic agents. The cost of medical care is increasing globally, but perhaps most rapidly in the United States. The increased cost will lead to more scrutiny regarding the need for operations, the quality, utilization and efficacy of care, changes in Medicare reimbursement, the ability of patients to pay and a demand for the use of less costly health care providers when possible. Technological advances are leading to less invasive procedures that can be done on patients who formerly would be ineligible for these surgical procedures.  The presenters and panelists will speculate as to what the practice of anesthesia will be like in the next ten years.

Moderator:  Jeffrey B. Cooper, PhD,  Director, Biomedical Engineering, Partners HealthCare System, Inc.; Associate Professor of Anaesthesia, Harvard Medical School, Massachusetts General Hospital, Director, Center for Medical Simulation, jcooper@partners.org

Douglas Raines, MD, Associate Professor, Harvard Medical School, Department of Anesthesia and Critical Care, MGH, draines@partners.org

Dr. Raines’ research focuses on the molecular mechanisms of anesthesia.  He will present the results of recent preclinical studies on a new intravenous anesthetic agent designed be ultra-short acting and to have minimal cardiovascular and respiratory side effects.  This agent is expected to be most useful for use in the elderly and critically ill and to allow more precise control of anesthetic effect.  

Panel will also include:

Emery Brown, MD, PhD, Massachusetts General Hospital Professor of Anaesthesia, Harvard Medical School, Department of Anesthesia and Critical Care, MGH, ebrown@partners.org

Dr. Brown develops in his statistical research signal processing algorithms and statistical methods to study how the brain and nervous system represent and transmit information. His experimental research uses combined functional magnetic resonance imaging and electrophysiological recordings to study how anesthetic drugs induce the state of general anesthesia in the human brain.

Keith Miller, DPhil, Mallinckrodt Professor of Pharmacology in Anaesthesia, Harvard Medical School; Director, Harvard Anaesthesia Center for Training and Research; Faculty Member, Biological and Biomedical Sciences, Neurobiology and Biophysics Graduate Programs, Harvard Medical School; Pharmacologist, Massachusetts General Hospital, kwmiller@partners.org

Dr. Miller’s research interest is the molecular mechanisms by which general anesthetics produce both the state of anesthesia and their side effects. His current work focuses on locating the binding sites of general anesthetics on neuronal ligand-gated ion channels.