Skip to main content
Log in

Progress and Perspective of Artificial Intelligence and Machine Learning of Prediction in Anesthesiology

  • Article
  • Published:
Journal of Shanghai Jiaotong University (Science) Aims and scope Submit manuscript

Abstract

Artificial intelligence (AI) has long been an attractive topic in medicine, especially in light of the rapid developments in digital and information technologies. AI has already provided some breakthroughs in medicine. With the assistance of AI, more precise models have been used for clinical predictions, diagnoses, and decision-making. This review defines the basic concepts of AI and machine learning (ML), and provides a simple introduction to certain frequently used algorithms in AI and ML. In addition, the review discusses the current common applications of AI and ML in the prediction of anesthesia conditions, including those for preoperative predictions of difficult airways, intraoperative predictions of adverse events and anesthetic effects, and postoperative predictions of vomiting and pain. The use of AI in anesthesiology remains in development, even without extensive promotion and clinical application; moreover, it has immense potential to maintain further development in the future. Finally, the limitations and challenges of AI development for anesthesia are also discussed, along with considerations regarding ethics and safety.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. JORDAN M I, MITCHELL T M. Machine learning: Trends, perspectives, and prospects [J]. Science, 2015, 349(6245): 255–260.

    Article  MathSciNet  MATH  Google Scholar 

  2. IBRAHIM A, PRIMAKOV S, BEUQUE M, et al. Radiomics for precision medicine: Current challenges, future prospects, and the proposal of a new framework [J]. Methods, 2021, 188: 20–29.

    Article  Google Scholar 

  3. ANEJA S, CHANG E, OMURO A. Applications of artificial intelligence in neuro-oncology [J]. Current Opinion in Neurology, 2019, 32(6): 850–856.

    Article  Google Scholar 

  4. SCHWYZER M, MARTINI K, BENZ D C, et al. Artificial intelligence for detecting small FDG-positive lung nodules in digital PET/CT: Impact of image reconstructions on diagnostic performance [J]. European Radiology, 2020, 30(4): 2031–2040.

    Article  Google Scholar 

  5. LAURITSEN S M, KRISTENSEN M, OLSEN M V, et al. Explainable artificial intelligence model to predict acute critical illness from electronic health records [J]. Nature Communications, 2020, 11(1): 3852.

    Article  Google Scholar 

  6. GUNASEKERAN D V, TING D S W, TAN G S W, et al. Artificial intelligence for diabetic retinopathy screening, prediction and management [J]. Current Opinion in Ophthalmology, 2020, 31(5): 357–365.

    Article  Google Scholar 

  7. LOFTUS T J, TIGHE P J, FILIBERTO A C, et al. Artificial intelligence and surgical decision-making [J]. JAMA Surgery, 2020, 155(2): 148–158.

    Article  Google Scholar 

  8. SHORTLIFFE E H, SEPÚLVEDA M J. Clinical decision support in the era of artificial intelligence [J]. JAMA, 2018, 320(21): 2199–2200.

    Article  Google Scholar 

  9. LEE M S, GRABOWSKI M M, HABBOUB G, et al. The impact of artificial intelligence on quality and safety [J]. Global Spine Journal, 2020, 10(Sup 1): 99–103.

    Article  Google Scholar 

  10. HOGARTY D T, MACKEY D A, HEWITT A W. Current state and future prospects of artificial intelligence in ophthalmology: A review [J]. Clinical & Experimental Ophthalmology, 2019, 47(1): 128–139.

    Article  Google Scholar 

  11. WANG S Y, PERSHING S, LEE A Y, et al. Big data requirements for artificial intelligence [J]. Current Opinion in Ophthalmology, 2020, 31(5): 318–323.

    Article  Google Scholar 

  12. CONNOR C W. Artificial intelligence and machine learning in anesthesiology [J]. Anesthesiology, 2019, 131(6): 1346–1359.

    Article  Google Scholar 

  13. RAJKOMAR A, DEAN J, KOHANE I. Machine learning in medicine [J]. The New England Journal of Medicine, 2019, 380(14): 1347–1358.

    Article  Google Scholar 

  14. HOWARD J. Artificial intelligence: Implications for the future of work [J]. American Journal of Industrial Medicine, 2019, 62(11): 917–926.

    Article  Google Scholar 

  15. HANDELMAN G S, KOK H K, CHANDRA R V, et al. eDoctor: Machine learning and the future of medicine [J]. Journal of Internal Medicine, 2018, 284(6): 603–619.

    Article  Google Scholar 

  16. MOORE M M, SLONIMSKY E, LONG A D, et al. Machine learning concepts, concerns and opportunities for a pediatric radiologist [J]. Pediatric Radiology, 2019, 49(4): 509–516.

    Article  Google Scholar 

  17. UDDIN S, KHAN A, HOSSAIN M E, et al. Comparing different supervised machine learning algorithms for disease prediction [J]. BMC Medical Informatics and Decision Making, 2019, 19(1): 281.

    Article  Google Scholar 

  18. CRUZ J A, WISHART D S. Applications of machine learning in cancer prediction and prognosis [J]. Cancer Informatics, 2007, 2: 59–77.

    Google Scholar 

  19. ZHAO X, WU Y H, LEE D L, et al. iForest: Interpreting random forests via visual analytics [J]. IEEE Transactions on Visualization and Computer Graphics, 2019, 25(1): 407–416.

    Article  Google Scholar 

  20. HASHIMOTO D A, WITKOWSKI E, GAO L, et al. Artificial intelligence in anesthesiology: Current techniques, clinical applications, and limitations [J]. Anesthesiology, 2020, 132(2): 379–394.

    Article  Google Scholar 

  21. PERGIALIOTIS V, POULIAKIS A, PARTHENIS C, et al. The utility of artificial neural networks and classification and regression trees for the prediction of endometrial cancer in postmenopausal women [J]. Public Health, 2018, 164: 1–6.

    Article  Google Scholar 

  22. HINTON G. Deep learning: A technology with the potential to transform health care [J]. JAMA, 2018, 320(11): 1101–1102.

    Article  Google Scholar 

  23. LECUN Y, BENGIO Y, HINTON G. Deep learning [J]. Nature, 2015, 521(7553): 436–444.

    Article  Google Scholar 

  24. GREGORY A, STAPELFELDT W H, KHANNA A K, et al. Intraoperative hypotension is associated with adverse clinical outcomes after noncardiac surgery [J]. Anesthesia and Analgesia, 2021, 132(6): 1654–1665.

    Article  Google Scholar 

  25. SMISCHNEY N J, SHAW A D, STAPELFELDT W H, et al. Postoperative hypotension in patients discharged to the intensive care unit after non-cardiac surgery is associated with adverse clinical outcomes [J]. Critical Care (London, England), 2020, 24(1): 682.

    Article  Google Scholar 

  26. HATIB F, JIAN Z P, BUDDI S, et al. Machine-learning algorithm to predict hypotension based on high-fidelity arterial pressure waveform analysis [J]. Anesthesiology, 2018, 129(4): 663–674.

    Article  Google Scholar 

  27. DAVIES S J, VISTISEN S T, JIAN Z P, et al. Ability of an arterial waveform analysis-derived hypotension prediction index to predict future hypotensive events in surgical patients [J]. Anesthesia and Analgesia, 2020, 130(2): 352–359.

    Article  Google Scholar 

  28. WIJNBERGE M, GEERTS B F, HOL L, et al. Effect of a machine learning-derived early warning system for intraoperative hypotension vs standard care on depth and duration of intraoperative hypotension during elective noncardiac surgery: The HYPE randomized clinical trial [J]. JAMA, 2020, 323(11): 1052–1060.

    Article  Google Scholar 

  29. MAHESHWARI K, BUDDI S, JIAN Z P, et al. Performance of the Hypotension Prediction Index with non-invasive arterial pressure waveforms in non-cardiac surgical patients [J]. Journal of Clinical Monitoring and Computing, 2021, 35(1): 71–78.

    Article  Google Scholar 

  30. LIN C S, CHANG C C, CHIU J S, et al. Application of an artificial neural network to predict postinduction hypotension during general anesthesia [J]. Medical Decision Making, 2011, 31(2): 308–314.

    Article  Google Scholar 

  31. KENDALE S, KULKARNI P, ROSENBERG A D, et al. Supervised machine-learning predictive analytics for prediction of postinduction hypotension [J]. Anesthesiology, 2018, 129(4): 675–688.

    Article  Google Scholar 

  32. KANG A R, LEE J, JUNG W, et al. Development of a prediction model for hypotension after induction of anesthesia using machine learning [J]. PLoS One, 2020, 15(4): e0231172.

    Article  Google Scholar 

  33. LUNDBERG S M, NAIR B, VAVILALA M S, et al. Explainable machine-learning predictions for the prevention of hypoxaemia during surgery [J]. Nature Biomedical Engineering, 2018, 2(10): 749–760.

    Article  Google Scholar 

  34. GENG W, TANG H, SHARMA A, et al. An artificial neural network model for prediction of hypoxemia during sedation for gastrointestinal endoscopy [J]. The Journal of International Medical Research, 2019, 47(5): 2097–2103.

    Article  Google Scholar 

  35. APFEL C C, KRANKE P, EBERHART L H J, et al. Comparison of predictive models for postoperative nausea and vomiting [J]. British Journal of Anaesthesia, 2002, 88(2): 234–240.

    Article  Google Scholar 

  36. EBERHART L H J, HÖGEL J, SEELING W, et al. Evaluation of three risk scores to predict postoperative nausea and vomiting [J]. Acta Anaesthesiologica Scandinavica, 2000, 44(4): 480–488.

    Article  Google Scholar 

  37. TRAEGER M, EBERHART A, GELDNER G, et al. Prediction of postoperative nausea and vomiting using an artificial neural network [J]. Der Anaesthesist, 2003, 52(12): 1132–1138.

    Google Scholar 

  38. PENG S Y, WU K C, WANG J J, et al. Predicting postoperative nausea and vomiting with the application of an artificial neural network [J]. British Journal of Anaesthesia, 2007, 98(1): 60–65.

    Article  Google Scholar 

  39. GONG C S A, YU L, TING C K, et al. Predicting postoperative vomiting for orthopedic patients receiving patient-controlled epidural analgesia with the application of an artificial neural network [J]. BioMed Research International, 2014, 2014: 786418.

    Article  Google Scholar 

  40. WU H Y, GONG C A, LIN S P, et al. Predicting postoperative vomiting among orthopedic patients receiving patient-controlled epidural analgesia using SVM and LR [J]. Scientific Reports, 2016, 6: 27041.

    Article  Google Scholar 

  41. WHITLOCK E L, FEINER J R, CHEN L L. Perioperative mortality, 2010 to 2014: A retrospective cohort study using the national anesthesia clinical outcomes registry [J]. Anesthesiology, 2015, 123(6): 1312–1321.

    Article  Google Scholar 

  42. HOVE L D, STEINMETZ J, CHRISTOFFERSEN J K, et al. Analysis of deaths related to anesthesia in the period 1996–2004 from closed claims registered by the Danish Patient Insurance Association [J]. Anesthesiology, 2007, 106(4): 675–680.

    Article  Google Scholar 

  43. DETSKY M E, JIVRAJ N, ADHIKARI N K, et al. Will this patient be difficult to intubate? [J]. JAMA, 2019, 321(5): 493.

    Article  Google Scholar 

  44. CONNOR C W, SEGAL S. The importance of subjective facial appearance on the ability of anesthesiologists to predict difficult intubation [J]. Anesthesia and Analgesia, 2014, 118(2): 419–427.

    Article  Google Scholar 

  45. CONNOR C W, SEGAL S. Accurate classification of difficult intubation by computerized facial analysis [J]. Anesthesia and Analgesia, 2011, 112(1): 84–93.

    Article  Google Scholar 

  46. CUENDET G L, SCHOETTKER P, YÜCE A, et al. Facial image analysis for fully automatic prediction of difficult endotracheal intubation [J]. IEEE Transactions on Biomedical Engineering, 2016, 63(2): 328–339.

    Article  Google Scholar 

  47. MATAVA C, PANKIV E, AHUMADA L, et al. Artificial intelligence, machine learning and the pediatric airway [J]. Paediatric Anaesthesia, 2020, 30(3): 264–268.

    Article  Google Scholar 

  48. DING Y M, WANG J X, GAO J D, et al. Severity evaluation of obstructive sleep apnea based on speech features [J]. Sleep and Breathing, 2021, 25(2): 787–795.

    Article  Google Scholar 

  49. ESPINOZA-CUADROS F, FERNÁNDEZ-POZO R, TOLEDANO D T, et al. Speech signal and facial image processing for obstructive sleep apnea assessment [J]. Computational and Mathematical Methods in Medicine, 2015, 2015: 489761.

    Article  Google Scholar 

  50. LIN C S, LI Y C, MOK M S, et al. Neural network modeling to predict the hypnotic effect of propofol bolus induction [C]//AMIA 2002 Annual Symposium Proceedings. San Antonio, TX: AMIA, 2002: 450–453.

    Google Scholar 

  51. IONESCU C M, DE KEYSER R, TORRICO B C, et al. Robust predictive control strategy applied for propofol dosing using BIS as a controlled variable during anesthesia [J]. IEEE Transactions on Biomedical Engineering, 2008, 55(9): 2161–2170.

    Article  Google Scholar 

  52. SEPÚLVEDA P O, CORTÍNEZ L I, RECART A, et al. Predictive ability of propofol effect-site concentrations during fast and slow infusion rates [J]. Acta Anaesthesiologica Scandinavica, 2010, 54(4): 447–452.

    Article  Google Scholar 

  53. YI J M, DOH I, LEE S H, et al. Predictive performance of a new pharmacokinetic model for propofol in underweight patients during target-controlled infusion [J]. Acta Anaesthesiologica Scandinavica, 2019, 63(4): 448–454.

    Article  Google Scholar 

  54. NUNES C S, MENDONCA T F, AMORIM P, et al. Radial basis function neural networks versus fuzzy models to predict return of consciousness after general anesthesia [C]// Proceedings of the 26th Annual International Conference of the IEEE EMBS. San Francisco, CA: IEEE, 2004: 865–868.

    Google Scholar 

  55. SANTANEN O A P, SVARTLING N, HAASIO J, et al. Neural nets and prediction of the recovery rate from neuromuscular block [J]. European Journal of Anaesthesiology, 2003, 20(2): 87–92.

    Article  Google Scholar 

  56. NAIR A A, VELAGAPUDI M A, LANG J A, et al. Machine learning approach to predict postoperative opioid requirements in ambulatory surgery patients [J]. PLoS One, 2020, 15(7): e0236833.

    Article  Google Scholar 

  57. LEE S, WEI S J, WHITE V, et al. Classification of opioid usage through semi-supervised learning for total joint replacement patients [J]. IEEE Journal of Biomedical and Health Informatics, 2021, 25(1): 189–200.

    Article  Google Scholar 

  58. LU Y N, FORLENZA E, WILBUR R R, et al. Machine-learning model successfully predicts patients at risk for prolonged postoperative opioid use following elective knee arthroscopy [J]. Knee Surgery, Sports Traumatology, Arthroscopy, 2021. https://doi.org/10.1007/s00167-020-06421-7.

  59. ELLIS R J, WANG Z C, GENES N, et al. Predicting opioid dependence from electronic health records with machine learning [J]. BioData Mining, 2019, 12:3.

    Article  Google Scholar 

  60. JUNGQUIST C R, CHANDOLA V, SPULECKI C, et al. Identifying patients experiencing opioid-induced respiratory depression during recovery from anesthesia: The application of electronic monitoring devices [J]. Worldviews on Evidence-Based Nursing, 2019, 16(3): 186–194.

    Article  Google Scholar 

  61. RAHMAN Q A, JANMOHAMED T, CLARKE H, et al. Interpretability and class imbalance in prediction models for pain volatility in manage my pain app users: Analysis using feature selection and majority voting methods [J]. JMIR Medical Informatics, 2019, 7(4): e15601.

    Article  Google Scholar 

  62. HU Y J, KU T H, JAN R H, et al. Decision tree-based learning to predict patient controlled analgesia consumption and readjustment [J]. BMC Medical Informatics and Decision Making, 2012, 12: 131.

    Article  Google Scholar 

  63. MILLER D D, BROWN E W. Artificial intelligence in medical practice: The question to the answer? [J]. The American Journal of Medicine, 2018, 131(2): 129–133.

    Article  Google Scholar 

  64. ALEXANDER J C, JOSHI G P. Anesthesiology, automation, and artificial intelligence [J]. Baylor University Medical Center Proceedings, 2018, 31(1): 117–119.

    Article  Google Scholar 

  65. LI W, LIU H, YANG P, et al. Supporting regularized logistic regression privately and efficiently [J]. PLoS One, 2016, 11(6): e0156479.

    Article  Google Scholar 

  66. CHAPALAIN X, HUET O. Is artificial intelligence (AI) at the doorstep of Intensive Care Units (ICU) and operating room (OR)? [J]. Anaesthesia, Critical Care & Pain Medicine, 2019, 38(4): 337–338.

    Article  Google Scholar 

  67. CHAR D S, SHAH N H, MAGNUS D. Implementing machine learning in health care-addressing ethical challenges [J]. The New England Journal of Medicine, 2018, 378(11): 981–983.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hong Jiang  (姜 虹).

Additional information

Foundation item: the Interdisciplinary Program of Shanghai Jiao Tong University (No. ZH2018ZDA14) and the Clinical Research Plan of the Shenkang Hospital Development Center (No. SHDC2020CR3043B)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Xia, M., Xu, T. & Jiang, H. Progress and Perspective of Artificial Intelligence and Machine Learning of Prediction in Anesthesiology. J. Shanghai Jiaotong Univ. (Sci.) 27, 112–120 (2022). https://doi.org/10.1007/s12204-021-2331-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12204-021-2331-3

Key words

CLC number

Document code

Navigation