Increasing reality in simulating intravenous anesthesia on the full-scale simulator

A total of 3 years have passed since a full-scale simulator (human patient simulator HPS) was introduced in Hamamatsu University for training in anest hesia. The software has been updated promptly in both inhalational and intr avenous (i.v.) anesthesia simulation programs during this period. However, in comparing the simulation reality of these inhalational and i.v. anesthes ia, there has been significant difference between them. In contrast to the inhalational anesthesia training, in which the change of concentration was accomplished by controlling the anesthesia machine directly, bolus dosing o r controlling the rate of continuous infusion are accomplished only on the computer display in i.v. infusion. There was no opportunity for trainees to touch the buttons of a pump to change the rate and to run the pump, and al so no chance to be engaged in the handling of troubles related with the pre paration of the infusion and those in the period of infusion (air bubble, p refilling of the catheter, control of the three-way stopcock, siphoning pro blems, etc.). We have developed an i.v. infusion training system to change this unrealistic environment to a real one. It consists of a PC (Compaq Arm ada) and pump (Graseby 3500), and software was developed by Pascal (Delphi 3.1) on the Windows operating system. The system supports both manual infus ion and target-controlled infusion (TCI) and can provide a tool to make the HPS more realistic in i.v. infusion training.