Anesthesia cockpit in Montreal controlling anesthesia in Pisa. THE CANADIAN PRESS/ho-Dept. of Anesthesia, McGill University, Montreal

Forget about falling asleep at the drop of a hat — how about at a click of a button?

In what's being billed as a world first, McGill University researchers partnered with a team from Pisa University in Italy in pioneering a way to administer anesthesia without being in the same room — or even on the same continent — as their patients.

During a two-week period, Dr. Thomas Hemmerling and his team from McGill's department of anesthesia treated 20 patients undergoing thyroid gland surgery in Italy, remotely from Montreal. The duration of the surgeries in the pilot project varied from between about 45 minutes and three hours.

The approach is part of a new technological advancement known as "teleanesthesia." It involves engineers, researchers and anesthesiologists administering drugs intravenously, which are then controlled remotely through an automated system.

There were two automated systems in place in both Montreal and Pisa, so if a video or Internet link was interrupted, the local automated system could still be taking care of anesthesia, Hemmerling said. The local team could override the administration of anesthesia at any time.

"It's like when you have a circuit somewhere and this circuit is interrupted, and you have a bypass already installed," Hemmerling said in an interview Friday.

"Your locally working automated system will continue to work whilst you are taking care of maybe re-establishing the link or just then make a decision what you will do, whether you continue with just a local automated system or go on a manual mode."

Four strategically placed video cameras allowed the team in Canada to monitor all aspects of patient care through a live stream.

A patient's breathing rate, vital signs, and surgery images are monitored on each camera, while a fourth was used for transmitting free-floating images. All of it is controlled by a remote computer station called the "anesthesia cockpit." The process also involves use of broadband Internet connection and Skype for the video link.

Once a pre-operation assessment is completed by video link, the patient heads to the operating room, has an IV put in, and the Montreal team takes over controlling the anesthesia while also helping to monitor the procedure. Administration of drugs was stopped remotely following surgery.

Hemmerling said there had been previous attempts in which people used video communications, even via satellite, to help someone in a remote area deal with a certain issue. But this was done, at least concerning anesthesia, on a consulting basis.

Researchers wanted to take a different approach and combine videoconferencing with controlling the process from a distance to see if the job of an anesthesiologist could be conducted through remote control.

Hemmerling said there has been a global trend towards telemedicine involving either remote medicine or remote control of procedures.

What's more, one of the common problems worldwide is a shortage of specialists. Hemmerling noted that in some African nations, there are fewer than 10 anesthesiologists in each country, and anesthesia care is often provided by nurses.

"Just imagine if in some African countries you could install locally an automated system, and you could then in addition either remotely control it, or at least be the remote backup," he said. "I'm sure you could increase quality or safety of the patient care."

Hemmerling said there was no link breakdown during the pilot-project surgeries. But he said the process needs to be repeated with a greater number of patients and a wider variety of surgeries, while also allowing researchers in Italy to control the anesthesia for patients in Montreal.

They will also do comparisons to see how the quality of remote anesthesia stacks up against standard administration.

"I think the quality of the anesthesia, so far, is at least as good as what we have as a standard anesthesia, if not superior, because it uses an automated system. So far it's been extremely successful."