Background and Objective The aim of this narrative review is to analyze whether or not artificial intelligence (AI) and its subsets are implemented in current clinical anesthetic practice, and to describe the current state of the research in the field. AI is a general term which refers to all the techniques that enable computers to mimic human intelligence. AI is based on algorithms that gives machines the ability to reason and perform functions such as problem-solving, object and word recognition, inference of world states, and decision-making. It includes machine learning (ML) and deep learning (DL). Methods We performed a narrative review of the literature on Scopus, PubMed and Cochrane databases. The research string comprised various combinations of “artificial intelligence”, “machine learning”, “anesthesia”, “anesthesiology”. The databases were searched independently by two authors. A third reviewer would mediate any disagreement the results of the two screeners. Key Content and Findings The application of AI has shown excellent results in both anesthesia and in operating room (OR) management. In each phase of the perioperative process, pre-, intra- and postoperative ones, it is able to perform different and specific tasks, using various techniques. Conclusions Thanks to the use of these new technologies, even anesthesia, as it is happening for other disciplines, is going through a real revolution, called Anesthesia 4.0. However, AI is not free from limitations and open issues. Unfortunately, the models created, provided they have excellent performance, have not yet entered daily practice. Clinical impact analyzes and external validations are needed before this happens. Therefore, qualitative research will be needed to better understand the ethical, cultural, and societal implications of integrating AI into clinical workflows.

BACKGROUND The potential role of artificial intelligence in enhancing human life and medical practice is under investigation but the knowledge of the topic among healthcare providers is under-investigated. OBJECTIVES To investigate knowledge of artificial intelligence in physicians working in the field of anaesthesiology, intensive care, and pain medicine. As secondary outcomes, we investigated the main concerns on the implementation of artificial intelligence. DESIGN Online survey. SETTING Anaesthesiology, intensive care and pain medicine. VOLUNTEERS We invited clinicians specialised in anaesthesia, resuscitation, intensive care and pain medicine who were active members of the European Society of Anaesthesiology and Intensive Care (ESAIC). INTERVENTION Online survey from 28 June 2022 to 29 October 2022. MAIN OUTCOME MEASURES Primary outcome was to investigate knowledge of artificial intelligence and telemedicine of participants. RESULTS A total of 4465 e-mails were sent and 220 specialists, age 46.5 ± 10.2; 128 men (58.2%) responded to the survey. In general, some knowledge of artificial intelligence and machine learning was reported by 207 of 220 (94.1%) and 180 of 220 (81.8%) members, respectively. In anaesthesiology, 168 of 220 (76.4%) and 151 of 220 (68.6%) have heard of artificial intelligence and machine learning. In intensive care, 154 of 220 (70.0%) and 133 of 220 (60.5%) had heard of artificial intelligence and machine learning, while these figures were much lower in pain medicine [artificial intelligence: only 70/220 (31.8%) and machine learning 67/220 (30.5%)]. The main barriers to implementing these tools in clinical practice were: lack of knowledge of algorithms leading to the results; few validation studies available and not enough knowledge of artificial intelligence. Knowledge of telemedicine was reported in 212 of 220 (96.4%) members. CONCLUSION Most anaesthesiologists are aware of artificial intelligence and machine learning. General thinking about the application of artificial intelligence in anaesthesiology, intensive care and pain management was positive overall, with most participants not considering this tool as a threat to their profession.