Advances in Remote Monitoring Technology Applications in Anesthesia: A Narrative Review

Clinical Snapshot

Key Findings

• P Value: Not reported

• Effect Size: Not formally reported in this review. The TRaCINg trial findings are described as 'exploratory' and suggesting potential reductions in unplanned ICU admissions and shorter hospital stays with continuous remote monitoring — no specific effect estimates are synthesised

• Primary Outcome: Narrative synthesis of remote monitoring technology applications across the perioperative pathway; primary clinical evidence anchor is the TRaCINg feasibility RCT examining continuous versus intermittent National Early Warning Score (NEWS) monitoring after major surgery

• Nnt Or Sensitivity: Not calculable from this narrative review. The TRaCINg trial is a feasibility RCT; definitive NNT estimates for clinical outcomes cannot be derived from feasibility-phase data. No sensitivity or specificity data for monitoring platforms are pooled or reported.

• Confidence Interval: Not reported

Clinical Application

Implementation feasibility varies substantially by healthcare setting. 5G-dependent platforms require robust telecommunications infrastructure not universally available. IoT device integration demands interoperability standards and cybersecurity frameworks. Staff training, workflow redesign, and alert fatigue management are identified as significant implementation barriers. Cost-effectiveness data are absent from this review, limiting health economic assessment. Remote monitoring technologies in anaesthesia have emerging relevance to Australian practice, particularly for rural and remote healthcare delivery where specialist anaesthesia oversight is limited. The Australian Digital Health Agency's national digital health strategy and the My Health Record system provide a policy framework for remote monitoring integration. The TGA would need to evaluate wearable monitoring devices as medical devices under the Therapeutic Goods Act 1989 before clinical deployment. RACGP and ANZCA guidelines do not yet formally address remote perioperative monitoring protocols. PBS listing of remote monitoring services would require evidence from definitive RCTs — not yet available. The Royal Flying Doctor Service and telehealth expansion post-COVID-19 represent existing infrastructure that could support remote anaesthesia monitoring in regional contexts. However, the evidence base reviewed here is insufficient to support formal guideline changes in Australian anaesthesia practice at this time. Perioperative patients undergoing surgery requiring anaesthesia, particularly those at elevated risk of postoperative complications who may benefit from continuous physiological monitoring beyond the immediate recovery period. Potentially most applicable to high-acuity surgical populations (major abdominal, cardiac, orthopaedic surgery) in hospital settings with adequate digital infrastructure.

Abstract

The swift progress of digital and sensor technologies is hastening the incorporation of remote monitoring into anesthesiology. While several reviews have explored telemedicine and artificial intelligence in anesthesia, most existing summaries either focus on conceptual outlook or lack systematic comparison of technical platforms and original clinical validation data. The present review provides a comprehensive, clinically oriented synthesis of remote monitoring in anesthesia, with clear focuses on technical principles, perioperative applications, platform comparisons, and evidence-based clinical outcomes. We critically assess clinical advantages and implementation hurdles, covering the full perioperative pathway - preoperative evaluation, intraoperative observation, and postoperative recovery. A head-to-head comparison of fifth generation of cellular network technology (5G), the Internet of Things (IoT), and cloud computing platforms is presented to clarify their infrastructure demands and suitability for real-world clinical scenarios. Notably, this review summarizes available clinical evidence, including evidence from the Trial of Remote Continuous versus Intermittent National Early Warning Score Monitoring after major surgery (TRaCINg) - a feasibility randomized controlled trial whose exploratory findings suggest that continuous remote monitoring may reduce unplanned intensive care unit admissions, shorten hospital stays, and facilitate earlier detection of postoperative complications. We further propose innovative solutions including multimodal data fusion and federated learning-driven predictive analytics to overcome current limitations in data interoperability, security, and clinical effectiveness. Accordingly, this paper synthesizes the latest advances in remote monitoring technology in anesthesia, clarifies its unique value relative to existing reviews, and provides practical guidance for clinical translation and future research.

References

1. 1.Chen, L., Cheng, S., Zhang, L., Li, H., Tu, Z., & Cai, X. (2026). Advances in remote monitoring technology applications in anesthesia: A narrative review. Medical Science Monitor: International Medical Journal of Experimental and Clinical Research. https://doi.org/10.12659/MSM.952513