Anaesthesia in 2050: how emerging technologies will transform our practice: The Sir Robert Macintosh Lecture 2025

In the next 25 years, we will see unprecedented technological progress due to the artificial intelligence (AI) revolution. AI-driven advances will be made in five strongly interconnected domains: reenergised drug discovery, continuous real-time monitoring, personalised medicine, automation and decentralised care. Drug discovery will move from in vitro to in silico approaches. We will identify molecules that fit protein targets and protein targets that fit molecules, allowing us to better understand mechanisms of anaesthesia and pain. Improved monitoring of physiological and biological variables will lead to better assessment and prediction of haemodynamics, anaesthetic depth and nociception. Anaesthetic care will be personalised by AI-driven analysis of population, personal and biomarker data, as well as an understanding of the values and wishes of patients. Automation will streamline routine tasks in hospitals, especially in relation to documentation and service delivery. Remote monitoring and assistance systems will help patients receive more of their care at home. The introduction of AI may have unforeseen consequences, especially for equity, sustainability and the future of work. We must think deeply about the future role of anaesthesiologists and ensure that we are involved in redesigning our role. AI can simulate empathy, and will do so increasingly well, but most of us will not be deceived because it is not the human-to-human connection that we crave. Perhaps the greatest gift of AI in anaesthesia practice will be that we come to value what it means to be human.