Artificial Intelligence in Anaesthesiology: Current Applications, Challenges, and Future Directions

Artificial intelligence (AI) is rapidly transforming anaesthesiology through advances in machine learning, deep learning, and large language models. AI-driven tools now contribute to nearly every phase of perioperative care, including preoperative risk stratification, intraoperative monitoring, imaging interpretation, airway assessment, regional anaesthesia, and critical care. Applications such as automated American Society of Anesthesiologists classification, prediction of postoperative complications and intensive care unit needs, electroencephalography-based depth-of-anaesthesia estimation, and proactive haemodynamic management are reshaping clinical decision-making. AI-augmented echocardiography enhances chamber recognition and functional measurements, whereas computer vision systems support airway evaluation and ultrasound-guided regional anaesthesia by providing real-time anatomical identification and facilitating training. In critical care, AI models facilitate the early detection of sepsis, organ dysfunction, and haemodynamic instability, while improving workflow efficiency and resource allocation. AI is increasingly used in academic writing, data processing, and medical education, offering opportunities for personalised learning and simulation but raising concerns about accuracy and hallucinations. In this review, we aimed to summarise the current applications of AI in anaesthesiology, highlight the methodological, ethical, and practical challenges that limit its integration, and discuss future directions for its safe and effective adoption in perioperative care.