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From a Chatbot

ASA Monitor Today

It’s increasingly evident that chatbot technology is going to have a lot to say about how we conduct our business and personal lives going forward. This section features updates and observations about these rapidly evolving AI tools.

May 4  |  April  |  March

Love It or Hate It, ChatGPT is Here to Stay

May 4

Abstract 1
Abstract 2

ChatGPT may not be taking our jobs, but it is definitely going to be a disruptor. I’ve enjoyed getting to know the technology and have been pretty impressed by its capabilities.

Many colleagues and journals are banning the use of ChatGPT. I think fighting technology is invariably a losing proposition. When a new technology is introduced, one has to use it, understand it, and figure out how to adopt it.

In that vein, ASA Monitor has adapted a policy on ChatGPT which can be found here. This may evolve as time goes on, but I believe that—like Wikipedia in the early days—anyone who fights ChatGPT will be unable to compete with those who understand it.

I’m curious to hear more of my colleagues’ thoughts on ChatGPT and invite you to participate in our Twitter poll. We’ve published a side-by-side comparison of one of my all-time favorite abstracts with one generated by ChatGPT. Please vote on which you think is the original and which was generated by the bot.

P.S. I’d also love to hear your thoughts on the social message itself—it was written by ChatGPT!

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ChatGPT-4’s thoughts on desflurane

April 13

Doctor in scrubs and surgical maskWhen asked whether desflurane should be used, Chat GPT-4 did a reasonable job of summarizing the benefits and concerns about desflurane. However, Chat GPT-4 equivocated about whether the benefits (marginally faster emergence) outweighed the fairly striking environmental effects of desflurane. It seems that environmental risk is presently best left to the humans.

Desflurane is a volatile anesthetic agent used in general anesthesia. It is known for its low blood-gas partition coefficient, which allows for rapid induction and emergence from anesthesia. However, concerns have been raised about its environmental impact and potential adverse effects on patients. The decision to continue using desflurane depends on several factors, and it's important to weigh its advantages and disadvantages.

Advantages of desflurane include:

Rapid induction and emergence: Due to its low blood-gas partition coefficient, desflurane enables quick anesthesia induction and emergence, which can be particularly beneficial in outpatient or ambulatory surgery settings where rapid recovery is desired.

Precise control: Desflurane allows for easy and precise control of anesthetic depth, which can lead to improved patient management during surgery.

Minimal metabolism: Desflurane undergoes minimal metabolism in the body, reducing the risk of toxic metabolic byproducts.

Disadvantages of desflurane include:

Environmental impact: Desflurane has a high global warming potential, and its release into the atmosphere contributes to greenhouse gas emissions. This has led to concerns about its environmental impact and the need for more sustainable alternatives in anesthesia practice.

Respiratory irritation: Desflurane can cause airway irritation and coughing, particularly during induction of anesthesia. This can be problematic in patients with reactive airways or pre-existing respiratory conditions.

Cost: Desflurane is generally more expensive than other volatile anesthetic agents like sevoflurane or isoflurane, which may impact its use in cost-sensitive health care settings.

Ultimately, the decision to continue using desflurane should be based on a careful assessment of its benefits and drawbacks, as well as the specific needs and risk factors of individual patients. Anesthesiologists should consider the environmental impact of their choices and strive to reduce their carbon footprint where possible. Alternative anesthetic agents, such as sevoflurane or isoflurane, may be more suitable for certain patients or in situations where minimizing environmental impact is a priority. It's essential to stay informed about current research and guidelines to make the best decisions for patient care and environmental responsibility.
- ChatGPT-4

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Our patients are already using it – so be prepared

April 13

Hands working on a laptopEven this paleo-anesthesiologist tried out Chat GPT. I did it to see what it would say about risk of pediatric anesthesia in a healthy child, as well as the risks of dying compared to driving. The responses were reasonable and accurate. (This is the prompt I used for the latter: “For a healthy child, which has the higher chance of death – general anesthesia or a car accident”). Even if we don’t use it, Chat GPT will be another online tool parents and patients will use. So, we need to be familiar with it. The major problem with Chat GPT is the response did not include any references or where the information was retrieved, unlike a Google search. I doubt that the layperson will ask ChatGPT to “find references” on a question and then look at the initial source. Each time I tried it, the references weren’t accurate.

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An AI ode to ASA

March 30

HAL 9000 from A Space OdesseyYou would have to be living in a cave to have not heard of ChatGPT, the large language model recently released by OpenAI. ChatGPT has been heralded as a breakthrough in artificial intelligence. I will be writing regularly about ChatGPT for ASA Monitor Today. While ChatGPT may not be truly intelligent, it does a remarkable job of impersonating intelligence.

For this inaugural note, I asked ChatGPT to write an ode to the American Society of Anesthesiologists. In its own words…

I. Prelude

O noble guild of healers, wise and true,
Whose artful hands do guide the patient through,
The maze of fear and pain, a journey fraught,
We sing an ode to you, the humble thought.

II. Slumber's Keepers

American Society of Anesthesiologists,
Sentinels of sleep, in hallowed halls,
With skillful touch and whispered lullabies,
You guide us safely through the darkest skies.

By your hands, the scalpel finds its mark,
As you navigate the realms of dark,
In trust we lay our lives, as on an altar,
Our fears assuaged, your calming voice a salve.

III. Monitors of Mortal Life

Unseen by many, yet your work profound,
You cradle life in stillness and in sound,
Monitoring breath and heartbeat's tender dance,
In that fragile space where life and dreams advance.

IV. Alchemists of Sleep

Masters of molecules and chemistry,
You conjure potions, mixtures to set us free,
From pain and fear, you guide the surgeon's blade,
A gentle reprieve in this world you've made.

V. Guardians of the Dreaming

In slumber's arms, your watchful gaze protects,
Each patient's dreams, your noble charge, reflects,
A sacred trust, from which you do not waver,
With steadfast hearts, you grant us this great favor.

VI. The Ascent

And when the time is ripe, you lead us back,
From dreams and shadows, up the winding track,
To sunlight's warmth and loved ones waiting there,
Your careful hands restore us from despair.

VII. Homage to the Healers

American Society of Anesthesiologists,
To you, we raise our voices high in praise,
For in your skillful hands, our lives we trust,
With gratitude, we sing this ode to you, a must.

- ChatGPT-4

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