An innovative prototype for better management of inhalation anesthesia, the Boston Anesthesia System, was developed by the Bioengineering Unit, Department of Anesthesia, Massachusetts General Hospital. The system performs all the traditional functions required of an anesthesia machine, but includes many innovative safety, display, and system monitoring functions. In this poject, this prototype is used as a foundation for developing a complete, integrated anesthesia management system including semi-automated record-keeping, comprehensive physiological monitoring, measurement of anesthetic concentration in the breathing circuit, and capabilities of performing as a sophisticated anesthesia training simulator. This advanced anesthesia research instrumentation will employ a communication structure that preserves the inherent safety and reliability of the anesthesia administration functions while allowing flexibility and innovation of application. The BAS will act as a separate device within the instrumentation system and will contain a fixed, unalterable operating program separate from and uneffected by recording, monitoring, or display activities. The system will be used to test the feasibility and value of various strategies for semi-automated record-keeping. During this final year of the project grant, the feasibility of computer assisted record-keeping using a digitizing tablet will be evaluated. A related, but hardware-independent "flight recorder" system will be completed. Most of these will provide the critical and unique documentation of machine and human performance and patient response that will be necessary to safely and thoroughly evaluate clinical trials of the BAS. Efforts will be continued to propagate the concept of a system's approach to the design of anesthesia apparatus by monitoring the transfer of this technology to anesthesia practice.