In recent years, the healthcare sector has witnessed significant advancements through the integration of Artificial Intelligence (AI) technologies into various medical specialties. Anesthesiology is one of the fields that can greatly benefit from these technologies due to its close association with continuous monitoring of patients’ vital functions and making critical medical decisions within seconds. This article aims to review the major applications of artificial intelligence in anesthesiology and explain how they contribute to improving patient safety and enhancing the efficiency of surgical procedures. 1. Predictive Monitoring and Vital Signs Analysis During surgical procedures, patients may experience rapid changes in blood pressure, heart rate, and oxygen levels. Artificial intelligence systems, particularly Machine Learning algorithms, can process large amounts of monitoring data in real time. • Predicting Hemodynamic Instability: Some intelligent models can predict a decrease in blood pressure before it occurs. One example is the Hypotension Prediction Index (HPI), which provides anesthesiologists with an opportunity to intervene early and prevent potential complications. • Monitoring Anesthesia Depth: Algorithms can assist in analyzing electroencephalography (EEG) signals to estimate the effects of anesthesia, supporting appropriate drug dose adjustments and reducing the risks associated with inadequate or excessive anesthesia. 2. Airway Management and Difficult Intubation Managing a difficult airway is one of the major challenges faced by anesthesiologists. Artificial intelligence has contributed to the development of tools that support airway assessment and predict difficult intubation through the following applications: • Computer Vision Systems: Image analysis technologies can be used to assess the anatomical features of a patient’s face and neck, helping predict the likelihood of difficult tracheal intubation. • Smart Airway Endoscopes: Artificial intelligence can be integrated with imaging systems to provide real-time visual information that assists in guiding endotracheal tube placement, improving procedural accuracy and potentially reducing associated complications. 3. Pharmacological Management and Closed-Loop Delivery Systems Patient safety during anesthesia depends on the accurate administration of intravenous medications and inhalational anesthetic agents. Intelligent systems play an important role in improving drug dose control through applications such as: • Closed-Loop Systems: These systems automatically adjust the administration rates of certain anesthetic drugs or neuromuscular blocking agents according to the patient’s measured responses obtained through monitoring devices. Their goal is to maintain the desired therapeutic level and reduce the likelihood of human error. 4. Surgical Planning and Postoperative Care The benefits of artificial intelligence are not limited to the operating room; they also extend to the preoperative and postoperative stages through the following applications: • Preoperative Risk Assessment: Medical data analysis models can examine patients’ medical records and identify potential risk factors, supporting the development of an appropriate anesthesia plan for each patient. • Postoperative Pain Management: Predictive algorithms can help estimate patients’ analgesic requirements and personalize pain management plans, improving recovery and reducing the unnecessary use of opioid analgesics. Challenges and Future Prospects Despite the promising benefits of artificial intelligence in anesthesiology, its implementation faces several challenges, including: • Data Privacy and Security: Protecting sensitive medical information used to train and operate intelligent systems is essential. • Medical and Legal Responsibility: Responsibilities must be clearly defined when technical or clinical errors occur in association with the use of intelligent systems.• Human Integration: Artificial intelligence remains a supportive tool for clinical decision-making and cannot replace the clinical expertise and direct assessment provided by anesthesiologists. Conclusion Artificial intelligence represents an important advancement in anesthesiology, enabling a shift from responding to complications after they occur toward predicting potential risks and preparing for them in advance. As technology continues to develop, these applications may contribute to safer operating rooms, more precise medical procedures, and improved quality of healthcare, while preserving the essential role of anesthesiologists in clinical decision-making. Al Mustaqbal University The First University in Iraq