WO1998047409A1 - Portable anesthesia delivery system - Google Patents

Abstract

A modular, portable anesthesia delivery system (10) includes a first unit (12) and a second unit (14) each having a number of individual cabinets (16, 18, 20, 22) releasably interconnected one on top of the other to form a stack which is movable on casters (26) or the like to an in-office operating suite. Once the surgical procedure is completed, the cabinets are easily separated from one another for independent handling and transport. A top cabinet (16) of one unit houses a suction device and a ventilator, and a top cabinet of the other unit mounts patient monitoring equipment, at least two pumping devices and a defibrillator. The remaining cabinets of the units have drawers (28, 30, 32, 34) which collectively house consumable products necessary to support the delivery of anesthesia, including medications, and airway, breathing and circulatory items.

Description

PORTABLE ANESTHESIA DELIVERY SYSTEM

This application is a continuation-in-part application of co-pending U.S. Patent Application Serial

No. 08/847,565, filed April 24, 1997, and entitled "Apparatus And Method for Total Intravenous Anesthesia

And Associated Procedures . "

Field of the Invention

This invention relates to anesthesia systems, and, more particularly, to an anesthesia system which is modular, portable and particularly intended for use in ambulatory care to deliver analgesic agents which achieve total intravenous anesthesia without the use of inhaled anesthetics .

Background of the Invention Historically, surgical procedures requiring anesthesia have been performed in the operating rooms of hospitals, or similarly equipped medical facilities. In these settings, inhalation anesthesia agents are typically employed with relatively sophisticated open or closed loop delivery systems available from a number of manufacturers . Delivery systems of this type incorporate electronic ventilation, flow management systems, an array of sensors to monitor various patient parameters, vaporization circuits, breathing circuits filtering devices and a variety of other equipment . The resulting system is expensive, bulky and essentially permanently located within a particular operating room once it has been set up and calibrated. The lack of portability of anesthesia systems of the type described above is also attributable to disposal requirements associated with inhaled anesthesia agents. Since inhaled anesthetics are airborne, governmental regulations such as those issued by OSHA in the United States require the use of scavenging systems to protect the environment and the occupants of the operating room. Conventional anesthesia systems are integrally connected to the scavenging system of the hospital to ensure removal of anesthesia agents dumped from the breathing circuit, or otherwise subject to possible spillage into the operating room. Integration of the anesthesia delivery system with the hospital scavenging system further restricts the movement of such anesthesia systems . Despite the tradition of performing surgical procedures in a hospital setting, with conventional inhaled anesthesia delivery systems, the recent trend in health care has been to replace in-patient hospital care with ambulatory care. It is estimated that ambulatory surgery now accounts for about 60% of all surgical procedures in the United States, and that percentage is expected to increase to about 80% by the year 2000. The impetus for this change includes a more universal acceptance among physicians of minimally invasive surgical techniques, financial pressures on the part of third party payers to reduce or refuse payments for certain procedures and/or extended hospital stays, and, the extent to which patients have embraced the convenience and efficacy of ambulatory care.

A variety of specialties and procedures have been identified as good candidates for office-based care including plastic surgery, dental and oral surgery, ophthalmology, podiatry, dermatology, OB/gyn procedures and infertility. The intent is to eliminate the high overhead of a hospital operating room when performing procedures in these areas, without transferring such costs to the individual physician. Nothing is gained on the part of the surgeon if he or she must purchase and install an inhalation-type anesthesia system, including a scavenging system, in order to perform in- office procedures . An important step in the effort to provide cost-effective anesthesia support for ambulatory procedures has been the development of analgesic agents which are capable of achieving total intravenous anesthesia without an inhaled anesthesia agent, and, hence, without the need for expensive scavenging systems . One agent of this type is commercially available from Glaxo Wellcome under the trademark "Ultiva" (remifentanil hydrochloride) , which is a mu- opioid agonist analgesic for intravenous administration. This agent is characterized by an extremely rapid achievement of the peak effect of an intravenous dose, and a rapid elimination via non-specific esterases which are found throughout the body. In fact, there is a virtually complete cessation of the effects of this agent within five to ten minutes after discontinuing its administration. Consequently, Ultiva can be titrated to high levels of opioid analgesic effect, and can be rapidly titrated during surgery to optimize analgesia, without delaying or prolonging the patient's recovery. This feature lends itself well to ambulatory procedures where short recovery time is highly desirable . Typically, a combination of agents with differing properties are used during anesthesia to achieve a balance of effects needed to maintain the anesthetic state, e.g. amnesia, analgesia, muscle relaxation and sedation. A second ultra-short acting agent has been developed and is offered by Zeneca under the trademark "Diprivan" (propofol) which is a sedative- hypnotic. When administered together, remifentanil and propofol have been shown to be highly effective in achieving total intravenous anesthesia in which peak effect is obtained rapidly, and wherein the effects wear off within a period of about five to ten minutes . Compared to traditional inhaled anesthesia agents, the rapid onset and offset characteristics of these intravenous agents make them the drugs of choice for ambulatory care.

To date, the advances made in intravenous analgesic agents have not been matched by equipment capable of delivering such drugs to the patient in an ambulatory setting. Physicians who wish to perform in- office procedures in the practice areas noted above, with the assistance of a licensed, qualified anesthesiologist, have been forced to purchase equipment necessary to support the conduct of anesthesia delivery in their office suites. Even though such expenditures are much less than what would be required with the equipment needed to deliver inhaled anesthesia agents, there is nevertheless a need for a more cost effective solution to this problem.

Summary of the Invention

It is therefore among the objectives of this invention to provide an anesthesia delivery system which achieves total intravenous anesthesia without inhaled anesthetic agents, which is particularly intended for ambulatory care, which complies with all standards of the American Society of Anesthesiologists, which avoids OSHA disposal issues, and, which is economical to purchase and operate . These objectives are accomplished in a modular, portable anesthesia delivery system which includes a first unit and a second unit each having a number of individual cabinets releasably interconnected one on top of the other to form a stack which is movable on casters or the like. Once the surgical procedure is completed, the cabinets are easily separated from one another for independent handling and transport . A top cabinet of one unit houses a suction device and a ventilator, and a top cabinet of the other unit mounts patient monitoring equipment, at least two pumping devices and a defibrillator . The remaining cabinets of the units have drawers which collectively house consumable products necessary to support the delivery of anesthesia, including medications, and airway, breathing and circulatory items.

This invention is predicated on the concept of providing a completely equipped system for delivering total intravenous anesthesia in an in-office or ambulatory care setting by a qualified anesthesiologist. All of the equipment and supplies required by ASA standards are contained in the various cabinets forming the two units. Unlike the bulky, essentially permanently mounted anesthesia systems employed in hospitals for the delivery of inhaled anesthesia agents, the system of this invention is modular and readily portable from one physician's office to another. The cabinets forming each unit are easily separated from one another and then loaded in a van or other vehicle for transport to the physician's office at which the ambulatory procedure is to be performed. When the anesthesiologist arrives at the surgeon's office, the cabinets are releasably interconnected one on top of the other to form a stack which is carried on a base having casters to permit movement of the stack or unit into the operating suite. After completion of the procedure, the units are rolled out of the surgeon's office, separated into individual cabinets for loading into the vehicle and then transported to the next office, clinic or other site as required.

In the presently preferred embodiment, each individual cabinet is formed with a top wall, bottom wall, opposed sidewalls and an endwall which define a hollow interior for receiving one or more drawers . As noted above, the top cabinets of one unit house a suction device and a ventilator, while the other unit has a top cabinet carrying patient monitoring equipment, two pumping devices and a defibrillator . The remaining cabinets house consumable items, described in more detail below, necessary for the conduct of anesthesia delivery.

Each cabinet has locking structure to interconnect the cabinets one on top of the other in a vertical stack. This locking structure includes a series of parallel ribs mounted on the top wall of the cabinets, with each rib having at least one notch along the length thereof . The bottom wall of each cabinet is formed with a series of recesses, each having at least one projection, which are located to receive the ribs on the top wall of a cabinet below so the projection within each recess is inserted within the notch of a corresponding rib. Additionally, each cabinet is formed with a pair of throughbores at the back corners which align with one another when the cabinets are in a stack. These throughbores each receive a pole, such as an IV pole, whose bottom end locks within a seat formed in the base upon which the cabinets rest. The IV poles add stability to the stack, in addition to the rib-recess connection between cabinets, and also provide a hand grip for movement of the stack along a flat surface and tilting of the stack for transport over a curb or up steps .

All of the electrical equipment housed in the top cabinet of each stack or unit is connected to a common multiple outlet receptacle strip, which, in turn, has a single electrical cord for connection to an outlet at the operating suite . A backup battery source is included on each unit to run the electrical equipment in the event of a power failure. In the presently preferred embodiment, the bottom cabinet of at least one unit includes hinged brackets which are movable between a folded position against the cabinet for transport, and an unfolded position to receive and mount one or more oxygen tanks .

As noted above, the system of this invention is intended for the delivery of total intravenous anesthesia as distinguished from inhaled anesthesia agents commonly employed in hospital settings . Total intravenous anesthesia requires no scavenging system, and is preferably performed with a combination of ultra short-acting agents including a sedative-hypnotic such as propofol and a narcotic analgesic such as remifentanil. These anesthesia agents rapidly achieve peak effect, and are rapidly eliminated within about five to ten minutes after discontinuing administration. Preferably, the pumping devices identified above are syringe-type infusion pumps which are capable of delivering these two agents to patients to optimize analgesia without delaying or prolonging recovery time. As such, propofol and remifentanil lend themselves well to the cost-effective performance of ambulatory procedures within an operating suite at an individual physician's office attended by a qualified anesthesiologist, instead of at the high overhead operating room at a hospital or clinic.

Description of the Drawings

The structure, operation and advantages of the presently preferred embodiment of this invention will become further apparent upon consideration of the following description, taken in conjunction with the accompanying drawings, wherein:

Fig. 1 is a perspective view of the two units which comprise the anesthesia delivery system of this invention;

Fig. 2 is front view of the units shown in Fig. 1;

Fig. 3 is a side view of one of the units depicted in Fig. 1;

Fig. 4 is a rear view of one of the units in Fig. 1 illustrating mounting of the oxygen tanks, and affixation of the IV poles to the top cabinet;

Fig. 5 is a top view of one of the brackets shown in Fig. 4;

Fig. 6 is a top view of one of the cabinets depicting a portion of the cabinet locking structure;

Fig . 7 is a front view of one cabinet showing another portion of the cabinet locking structure; Fig. 8 is a top view of the base herein; and Fig. 9 is a side view of the base shown in Fig. 8.

Detailed Description of the Invention

Referring now to the Figs . the portable anesthesia delivery system 10 of this invention comprises a first unit 12 and a second unit 14 both of which are modular in construction and portable, as described in detail below. The construction of each unit 12, 14 is essentially identical, except for specific features noted below, and therefore the same reference numbers , with the addition of a " ' " , are used to identify the structure of second unit 14 which is common to first unit 12.

The first unit 12 comprises a number of individual cabinets which are releasably interconnected one on top of the other to form a stack, as depicted in Figs. 1-4, and then separated from one another for ease of handling and transport. Specifically, unit 12 includes a top cabinet 16, a bottom cabinet 18 and two intermediate cabinets 20 and 22 located between the top and bottom cabinets 16, 18. Each of the cabinets 16, 18, 20 and 22 is formed of a lightweight material such as plastic composite, honeycombed aluminum or the like. The bottom cabinet 18 rests atop a base 24, which, as best seen in Figs. 8 and 9, is square or rectangular in shape and has a caster or roller 26 mounted at each corner. Preferably, two of the rollers 26 are swivel casters, and the other two do not swivel, to facilitate movement of units 12, 14, as described below. Additionally, at least one of the casters or rollers 26 has a locking device (not shown) .

Each of the intermediate cabinets 20 and 22, and the bottom cabinet 18, form essentially a rectangular box having a hollow interior to receive one or more drawers. With reference to Figs. 1-4 and 6 and 7, the intermediate cabinet 22, for example, includes a top wall 22A, a bottom wall 22B, opposed side walls 22C and 22D and a back wall 22E. These walls 22A-E collectively define an interior which receives a drawer 28. The intermediate cabinet 20 and bottom cabinet 18 have the identical wall construction, except that intermediate cabinet 20 receives an upper drawer 30 and a lower drawer 32, while bottom cabinet 18 receives a single drawer 34. Each of the drawers 28, 30, 32, and 34 have a handle 36, as shown. The top cabinets 16 and 16' of units 12, 14, respectively, are identical to one another in construction, but differ to some extent from the remaining cabinets. Top cabinet 16, for example, has a top wall 16A, bottom wall 16B, opposed side walls 16C and 16D, and, a back wall 16E. These walls 16A-E collectively define a hollow interior which is closed by a removable front cover 35 shaped to fit over the front portion of the top cabinet 16. The inside of back wall 16E of top cabinet 16 mounts a multiple outlet receptacle strip 38 which has a number of receptacles for electrical equipment described in more detail below. The receptacle strip 38, in turn, is connected by a single cord 40 to an electrical outlet in the operating suite where the system 10 is to be used. In the presently preferred embodiment, a back-up, battery pack 42' is shown mounted to the back wall 16E' of top cabinet 16', and connected by a line 44' to the receptacle strip 38'. The battery packs 42 and 42' provide an auxiliary power source in the event of a power failure .

As best seen in Fig. 2, each of the top cabinets 16 and 16' carry a variety of electrically- powered components necessary for the conduct of anesthesia delivery. Top cabinet 16 mounts a ventilator 46 and a suction device 48, while the top cabinet 16' mounts a patient monitor device 50, a defibrillator 52 and a pair of syringe-type infusion pumps 54 and 55. The ventilator 46 is preferably a "Uni-Vent" "Eagle" Model 754 sold by Impact Instrumentation Inc. of West Caldwell, New Jersey. This unit is extremely small and lightweight, and, unlike most ventilators, has an internal compressor. The suction device 48 is one of any number of standard units currently commercially available. The patient monitor 50 is preferably of the type sold under the name and mark "Propak Encore" by Protocol Systems Inc. of Beaverton, Oregon. This single monitor 50 is capable of monitoring a number of patient parameters in a single unit including heart/pulse rate, electrocardiogram (ECG) , blood pressure, temperature, pulse oximetry, capnography, impedance respiration and apnea. The defibrillator 52 is preferably of the type sold by Heartstream, Inc. of Seattle, Washington under any of the model designations S, EM and E. The infusion pumps 54 and 55 are preferably syringe-type infusion pumps sold under the registered trademark "Auto Syringe", Model number AS50, by the Baxter IV Systems Division. It is contemplated that other equipment of the type noted above could be utilized in the system 10 of this invention, provided the performance characteristics are comparable .

One important aspect of the system 10 of this invention is that it is capable of allowing the anesthesiologist to employ total intravenous anesthesia in an ambulatory care environment. To this end, one of the infusion pumps 54 is connected to a source 56 of an ultra short acting narcotic analgesic such as remifentanil, and the other infusion pump 55 is connected to a source 58 of an ultra short acting sedative-hypnotic such as propofol. For purposes of illustration, the "sources" 56 and 58 of these anesthesia agents are depicted as an IV bag carried by an IV pole 74' described below. As described in detail above, the combination of remifentanil and propofol has both a quick onset, achieving peak effect very rapidly, and also a quick offset wherein their effects wear off within about five to ten minutes from discontinuance of administration. In addition to these analgesic agents 56, 58, the system 10 is equipped with an extensive inventory of other items necessary for the conduct of total intravenous anesthesia. This inventory includes a wide variety of medications; airway/ventilation items such as endotracheal tubes , laryngoscope handles and blades, oral and nasal airways, masks, etc.; and IV/circulatory items such as IV catheters and tubing, syringes, needles and the like. All of these items are contained within the drawers of intermediate cabinets 20, 20', intermediate cabinets 22, 22', and, base cabinets 18, 18' of units 12 and 14, respectively. As such, the portable anesthesia system 10 of this invention is fully stocked with all equipment and supplies in conformation with the requirements and specifications of the American Society of Anesthesiologists .

Referring now to Figs. 6-9, the locking structure for releasably interconnecting the cabinets one on top of the other is illustrated. This locking structure is common to the intermediate cabinets 20, 20', intermediate cabinets 22, 22' bottom cabinets 18, 18', and, a portion of top cabinets 16, 16'. As such, only the locking structure associated with intermediate cabinet 22 of unit 12 is discussed in detail herein, it being understood that all other locking structure is functionally and structurally identical.

The locking structure includes a series of three parallel ribs 60 mounted to the top wall 22A of intermediate cabinet 22. Each of these ribs 60 has a pair of notches 62 and 64 along the length thereof. The bottom wall 22B of cabinet 22 is formed with three recesses 66, one of which is shown in Fig. 7, each having a pair of projections 68 and 70. The intermediate cabinet 20 of unit 12 has the same locking structure so when it is placed atop the intermediate cabinet 22, the ribs 60 on the top wall 22A of intermediate cabinet 22 are received within the recesses 66 in the bottom wall 20B of intermediate cabinet 20. Additionally, the projections 68 and 70 within the recesses 66 of intermediate cabinet 20 enter the notches 62 and 64 within the ribs 60 of intermediate cabinet 22. The connection between the ribs 60 and recesses 66 releasably interlock the intermediate cabinets 20 and 22 in a front-to-back direction, whereas the engagement between projections 68, 70 and notches 62, 64 resist side-to-side movement.

The bottom cabinet 18 has the identical locking structure of intermediate cabinets 20 and 22, but the base 24 includes only ribs 60. The ribs 60 along the top wall 18A of bottom cabinet 18 extend within the recesses 66 of intermediate cabinet 22, while the ribs 60 formed on the base 24 extend within the recesses 66 in the bottom wall 18B of the bottom cabinet 18. Additionally, because the top cabinets 16 and 16' form the uppermost surface of the units 12, 14, such cabinets 16, 16' do not include ribs 60. Nevertheless, the bottom wall 16B and 16B' of each top cabinet 16 and 16' is formed with recesses 66 to receive the ribs 60 of the respective intermediate cabinets 20 and 20' beneath.

In addition to the locking structure described above, each of the first and second units 12 and 14 is further stabilized by the presence of IV poles 74 and 76. As best shown in Figs. 3, 4, 6 and 7, each of the intermediate cabinets 20 and 22, and the bottom cabinet 18, is formed with a pair of throughbores 78 and 80 at the rear corners thereof. A pair of seats 82 and 83 are formed at the rear corner of base 24, as depicted in Fig. 8. When the cabinets 18, 20 and 22 are stacked one on top of the other, the throughbores 78 and 80 of each cabinet align with those of the cabinet beneath, and with the seats 82 and 83, respectively, in the base 24. The IV pole 74 is insertable through the throughbore 78 of each cabinet 18, 20, 22, and the IV pole 76 is insertable through the throughbore 80 of each cabinet 18, 20, 22 so that they extend along the entire height of units 12 and 14. The lowermost end of IV poles 74 and 76 snugly fits within a respective seat 82 and 83 in the base 24 to secure them in place. Preferably, releasable straps 84 and 86 are mounted on the back wall 16E, 16E' of each top cabinet 16 and 16' to secure the upper end of IV poles 74, 76, respectively, in place at the top of units 12, 14.

In addition to stabilizing the cabinets within each unit 12 and 14, the IV poles 74, 76 provide a convenient means of transporting the units 12, 14 once assembled. For that purpose, each pole 74 and 76 has a handle grip 88 at its upper end. The units 12 and 14 are moved along a flat surface on all four rollers 26 by grasping the handle grips 88 and pushing or pulling the units 12, 14 therealong . If either unit 12 or 14 must be moved over a curb or up steps, the unit 12 or 14 is tilted using the handle grips 88 and pulled upwardly over the obstruction. In the presently preferred embodiment, the bottom cabinet 18' of at least the unit 14 mounts a pair of brackets 90 and 92 by hinges 94 and 96, respectively. The brackets 90, 92 are placed in a folded position for the transport of unit 14, and are unfolded to the position depicted in Fig. 4 in order to mount oxygen tanks 98 and 100. The bracket 90 is pivotal in an upward direction about its hinge 94, while the bracket 92 is pivotal downwardly about its hinge 96. Bracket 90 is formed with a pair of rings 102, 104, as best seen in Fig. 5, which receive and position the oxygen tanks 98 and 100 therealong . The base of each tank 98, 100 rests atop the second or lower bracket 92 when the unit 14 is ready for use. The oxygen tanks 98, 100 are removed from the brackets 90, 92 for transport, at which time they are pivoted to their folded position depicted in Fig. 3. The anesthesia system 10 of this invention therefore provides a modular, portable unit for the performance of total intravenous anesthesia in an in- office or ambulatory care situation. Each of the cabinets 16, 16', 18, 18', 20, 20' and 22, 22' preferably weigh less than fifty pounds each, and can be readily placed into the back of a van or other vehicle by the anesthesiologist for transport to a particular surgeon's office. Upon arrival at such office, the cabinets are stacked one on top of the other, all carried by base 24, and interconnected with the locking structure described above. The IV poles 74 and 76 are then inserted through the throughbores 78, 80 at the back corner of each cabinet and into the seats 82, 83 of base 24 to further stabilize each unit 12 and 14, and to provide a convenient means to grip and move the units 12, 14 along the rollers 26 of base 24. Once in the operating suite of a physician's office, the cords 40 of each unit 12 and 14 are plugged into a wall socket to activate the electronic equipment carried in the top cabinets 16 and 16', as described above. All of the medications, airway/ventilation items and IV/circulatory items required in the conduct of anesthesia delivery are contained within the drawers of the various cabinets in an organized, readily accessible fashion. After the surgical procedure is completed, the anesthesiologist merely moves each unit 12 and 14 to his or her vehicle, disassembles the cabinets from one another and from the base, and loads them into the vehicle for transport to another location as desired.

While the invention has been described with reference to a preferred embodiment, it will be understood by those skilled in the art that various changes may be made and equivalents may be substituted for elements thereof without departing from the scope of the invention. In addition, many modifications can be made to adapt a particular situation or material to the teachings of the invention without departing from the essential scope thereof .

For example, while the defibrillator 52 is shown mounted within the top cabinet 16' of unit 14, it is contemplated that the defibrillator 52 could be placed within any of the other drawers 29,28', 30,30', 32,32' or 34,34', as desired. Therefore, it is intended that the invention not be limited to the particular embodiment disclosed as the best mode contemplated for carrying out this invention, but that the invention will include all embodiments falling within the scope of the appended claims .

We claim:

Claims

1. A portable anesthesia delivery system, comprising: a bottom cabinet, a top cabinet and at least one intermediate cabinet located between said bottom and top cabinets; said bottom, top and at least one intermediate cabinets collectively containing:

(i) patient monitoring equipment for monitoring selected vital signs of a patient during an anesthesia procedure;

(ii) a suction device for applying suction to the patient;

(iii) a ventilator device for ventilating the patient; (iv) a first pumping device and a second pumping device for delivering quick-onset and quick-offset anesthesia agents to the patient;

(v) consumable products including medication, and airway, breathing and circulatory items , to support the conduct of anesthesia delivery. locking structure, carried by each of said bottom, top and at least one intermediate cabinets, for interconnecting said cabinets in a position wherein said cabinets are stacked one on top of the other, said locking structure being releasable to permit separation of said cabinets for individual handling; a transport mechanism, connected to said bottom cabinet, which permits movement of said cabinets as a unit along a surface when said cabinets are in said operational position.

2. The system of claim 1 in which each of said bottom cabinet and said at least one intermediate cabinet comprises a bottom wall, top wall, opposed side walls, and a back wall which define a hollow interior, said hollow interior receiving at least one drawer.

3. The system of claim 1 in which each of said cabinets includes a top wall and a bottom wall, said locking structure including a series of ribs mounted to said top wall of said bottom cabinet and to said top wall of said at least one intermediate cabinet, and a mating series of recesses formed in said bottom wall of said top cabinet and in said bottom wall of said at least one intermediate cabinet, said ribs releasably engaging said recesses with said cabinets in said stacked position so that said at least one intermediate cabinet is connected to said top cabinet and to said bottom cabinet .

4. The system of claim 3 in which each of said ribs is formed with at least one notch, and a projection is formed within each of such recesses in a position to engage said notch with said cabinets stacked atop one another .

5. The system of claim 3 in which said ribs are parallel to one another.

6. The system of claim 3 in which each of said bottom cabinet and said at least one intermediate cabinet is formed with at least one throughbore, said throughbore of said bottom cabinet and said throughbore of said at least one intermediate cabinet aligning with one another in said stacked position, said locking structure further including at least one pole insertable within said throughbores and extending between said bottom cabinet and said at least one intermediate cabinet.

7. The system of claim 1 in which said transport mechanism is a base releasably connected to said bottom cabinet, said base having a number of rollers to permit movement along a surface .

8. The system of claim 7 in which said bottom cabinet and said at least one intermediate cabinet are each formed with at least one throughbore which align with one another with said cabinets is said stacked position, said base being formed with a seat which aligns with said throughbore in said cabinets, a pole extending through said throughbore in said cabinets and releasably locking within said seat in said base to assist in interconnecting said cabinets in said stacked position and to assist in moving said cabinets along said swivel rollers of said base.

9. The system of claim 8 in which said pole is formed with a handle grip.

10. The system of claim 1 in which said bottom cabinet includes a support for mounting at least one oxygen tank.

11. The system of claim 10 in which said support comprises a first bracket and a second bracket, each of such brackets being connected by a hinge to said bottom cabinet and being movable between a folded, storage position and an unfolded, tank support position.

12. An anesthesia delivery system, comprising: a number of cabinets releasably interconnected one on top of the top to form a stack; said stack of cabinets collectively housing patient monitoring equipment, a suction device, a ventilator device, first and second pumping devices, and, consumable products including medications, and airway, breathing and circulatory items, necessary to support the conduct of anesthesia delivery; said cabinets being movable as a unit in said stack to a desired location for support of a surgical procedure, and said cabinets being disconnected from one another for individual handling and transport.

13. The system of claim 1 in which said number of cabinets includes a bottom cabinet, a top cabinet and at least one intermediate cabinet located between said bottom cabinet and said top cabinet within said stack, said system further including: locking structure, carried by each of said bottom, top and at least one intermediate cabinets, for interconnecting said cabinets to form said stack and to permit disconnection of said cabinets; a transport mechanism, connected to said base cabinet, which permits movement of said cabinets along a surface when said cabinets are in a stack.

14. The system of claim 13 in which each of said bottom cabinet and said at least one intermediate cabinet comprises a bottom wall, top wall, opposed side wall, and a back wall which define a hollow interior, said hollow interior receiving at least one drawer .

15. The system of claim 13 in which each of said cabinets includes a top wall and a bottom wall, said locking structure including a series of ribs mounted to said top wall of said bottom cabinet and to said top wall of said at least one intermediate cabinet, and a mating series of recesses formed in said bottom wall of said top cabinet and in said bottom wall of said at least one intermediate cabinet, said ribs releasably engaging said recesses with said cabinets in said stacked position so that said at least one intermediate cabinet is connected to said top cabinet and to said bottom cabinet.

16. The system of claim 15 in which each of said ribs is formed with at least one notch, and a projection is formed within each of said recesses in a position to engage said notch with said cabinets stacked atop one another .

17. The system of claim 3 in which each of said bottom cabinet and said at least one intermediate cabinets is formed with at least one throughbore, said throughbores of said bottom cabinet and said throughbores of said at least one intermediate cabinet aligning with one another in said stacked position, said locking structure further including at least one pole insertable within said throughbores and extending between said bottom cabinet and said at least one intermediate cabinet.

18. The system of claim 13 is which said transport mechanism is a base releasably connected to said bottom cabinet, such base having a number of rollers to permit movement along a surface .

19. The system of claim 18 in which said bottom cabinet and said at least one intermediate cabinet are each formed with at least one throughbore which align with one another with said cabinets is said stacked position, said base being formed with a seat which aligns with said throughbore in said cabinets, a pole extending through said throughbore in said cabinets and releasably locking within said seat in said base to assist in interconnecting said cabinets in said stacked position and to assist in moving said cabinets along said swivel rollers of said base.

20. An anesthesia delivery system, comprising: a number of cabinets releasably interconnected one on top of the top to form a stack; said stack of cabinets collectively housing patient monitoring equipment, a suction device, a ventilator device, first and second pumping devices, and, consumable products including medications, and airway, breathing and circulatory items, to support the conduct of anesthesia delivery; said cabinets being movable as a unit in said stack to a desired location for the support of a surgical procedure, and said cabinets being disconnected from one another for individual handling and transport; a supply of a first intravenous anesthesia agent connected to said first pumping device, and a supply of a second intravenous anesthesia agent connected to said second pumping device, each of such first and second intravenous anesthesia agents having a relatively quick offset and being effective to achieve total intravenous anesthesia when delivered to a patient, without an inhaled anesthesia agent.

21. The system of claim 20 in which said first intravenous anesthesia agent is an ultra short-acting sedative-hypnotic .

22. The system of claim 20 in which said second intravenous anesthesia agent is an ultra short-acting narcotic analgesic .

23. The system of claim 20 in which said first and second pumping devices are infusion pumps.

24. The system of claim 20 in which each of said first and second intravenous anesthesia agents is characterized by a quick-onset and a quick-offset.

25. An anesthesia delivery system, comprising: a number of cabinets releasably interconnected one on top of the other to form a stack, said cabinets being movable as a unit in said stack to a desired location for the support of a surgical procedure, said cabinets being disconnected from one another for individual handling and transport; a supply of a first intravenous anesthesia agent connected to a first pumping device which is carried by one of such cabinets, and a supply at a second intravenous anesthesia agent connected to a second pumping device, each of said first and second intravenous anesthesia agents having a relatively quick offset and collectively being effective achieve total intravenous anesthesia when delivered to a patient, without an inhaled anesthesia agent.

26. The system of claim 25 in which said first intravenous anesthesia agent is an ultra short-acting sedative-hypnotic .

27. The system of claim 25 in which said second intravenous anesthesia agent is an ultra short-acting narcotic analgesic .

28. The system of claim 25 in which said first and second pumping devices are infusion pumps .

29. The system of claim 25 in which each of said first and second intravenous anesthesia agents are characterized by a quick-onset and a quick-offset.

30. A portable anesthesia delivery system,' comprising: a first unit and a second unit, each of said first and second units including: (i) a bottom cabinet, a top cabinet and at least one intermediate cabinet located between said bottom cabinet and said top cabinet;

(ii) locking structure, carried by each of said bottom, top and at least one intermediate cabinet, for interconnecting said cabinets in a position in which said cabinets are stacked one on top of the other, said locking structure being releasable to permit separation of said cabinets for individual handling;

(iii) a transport mechanism, connected to said bottom cabinet, which permits movement of said cabinets as a unit along a surface when said cabinets are in said stacked position; said top cabinet of said first unit housing a suction device and a ventilator device, said top cabinet of said second unit housing patient monitoring equipment, first and second pumping devices and a defibrillator, said bottom cabinets and said at least one intermediate cabinets of said first and second units collectively housing consumable products including medications, and airway, breathing and circulatory items, to support the conduct of anesthesia delivery.

31. The system of claim 30 in which each of said bottom cabinet and at least one intermediate cabinet comprises a bottom wall, top wall, opposed side walls, and a back wall which define a hollow interior, said hollow interior receiving at least one drawer.

32. The system of claim 30 in which each of said cabinets includes a top wall and a bottom wall, said locking structure including a series of ribs mounted to said top wall of said bottom cabinet and to said top wall of said at least one intermediate cabinet, and a mating series of recesses formed in said bottom wall of said top cabinet and said bottom wall of said at least one intermediate cabinet, said ribs releasably engaging said recesses with said cabinets in said stacked position so that said at least one intermediate cabinet is connected to said top cabinet and to said bottom cabinet.

33. The system of claim 32 in which each of said ribs is formed with at least one notch, and a projection is formed within each of said recesses in a position to engage said notch with said cabinets stacked atop one another .

34. The system of claim 32 in which each of said bottom cabinet and said at least one intermediate cabinet is formed with at least one throughbore, said throughbore of said bottom cabinet and said throughbore of said at least one intermediate cabinet aligning with one another in said stacked position, said locking structure further including at least one pole insertable within said throughbores and extending between said base cabinet and said at least one intermediate cabinet.

35. The system of claim 30 is which said transport mechanism is a base releasably connected to said bottom cabinet, such base having a number of rollers to permit movement along a surface .

36. The system of claim 35 in which said bottom cabinet and said at least one intermediate cabinet are each formed with at least one throughbore which align with one another with said cabinets is said stacked position, said base being formed with a seat which aligns with said throughbore in said cabinets, a pole extending through said throughbore in said cabinets and releasably locking within said seat in said base to assist in interconnecting said cabinets in said stacked position and to assist in moving said cabinets along said swivel rollers of said base.

37. The system of claim 36 in which said pole is formed with a handle grip.

38. The system of claim 30 in which said bottom cabinet includes a support for mounting at least one oxygen tank.

39. The system of claim 38 in which said support comprises a first bracket and a second bracket, each of said brackets being connected by a hinge to said bottom cabinet and being movable between a folded, storage position and an unfolded, tank support position.