Department of AnesthesiaThe Scarborough HospitalToronto, Ontario, CanadaM1P 2V5oyston@oyston.comURL: http://www.manbit.com , Publisher: Manbit PL (Kingswood, New South Wales, Australia) , Main Authors: Phil Dey, M.D. and Andy Pybus, M.D.So many anesthesia Web sites consist of a little information (perhaps the officers of a society, or the curriculum of a residency program), followed by a list of links, with no original content of interest to most practicing anesthesiologists. Manbit, in contrast, offers such a wealth of free information that it seems somewhat ungrateful to offer any criticism at all.Manbit PL is an Australian software company which specializes in the production of anesthesia-related software, including Anesthesia Recording Systems, Educational Software, Medical Hypertexts, Anesthesia Billing Systems, and Simulation Software. Many of these are demonstrated, or available for download, on the site. Manbit PL is run by Drs. Phil Dey and Andy Pybus, who are both practicing clinical anesthesiologists.What would you like? A multiple choice quiz? A Pulmonary Artery Catheter simulator? An interactive oxygen dissociation curve? How about a manual of obstetric anesthesia? Or would you prefer an Anesthetic Record Keeper and Information System? What about a new billing system? Or a Medline search utility? All the above are available, free of charge, at the Manbit site!The St. George MCQ is a Web-based Multiple Choice Questionnaire intended for candidates sitting for specialist examinations in anesthesia. It is available for free on the Manbit Web site. One can choose which areas one wishes to be tested on, and appropriate questions are provided. The software keeps a running score. Unfortunately one has to know what “K” and “A” type questions are before one can understand the system.The pulmonary artery catheter simulator is a sophisticated simulation system intended for teaching medical and paramedical staff the skills required for the safe use of pulmonary artery catheters. In addition to the electrocardiographic and pressure simulations of the passage of a pulmonary artery catheter, the simulator includes a working model of the hemoglobin dissociation curve and hemodynamic and infusion calculators. It is available for free as a “zip” compressed file in Windows format. Unfortunately, the only documentation is a “Help” file. Only the electrocardiogram and the pulmonary artery catheter waveform are displayed, not the arterial waveform, making interpretation of the waveform more difficult.Manbit is home to the “Hypertextbook of Regional Anaesthesia for Obstetrics—An international perspective,” edited by Stephen P. Gatt and sponsored by Becton Dickinson. This collaborative textbook includes contributions from many established authors in the field, but does not make use of the ability of the Internet to serve up images or video. Some sections are very brief, and others are now out of date. (I was unable to find a date on this section of the site, but a 1995 reference was marked as being “in press.”)The site includes a lay guide to pain relief in labor, written by Drs. Leonie Watterson, Nicola Meares, and Elizabeth Ward of the Royal North Shore Hospital Department of Anaesthesia and Pain Management. This section also includes extracts from Dr. Peter Brownridge’s acclaimed book on childbirth.The Manbit Anaesthesia Billing System is a Windows-based billing system intended for use by Specialist Anaesthetists in Australia. A demonstration copy of what is claimed to be the cheapest, most user-friendly anaesthesia billing system available in Australia can be obtained by e-mail from the Manbit Web site. The Australian billing schedule is also available for download.This fully featured anesthesia charting system, which interfaces with a variety of common monitoring devices, is available for download for evaluation.The Medline search utility is just an interface which links to The National Library of Medicine’s Medline database at http://www.ncbi.nlm.nih.gov. Free Medline searching was once a rare and precious thing, but it is now commonplace.There is even more—ignore the left-sided menu bar and scroll way down the home page and you will find information about “Diprivan Anaesthesia,” a Windows-based program to model the administration of propofol by infusion, using a variety of pharmacokinetic models. There is also information about “The Sydney Perfusion Simulator,” a sophisticated, computer-controlled, hydraulic model of the human circulation which is intended for use in cardiopulmonary bypass training.This is an amazing, almost overwhelming, site. It could do with a little reorganization and updating, or it may begin to seem like a graveyard for expired projects. However, Drs. Dey and Pybus obviously have a great interest in the use of computers in anesthesia, and have been successful in acquiring sponsorship from a variety of companies which has allowed them to distribute their software and educational material at no charge to users.