Hypnosis regulation in propofol anaesthesia employing super‐twisting sliding mode control to compensate variability dynamics

Regulation of hypnosis level on bi-spectral index monitor (BIS) during a surgical procedure in propofol anaesthesia administration is a challenging task for an anaesthesiologist in multi-tasking environment of the operation theater. Automation in anaesthesia has the potential to solve issues arising from manual administration. Automation in anaesthesia is based on developing the three-compartmental model including pharmacokinetics and pharmacodynamic of the silico patients. This study focuses on regulation of the hypnosis level in the presence of surgical stimulus including skin incision, surgical diathermy and laryngoscopy as well as inter-patient variability by designing super-twisting sliding mode control (STSMC). The depth of the hypnosis level is maintained to 50 on the BIS level in the maintenance phase after improving the induction phase to 60 s using the conventional sliding mode control and 30 s with STSMC. The proposed scheme also compensates the inter-patient variability dynamics including height, age and weight of the different silico patients. Moreover, the surgical stimuli direct the hypnosis level towards the state of consciousness and stimulate the controller to provide continuous drug infusion during the interval 80-90 s. Simulation results witness that the oscillatory behaviour is observed in drug infusion to ensure the moderate level of hypnosis (40-60) for general surgery.

[1]  A. Absalom,et al.  Closed-loop Control of Anesthesia Using Bispectral Index: Performance Assessment in Patients Undergoing Major Orthopedic Surgery under Combined General and Regional Anesthesia , 2002, Anesthesiology.

[2]  S. Shafer,et al.  The Influence of Method of Administration and Covariates on the Pharmacokinetics of Propofol in Adult Volunteers , 1998, Anesthesiology.

[3]  Juan A. Méndez,et al.  ACLAC: An approach for adaptive closed-loop anesthesia control , 2013, Proceedings of the 26th IEEE International Symposium on Computer-Based Medical Systems.

[4]  Fucheng Liao,et al.  Design of a Backstepping Tracking Controller for a Class of Linear Systems with Actuator Delay , 2015 .

[5]  Jamshed Iqbal,et al.  Nonlinear Control of a Flexible Joint Robotic Manipulator with Experimental Validation , 2018 .

[6]  P. P. Newman,et al.  THE EFFECTS OF PULSED ELECTROMAGNETIC ENERGY ON PERIPHERAL NERVE REGENERATION * , 1974, Annals of the New York Academy of Sciences.

[7]  Guy A. Dumont,et al.  Dynamic behavior of BIS, M-entropy and neuroSENSE brain function monitors , 2011, Journal of Clinical Monitoring and Computing.

[8]  K L Posner,et al.  Awareness during anesthesia: a closed claims analysis. , 1999, Anesthesiology.

[9]  R. Kaliszan,et al.  Pharmacokinetics and pharmacodynamics of propofol in children undergoing different types of surgeries , 2014, Pharmacological reports : PR.

[10]  Julio E. Normey-Rico,et al.  Robust Predictive Control Strategy Applied for Propofol Dosing Using BIS as a Controlled Variable During Anesthesia , 2008, IEEE Transactions on Biomedical Engineering.

[11]  Paulo Warpechowski,et al.  Effects of propofol on the cardiac conduction system. , 2010, Revista brasileira de anestesiologia.

[12]  Zeung nam Bien,et al.  Robust sliding mode control of a robot manipulator based on variable structure-model reference adaptive control approach , 2007 .

[13]  M. Janda,et al.  Clinical evaluation of a simultaneous closed‐loop anaesthesia control system for depth of anaesthesia and neuromuscular blockade * , 2011, Anaesthesia.

[14]  Xinghuo Yu,et al.  Continuous nonsingular terminal sliding mode control for systems with mismatched disturbances , 2013, Autom..

[15]  Antonio Visioli,et al.  Inversion-based propofol dosing for intravenous induction of hypnosis , 2016, Commun. Nonlinear Sci. Numer. Simul..

[16]  S. Drid,et al.  Optimized Torque Control via Backstepping Using Genetic Algorithm of Induction Motor , 2016 .

[17]  P. J. Pereira,et al.  Efeitos do propofol sobre o sistema de condução cardíaca , 2010 .

[18]  Kristian Soltesz,et al.  Design and Clinical Evaluation of Robust PID Control of Propofol Anesthesia in Children , 2014, IEEE Transactions on Control Systems Technology.

[19]  Raza Ul Islam,et al.  Optimal and Robust Control of Multi DOF Robotic Manipulator: Design and Hardware Realization , 2018, Cybern. Syst..

[20]  Guy Albert Dumont,et al.  Introduction to Automated Drug Delivery in Clinical Anesthesia , 2005, Eur. J. Control.

[21]  C Thornton,et al.  Monitoring evoked potentials during surgery to assess the level of anaesthesia. , 1995, Journal of medical engineering & technology.