Modelling neuromuscular blockade: a stochastic approach based on clinical data

During surgical interventions, a muscle relaxant drug is frequently administered with the objective of inducing muscle paralysis. Clinical environment and patient safety issues lead to a huge variety of situations that must be taken into account requiring intensive simulation studies. Hence, population models are crucial for research and development in this field. This work develops a stochastic population model for the neuromuscular blockade (NMB) (muscle paralysis) level induced by atracurium based on a deterministic individual model already proposed in the literature. To achieve this goal, a joint Lognormal distribution is considered for the patient-dependent parameters. This study is based on clinical data collected during general anaesthesia. The procedure developed enables to construct a reliable reference bank of parametrized models that not only reproduces the overall features of the NMB, but also the inter-individual variability characteristic of physiological signals. It turns out that this bank constitutes a fundamental tool to support research on identification and control algorithms and is suitable to be integrated in clinical decision support systems.

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