Predictive Adaptive Control of the Bispectral Index of the EEG (BIS) - Using the Intravenous Anaesthetic Drug Propofol

The problem of controlling the level of unconsciousness measured by the Bispectral Index of the EEG (BIS) of patients under anaesthesia, is considered. It is assumed that the manipulated variable is the infusion rate of the hypnotic drug propofol, while the drug remifentanil is also administered for analgesia. Since these two drugs interact, the administration rate of remifentanil is considered as an accessible disturbance. In order to tackle the high uncertain present on the system, the predictive adaptive controller MUSMAR is used. The performance of the controller is illustrated by means of simulation with 45 patient individual adjusted models, which incorporate the effect of the drugs interaction on BIS. This controller structure proved to be robust to the remifentanil disturbance, different reference values and noise. A reduction of propofol consumption was also observed when comparing to the real clinical dose used for a similar BIS trend.

[1]  Edoardo Mosca,et al.  Robustness of multipredictor adaptive regulators: MUSMAR , 1988, Autom..

[2]  Pedro Amorim,et al.  Predictive adaptive control of unconsciousness - exploiting remifentanil as an accessible disturbance , 2006, 2006 IEEE Conference on Computer Aided Control System Design, 2006 IEEE International Conference on Control Applications, 2006 IEEE International Symposium on Intelligent Control.

[3]  Pedro Amorim,et al.  Propofol and Remifentanil Pharmacokinetics/Pharmacodynamics During Induction May Predict Recovery of Anesthesia , 2005 .

[4]  N. Morton,et al.  Pharmacokinetic model driven infusion of propofol in children. , 1991, British journal of anaesthesia.

[5]  Eiko Furutani,et al.  Computer control of physiological states of patients under and after surgical operation , 2005, Annu. Rev. Control..

[6]  Pedro Amorim,et al.  MODELLING DRUGS' PHARMACODYNAMIC INTERACTION DURING GENERAL ANAESTHESIA: THE CHOICE OF PHARMACOKINETIC MODEL , 2006 .

[7]  S L Shafer,et al.  Response Surface Model for Anesthetic Drug Interactions , 2000, Anesthesiology.

[8]  Thomas W. Schnider,et al.  Influence of age and gender on the pharmacokinetics and pharmacodynamics of remifentanil. I. Model development , 1997 .

[9]  Pedro Amorim,et al.  Regular clinical use bispectral index monitoring may result in lighter depth of anesthesia as reflected in average higher bispectral index values. , 2005, Anesthesiology.

[10]  W. Haddad,et al.  Drug dosing control in clinical pharmacology , 2005, IEEE Control Systems.

[11]  J. Bruhn,et al.  Correlation of Approximate Entropy, Bispectral Index, and Spectral Edge Frequency 95 (SEF95) with Clinical Signs of “Anesthetic Depth” during Coadministration of Propofol and Remifentanil , 2003, Anesthesiology.