Modelling and multivariable control in anaesthesia using neural-fuzzy paradigms: Part II. Closed-loop control of simultaneous administration of propofol and remifentanil

OBJECTIVE Part II of this research study is concerned with the development of a closed-loop simulation linking the patient model as well as the fuzzy relational classifier already introduced in Part I with a control algorithm. The overall architecture is in fact a system advisor, which provides information to the anaesthetist about the adequate infusion-rates of propofol and remifentanil simultaneously. METHODS AND MATERIAL The developed fuzzy multivariable controller includes three rule-bases and takes into account the synergetic interactions between the above drugs and uses such knowledge to achieve rapidly the desired depth of anaesthesia (DOA) level. RESULTS The result of the study is a closed-loop control scheme, which adjusts efficiently the infusion-rates of two drugs in response to DOA changes. This controller can either be used in an advisory mode or closed-loop feedback mode in the operating theatre during surgery. CONCLUSION It is hoped that this control scheme coupled with the patient model presented in Part I of this study will be used routinely in the operating theatre in the very near future.