EPSAC‐controlled anesthesia with online gain adaptation

This paper presents the application of predictive control to drug dosing during anesthesia in patients undergoing surgery. A single-input (propofol) single-output (bispectral index (BIS)) model of the patient has been assumed for prediction. The performance of our previous strategy in drug dosing control has been improved to tackle inter-patient variability. A set of 12 patient models was studied and, in order to ensure the applicability of the proposed controller, gain adaptation in the controller is proposed. Preliminary studies have shown that due to static nonlinearity in the sigmoid curve of the patient model, feedback control is not feasible in the first part of the induction phase. Therefore, the control strategy applied in this study consists of controlling the effect site concentration (C-e) during the first phase and controlling BIS once the relation BIS/C-e has been identified. The policy of switching and adapting the control strategies shows a good performance during the induction phase in simulation studies. Clinical tests have been scheduled at the Ghent University Hospital for the coming months. Copyright (C) 2008 John Wiley & Sons, Ltd.

[1]  A J Asbury.  Feedback control in anaesthesia , 1997, International journal of clinical monitoring and computing.

[2]  L. Biegler.  Advances in nonlinear programming concepts for process control , 1997 .

[3]  S L Shafer,et al.  The influence of age on propofol pharmacodynamics. , 1999, Anesthesiology.

[4]  David W. Clarke,et al.  Generalized predictive control - Part I. The basic algorithm , 1987, Autom..

[5]  S G Greenhow,et al.  Pilot study of an expert system adviser for controlling general anaesthesia. , 1993, British journal of anaesthesia.

[6]  Derek A. Linkens,et al.  Migrating from target-controlled infusion to closed-loop control in general anaesthesia , 2004, Comput. Methods Programs Biomed..

[7]  Harald Ihmsen.  Population Pharmacokinetics of Propofol , 2000 .

[8]  C. DeVane.  Principles of Pharmacokinetics and Pharmacodynamics , 2009 .

[9]  D. Bogen,et al.  The Use of Computers for Controlling the Delivery of Anesthesia , 1992, Anesthesiology.

[10]  J Schüttler,et al.  Population Pharmacokinetics of Propofol: A Multicenter Study , 2000, Anesthesiology.

[11]  Mahdi Mahfouf,et al.  Supervisory generalised predictive control and fault detection for multivariable anaesthesia , 1994 .

[12]  G N Kenny,et al.  Closed-loop control of propofol anaesthesia. , 1999, British journal of anaesthesia.

[13]  T. Short,et al.  Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control , 2000, Anaesthesia.

[14]  R.J. Roy,et al.  Depth of anesthesia estimation and control [using auditory evoked potentials] , 1999, IEEE Transactions on Biomedical Engineering.

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

[16]  Satoshi Hagihira,et al.  What we can know from bispectral analysis of EEG , 2005 .

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

[18]  M. Curatolo,et al.  Fuzzy logic control of inspired isoflurane and oxygen concentrations using minimal flow anaesthesia. , 1996, British journal of anaesthesia.

[19]  E Kochs,et al.  EEG-based indices of anaesthesia: correlation between bispectral index and patient state index? , 2004, European journal of anaesthesiology.

[20]  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.

[21]  Hugo Vereecke,et al.  Ability of the Bispectral Index, Autoregressive Modelling with Exogenous Input-derived Auditory Evoked Potentials, and Predicted Propofol Concentrations to Measure Patient Responsiveness during Anesthesia with Propofol and Remifentanil , 2003, Anesthesiology.

[22]  Nassib G. Chamoun,et al.  An introduction to bispectral analysis for the electroencephalogram , 1994, Journal of Clinical Monitoring.

[23]  Wassim M. Haddad,et al.  Nonlinear adaptive control for intensive care unit sedation and operating room hypnosis , 2003, Proceedings of the 2003 American Control Conference, 2003..

[24]  Julio E. Normey-Rico,et al.  Robustness effects of a prefilter in a Smith predictor-based generalised predictive controller , 1999 .

[25]  E. Krüger-Thiemer,et al.  Continuous intravenous infusion and multicompartment accumulation. , 1968, European journal of pharmacology.

[26]  Michel M. R. F. Struys,et al.  Estimation of Optimal Modeling Weights for a Bayesian-Based Closed-Loop System for Propofol Administration Using the Bispectral Index as a Controlled Variable: A Simulation Study , 2007, Anesthesia and analgesia.

[27]  Eiko Furutani,et al.  A Model-Predictive Hypnosis Control System Under Total Intravenous Anesthesia , 2008, IEEE Transactions on Biomedical Engineering.