A Model for Use in Automated Control of Muscle Relaxation During Surgical Procedures

Abstract It is proposed to use an automatated feedback control system to solve the clinical problems associated with the achievement of muscle relaxation during surgical procedures. Due to the variability between individuals a 1 self-tuning' control system would" be required. This paper deals with the problems of determining a suitable model structure and model order for the human response to the muscle relaxant drug curare (or d-Tubocurarine) for use in such a self-tuning control loop. We present a formalism based on linear compartmental theory, and show by examining its structural identiflability how it can be commpared with existing clinical models. We then use off-line non-linear least-squares fitting and the general linear test to obtain a simple bi-compartment model structure, which we show by simulation to be suitable for control purposes and an improvement over existing models.

[1]  S. Spector,et al.  Determination of serum d-tubocurarine concentration by radioimmunoassay. , 1973, The Journal of pharmacology and experimental therapeutics.

[2]  L. B. Wingard,et al.  Pharmacodynamics of tubocurarine in humans. , 1976, British journal of anaesthesia.

[3]  John G. Wagner,et al.  Model-Independent Linear Pharmacokinetics , 1976 .

[4]  David Clarke,et al.  Self-tuning control , 1979 .

[5]  M. Gibaldi,et al.  Kinetics of the Elimination and Neuromuscular Blocking Effect of d-Tubocurarine in Man , 1972, Anesthesiology.

[6]  D. Meijer,et al.  Comparative pharmacokinetics of d-tubocurarine and metocurine in man. , 1979 .

[7]  H. Beecher,et al.  A study of the deaths associated with anesthesia and surgery: based on a study of 599, 548 anesthesias in ten institutions 1948-1952, inclusive. , 1954, Annals of surgery.

[8]  Karl Johan Åström,et al.  BOOK REVIEW SYSTEM IDENTIFICATION , 1994, Econometric Theory.

[9]  R. Matteo,et al.  Dosage-schedule independence of d-tubocurarine pharmacokinetics and pharmacodynamics, and recovery of neuromuscular function. , 1979 .

[10]  Lewis B. Sheiner,et al.  Simultaneous modeling of pharmacokinetics and pharmacodynamics: Application to d‐tubocurarine , 1979 .

[11]  L. Sheiner,et al.  Pharmacokinetics and Pharmacodynamics of d-Tubocurarine during Nitrous Oxide–Narcotic and Halothane Anesthesia in Man , 1979 .

[12]  R. Bellman,et al.  On structural identifiability , 1970 .

[13]  B. Waud Serum d -Tubocurarine Concentration and Twitch Height , 1975 .

[14]  J. Viby-Mogensen,et al.  Residual curarization in the recovery room. , 1979, Anesthesiology.