ℒ1-adaptive methods for control of patient response to anesthesia

In this paper, we discuss the first application of recently developed L1-adaptive control methods for closed-loop control of anesthesia delivery during surgery. Our initial objective, described herein, is to design controllers that are robust to inter-patient variability, such that patients follow a prespecifled Bispectral Index profile. The controllers are designed from identification-based models constructed from clinical trial data.

[1]  W. Snodgrass Physiology , 1897, Nature.

[2]  H. Schwilden,et al.  Closed-loop feedback control of propofol anaesthesia by quantitative EEG analysis in humans. , 1989, British journal of anaesthesia.

[3]  H Schwilden,et al.  Effective therapeutic infusions produced by closed-loop feedback control of methohexital administration during total intravenous anesthesia with fentanyl. , 1990, Anesthesiology.

[4]  H Schwilden,et al.  Adaptive closed-loop feedback control of vecuronium-induced neuromuscular relaxation. , 1991, European journal of anaesthesiology.

[5]  H Schwilden,et al.  Closed-loop feedback controlled administration of alfentanil during alfentanil-nitrous oxide anaesthesia. , 1993, British journal of anaesthesia.

[6]  E. Williams,et al.  Algorithm to control "effect compartment" drug concentrations in pharmacokinetic model-driven drug delivery , 1993, IEEE Transactions on Biomedical Engineering.

[7]  D. Ward,et al.  The hybrid model: a new pharmacokinetic model for computer-controlled infusion pumps , 1994, IEEE Transactions on Biomedical Engineering.

[8]  M. Kremer Anesthesia providers, patient outcomes, and costs. , 1996, Anesthesia and analgesia.

[9]  P Manberg,et al.  Bispectral Analysis Measures Sedation and Memory Effects of Propofol, Midazolam, Isoflurane, and Alfentanil in Healthy Volunteers , 1997, Anesthesiology.

[10]  N. T. Smith,et al.  A Multicenter Study of Bispectral Electroencephalogram Analysis for Monitoring Anesthetic Effect , 1997, Anesthesia and analgesia.

[11]  Peter S. Sebel,et al.  Bispectral Analysis Measures Sedation and Memory Effects of Propofol, Midazolam, Isoflurane, and Alfentanil in Healthy Volunteers , 1997, Anesthesiology.

[12]  G Rolly,et al.  Closed‐loop controlled administration of propofol using bispectral analysis , 1998, Anaesthesia.

[13]  Peter S. Sebel,et al.  Bispectral Monitoring Technology: Clinical Applications , 1999 .

[14]  Manfred Morari,et al.  Automation in anesthesia , 1999, Proceedings of the 1999 American Control Conference (Cat. No. 99CH36251).

[15]  Manfred Morari,et al.  Improving regulation of mean arterial blood pressure during anesthesia through estimates of surgery effects , 2000, IEEE Transactions on Biomedical Engineering.

[16]  M. Morari,et al.  Multitasked closed-loop control in anesthesia , 2001, IEEE Engineering in Medicine and Biology Magazine.

[17]  Manfred Morari,et al.  Modeling and closed-loop control of hypnosis by means of bispectral index (BIS) with isoflurane , 2001, IEEE Transactions on Biomedical Engineering.

[18]  Wassim M. Haddad,et al.  Adaptive control for nonnegative and compartmental dynamical systems with applications to general anesthesia , 2002, Proceedings of the 41st IEEE Conference on Decision and Control, 2002..

[19]  Manfred Morari,et al.  A new paradigm for the closed-loop intraoperative administration of analgesics in humans , 2002, IEEE Transactions on Biomedical Engineering.

[20]  Wassim M. Haddad,et al.  Adaptive control for non-negative and compartmental dynamical systems with applications to general anesthesia , 2003 .

[21]  D. Sessler,et al.  Opioid-induced bowel dysfunction: pathophysiology and potential new therapies. , 2003, Drugs.

[22]  Carolyn L. Beck,et al.  On the use of multivariable piecewise-linear models for predicting human response to anesthesia , 2004, IEEE Transactions on Biomedical Engineering.

[23]  A. Sardesai,et al.  Monitoring techniques: neuromuscular blockade , 2005 .

[24]  Naira Hovakimyan,et al.  Neural network adaptive control for nonlinear nonnegative dynamical systems , 2005, IEEE Transactions on Neural Networks.

[25]  Bruno Guignard,et al.  Monitoring analgesia. , 2006, Best practice & research. Clinical anaesthesiology.

[26]  Jiang Wang,et al.  Novel L1 Adaptive Control Approach to Autonomous Aerial Refueling with Guaranteed Transient Performance , 2006, 2006 American Control Conference.

[27]  Barbara Kabon,et al.  Optimal perioperative oxygen administration , 2006, Current opinion in anaesthesiology.

[28]  Naira Hovakimyan,et al.  Are phase and time-delay margins always adversely affected by high-gain? , 2006 .

[29]  Chengyu Cao,et al.  Stability Margins of L1 Adaptive Controller: Part II , 2007, 2007 American Control Conference.

[30]  Carolyn L. Beck,et al.  Modeling and Control of Anesthetic Pharmacodynamics , 2007 .

[31]  Naira Hovakimyan,et al.  L1 Adaptive Output Feedback Controller to Systems of Unknown Dimension , 2007, 2007 American Control Conference.

[32]  Naira Hovakimyan,et al.  ℒ 1 Adaptive controller for tailless unstable aircraft in the presence of unknown actuator failures , 2007 .

[33]  Carolyn L. Beck,et al.  Multivariable LPV control of anesthesia delivery during surgery , 2008, 2008 American Control Conference.

[34]  Naira Hovakimyan,et al.  Novel L1 adaptive control methodology for aerial refueling with guaranteed transient performance , 2008 .

[35]  Naira Hovakimyan,et al.  Design and Analysis of a Novel ${\cal L}_1$ Adaptive Control Architecture With Guaranteed Transient Performance , 2008, IEEE Transactions on Automatic Control.

[36]  Chengyu Cao,et al.  L1 adaptive controller for multi-input multi-output systems in the presence of nonlinear unmatched uncertainties , 2010, Proceedings of the 2010 American Control Conference.

[37]  Matthew A. Ralph L1-Adaptive Control for Anesthesia Delivery , 2011 .

[38]  Nick Holford,et al.  Holford NHG and Sheiner LB “Understanding the Dose-Effect Relationship-Clinical Application of Pharmacokinetic-Pharmacodynamic Models”, Clin Pharmacokin 6:429–453 (1981)—The Backstory , 2011, The AAPS Journal.