Estrategias de control en la práctica de anestesia

  1. Juan Albino Méndez Pérez 1
  2. Santiago Torres 1
  3. José Antonio Reboso 2
  4. Héctor Reboso 1
  1. 1 Dpto. de Ingeniería de Sistemas y Automática y Arquitectura y Tecnología de Computadores
  2. 2 Departamento de Hospital Universitario de Canarias
Journal:
Revista iberoamericana de automática e informática industrial ( RIAI )

ISSN: 1697-7920

Year of publication: 2011

Volume: 8

Issue: 3

Pages: 241-249

Type: Article

DOI: 10.1016/J.RIAI.2011.06.011 DIALNET GOOGLE SCHOLAR lock_openOpen access editor

More publications in: Revista iberoamericana de automática e informática industrial ( RIAI )

Sustainable development goals

Abstract

This paper is focused on modeling and control the hypnosis of patients undergoing to anaesthesia during surgery. On the one hand, this paper addresses the problem of modeling the process and shows results validated with real patients. It also proposes an advanced controller to regulate the patient hypnosis. The proposed algorithm is based on combining a nominal input, obtained from the inverse dynamics of the patient model, together with a corrective action derived from a predictive controller. The aim of this work is to develop a technique for regulating the patient's degree of hypnosis, being the control technique adaptable to different individuals. Preliminary results of the proposed strategy demonstrate the efficiency of the system with the proposed algorithm.

Bibliographic References

  • Absalom, A.R., Sutcliffe, Kenny, G.N.C., (2002(1)). Closed-loop Control of Anesthesia Using Bispectral Index. Performance Assessment in Patients Undergoing Major Orthopedic Surgery under Combined General and Regional Anesthesia. Anesthesiology; 96:67–73.
  • Absalom, A.R., Leslie, K., Kenny, G. N. C. (2002(2)). Closed loop control of sedation for colonoscopy using the Bispectral Index. Anaesthesia, 57: 690–709.
  • Absalom, A.R., Kenny, G. N. C. (2003). Closed-loop control of propofol anaesthesia using bispectral indexTM: performance assessment in patients receiving computer controlled propofol and manually controlled remifentanil infusions for minor surgery. British Journal of Anaesthesia 90 (6): 737-741 (2003).
  • Box, G.E.P., Jenkins, G.M., and Reinsel, G.C. (1994). Time Series Analysis: Forecasting and Control. Third edition. Prentice-Hall.
  • Dumont, G. A., Martinez, A. and Ansermino, J.M. (2009). Robust control of depth of anesthesia. International Journal of Adaptive Control and Signal Processing 23:435–454.
  • Furutani, E., Sawaguchi, Y., Shirakami, G., Araki, M. and Fukuda, K. (2005). A hypnosis control system using a model predictive controller with online identification of individual parameters. Proceedings of the 2005 IEEE Conference on Control Applications. Toronto, Canada, August 28-31.
  • Gentillini, A. L. (2001), Feedback Control of Hypnosis and Analgesia in Humans, Tesis Doctoral, Diss. ETH No. 14070, ETH, Zurich.
  • Hemmerling, T.M. (2007). Automated Anesthesia. Advances in Anesthesia, 25, 17–39.
  • Ionescu, C.M., De Keyser, R., Torrico, B.C., De Smet, T., Struys, M.M. and Normey-Rico, J.E. (2008). Robust Predictive Control Strategy Applied for Propofol Dosing Using BIS as a Controlled Variable During Anesthesia. IEEE Transactions On Biomedical Engineering, 55, No. 9, 2161-2170.
  • Kenny G. N. C., Mantzaridis, H. (1999). Closed-loop control of propofol anaesthesia. British Journal of Anaesthesia 83 (2): 223-8.
  • Liu, N., Chazot, T., Genty, A., Landais, A., Restoux, A., McGee, K., Laloë, P.A., Trillat, B., Barvais, L., Fischler, M. (2006). Titration of Propofol for Anesthetic Induction and Maintenance Guided by the Bispectral Index: Closed-loop versus Manual Control. A Prospective, Randomized, Multicenter Study. Anesthesiology; 104:686–95 © 2006 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.
  • Marsh, B., White, M., Morton, N., Kenny, G.N.C. (1991). Pharmacokinetic model driven infusion of Propofol in children. Br J Anaesth., 67: 41-8.
  • Mayo, C.W., Bickford, R.G., Faulconer, A. (1950) Electroencephalographically controlled anesthesia in abdominal surgery. - Journal of the American Medical Association; 144(13): 1081– 1083.
  • Méndez, J.A., Torres, S., Reboso, J.A., Reboso, H. (2009(1)). Adaptive Computer Control of Anesthesia in Humans. Computer Methods in Biomechanics and Biomedical Engineering (6): 727–734.
  • Méndez, J.A., Torres, S., Reboso, J.A., Reboso, H. (2009(2)). Modelbased controller for anesthesia automation. Proceedings of the IEEE Conference on Automation Science and Engineering, Bangalore, India.
  • Morley, A., Derrick, J., Mainland, P., Lee, B. B. and Short, T. G. (2000). Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control. Anaesthesia, 55 953-959.
  • Niño J., De Keyser, R., Syafiie S., Ionescu, C. and Struys, M.M. (2009). EPSAC-controlled anesthesia with online gain adaptation International Journal of Adaptative Control and Signal Processing; 23:455–471.
  • Reboso J.A., Méndez, J.A., Reboso, H., González-Miranda, F. (2007). Closed-Loop Control of Propofol Infusion using the BIS: Preliminary Results. Book of Abstracts of the First World Congress of Total Intravenous Anesthesia-TC, Venice (Italy).
  • Sakai, T., Matsuki A, White P.F. & Giesecke A.H. (2000). Use of an EEG-bispectral closed-loop delivery system for administering propofol. Acta Anaesthesiologica Scandinavica; 44: 1007-1010.
  • Sawaguchi, Y., Purutani, E., Shirakami, G., Araki, M. and Fukuda, K. (2003). A model predictive sedation control system under total intravenous anesthesia. Proc. of the IEEE EMBS Asian-Pacific Conference on Biomedical Engineering, pp. 358- 359.
  • Schnider, T.W., Minto, C.F., Gambus, P.L., Anderson, C., Goodale, D.B., Shafer, S.L. and Youngs, E.J (1998). The Influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteer. Anesthesiology, 88:1170-1182.
  • Sigl, J.C., Chamoun, N.G. (1994). An introduction to bispectral analysis for the electroencephalogram. - Journal of Clinical Monitoring 10(6):392-404.
  • Söderström, T., and Stoica, P. (1989). System Identification. Prentice Hall International.
  • Sreenivas, Y., Samavedham, L. and Rangaiah, G. P. (2008). Advanced Regulatory Controller for Automatic Control of Anesthesia. Proceedings of the 17th World Congress The International Federation of Automatic Control Seoul, Korea, July 6-11.
  • Sreenivas, Y., Samavedham, L. and Rangaiah, G. P. (2009). Advanced Control Strategies for the Regulation of Hypnosis with Propofol., Ind. Eng. Chem. Res., 48:3880–3897.
  • Struys, M.M., De Smet, T., Depoorter, B., Versichelen, L.F., Mortier, E.P., Dumortier, F.J., Shafer, S.L., Rolly, G. (2000), Comparison of plasma compartment versus two methods for effect compartmentcontrolled target controlled infusion for Propofol, Anesthesiology 92(2):399–406.
  • Struys, M.M., De Smet, T., Versichelen, L.F., Van De Velde, S., Van den Broecke, R., Mortier, E.P. (2001). A Comparison of Closed-loop Controlled Administration of Propofol Using Bispectral Index as the Controlled Variable versus “Standard Practice” Controlled Administration. Anesthesiology; 95: 6–17.
  • Syafiie, S., Niño, J., Ionescu, C., and De Keyser, R. (2009). NMPC for Propofol Drug Dosing during Anesthesia Induction. L. Magni et al. (Eds.): Nonlinear Model Predictive Control, LNCIS 384, pp. 501–509.
  • Torrico, B. C., De Keyser, R., Ionescu, C., Normey-Rico, J.E. (2007). Predictive Control with Robust Dead-Time Compensation: Application to drug dosing during Anesthesia. Prepints of the 7th IFAC Symposium on Nonlinear Control Systems. 21-24 August, 2007, Pretoria, South Africa.
  • Vanluchene, A.L.G., Vereecke, H., Thas, O., Mortier, E.P., Shafer, S.L. and Struys, M.M. (2004), Spectral Entropy as an electroencephalographic measure of anesthetic drug effect. Anesthesiology, 101:34–42.
Data source: Dialnet