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Open loop control of multiple drug effects in anesthesia

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2 Author(s)
Wada, D.R. ; Dept. of Anesthesiology & Electr. Eng., California Univ., Los Angeles, CA, USA ; Ward, Denham S.

Current open-loop computer-controlled infusion pumps do not explicitly control the transient adverse side effects of intravenous drugs during anesthesia. The authors used optimal control principles to synthesize a single-input multiple-output controller that regulates concentrations at the site of desirable drug effect while penalizing excessive side-effect drug concentrations. The cost function incorporates model-based predictions of future effect-site concentrations, and the capability of the anesthesiologist to anticipate upcoming surgical events. The controller was evaluated and then compared with alternative control strategies through computer simulation of a physiologically based pharmacokinetic model for the intravenous drug alfentanil. Multiple-effect control offers an analytic approach to limit the overshoot in adverse side-effect concentrations at the consequence of increasing the time to achieve the desired drug effect.

Published in:

Biomedical Engineering, IEEE Transactions on  (Volume:42 ,  Issue: 7 )