Anesthesia regulation: Towards completing the picture

This paper introduces for the first time in literature the complete picture of depth of anesthesia regulatory paradigm. The simulation model proposes to include not only the three anesthesia features: hypnosis, analgesia and neuromuscular blockade, but also to introduce the interaction with the hemodynamic system (cardio-regulatory loops). Disturbances occurring in the operation theatre origin from surgical stimulation, for which profiles are available. A novel addition is the model of nociceptor pathway, recently developed and thus available for analysis. The nociceptor pathway model makes the link between the surgical stimulation and the perception to the patient of its effect. In conclusion, this paper presents a nonlinear multiple input multiple output model for further development of control algorithms in this application field.