A modified PID-based control scheme for depth-of-hypnosis control: Design and experimental results.

Clinical results Coadministration Depth-of-Hypnosis control PID control Total intravenous anesthesia

Journal

Computer methods and programs in biomedicine
ISSN: 1872-7565
Titre abrégé: Comput Methods Programs Biomed
Pays: Ireland
ID NLM: 8506513

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 06 12 2021
revised: 05 03 2022
accepted: 17 03 2022
pubmed: 30 3 2022
medline: 11 5 2022
entrez: 29 3 2022
Statut: ppublish

Résumé

Many methodologies have been proposed for the control of total intravenous anesthesia in general surgery, as this yields a reduced stress for the anesthesiologist and an increased safety for the patient. The objective of this work is to design a PID-based control system for the regulation of the depth of hypnosis by propofol and remifentanil coadministration that takes into account the clinical practice. With respect to a standard PID control system, additional functionalities have been implemented in order to consider specific requirements related to the clinical practice. In particular, suitable boluses are determined and used in the induction phase and a nonzero baseline infusion is used in the maintenance phase when the predicted effect-site concentration drops below a safety threshold. The modified controller has been experimentally assessed on a group of 10 patients receiving general anesthesia for elective plastic surgery. The control system has been able to induce and maintain adequate anesthesia without any manual intervention from the anesthesiologist. Results confirm the effectiveness of the overall design approach and, in particular, highlight that the new version of the control system, with respect to a standard PID controller, provides significant advantages from a clinical standpoint.

Sections du résumé

BACKGROUND AND OBJECTIVE OBJECTIVE
Many methodologies have been proposed for the control of total intravenous anesthesia in general surgery, as this yields a reduced stress for the anesthesiologist and an increased safety for the patient. The objective of this work is to design a PID-based control system for the regulation of the depth of hypnosis by propofol and remifentanil coadministration that takes into account the clinical practice.
METHODS METHODS
With respect to a standard PID control system, additional functionalities have been implemented in order to consider specific requirements related to the clinical practice. In particular, suitable boluses are determined and used in the induction phase and a nonzero baseline infusion is used in the maintenance phase when the predicted effect-site concentration drops below a safety threshold.
RESULTS RESULTS
The modified controller has been experimentally assessed on a group of 10 patients receiving general anesthesia for elective plastic surgery. The control system has been able to induce and maintain adequate anesthesia without any manual intervention from the anesthesiologist.
CONCLUSIONS CONCLUSIONS
Results confirm the effectiveness of the overall design approach and, in particular, highlight that the new version of the control system, with respect to a standard PID controller, provides significant advantages from a clinical standpoint.

Identifiants

pubmed: 35349908
pii: S0169-2607(22)00149-3
doi: 10.1016/j.cmpb.2022.106763
pii:
doi:

Substances chimiques

Anesthetics, Intravenous 0
Remifentanil P10582JYYK
Propofol YI7VU623SF

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

106763

Informations de copyright

Copyright © 2022 Elsevier B.V. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors declare that there are no conflicts of interests.

Auteurs

Michele Schiavo (M)

Dipartimento di Ingegneria dell'Informazione, University of Brescia, Brescia, Italy. Electronic address: m.schiavo003@unibs.it.

Fabrizio Padula (F)

Curtin Centre for Optimisation and Decision Science, Curtin University, Perth, Australia. Electronic address: fabrizio.padula@curtin.edu.au.

Nicola Latronico (N)

Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy; Department of Anesthesiology, Critical Care and Emergency Spedali Civili di Brescia, Brescia, Italy. Electronic address: nicola.latronico@unibs.it.

Massimiliano Paltenghi (M)

Department of Anesthesiology, Critical Care and Emergency Spedali Civili di Brescia, Brescia, Italy. Electronic address: massimiliano.paltenghi@asst-spedalicivili.it.

Antonio Visioli (A)

Dipartimento di Ingegneria Meccanica e Industriale University of Brescia, Brescia, Italy. Electronic address: antonio.visioli@unibs.it.

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Classifications MeSH