Control of muscle relaxation during anesthesia: a novel approach for clinical routine
Publisher DOI
PubMed ID
16532765
Abstract
During general anesthesia drugs are administered to provide hypnosis, ensure analgesia, and skeletal muscle relaxation. In this paper, the main components of a newly developed controller for skeletal muscle relaxation are described. Muscle relaxation is controlled by administration of neuromuscular blocking agents. The degree of relaxation is assessed by supramaximal train-of-four stimulation of the ulnar nerve and measuring the electromyogram response of the adductor pollicis muscle. For closed-loop control purposes, a physiologically based pharmacokinetic and pharmacodynamic model of the neuromuscular blocking agent mivacurium is derived. The model is used to design an observer-based state feedback controller. Contrary to similar automatic systems described in the literature this controller makes use of two different measures obtained in the train-of-four measurement to maintain the desired level of relaxation. The controller is validated in a clinical study comparing the performance of the controller to the performance of the anesthesiologist. As presented, the controller was able to maintain a preselected degree of muscle relaxation with excellent precision while minimizing drug administration. The controller performed at least equally well as the anesthesiologist.
Date Issued
2006
Publication Type
Article
Language(s)
en
Author(s)
Stadler, Konrad S | |
Schumacher, Peter M | |
Hirter, Sibylle | |
Leibundgut, Daniel | |
Glattfelder, Adolf H | |
Zbinden, Alex M |
Additional Credits
Journal
IEEE transactions on biomedical engineering
Publisher
Institute of Electrical and Electronics Engineers IEEE
ISSN
0018-9294
ISBN
16532765
Access(Rights)
metadata.only