全身麻醉中从靶控输注过渡到闭环控制

Migrating from target-controlled infusion to closed-loop control in general anaesthesia.

作者信息

Ting C H, Arnott R H, Linkens D A, Angel A

机构信息

Department of Biomechatronics Engineering, National Chiayi University, Taipei, Taiwan.

出版信息

Comput Methods Programs Biomed. 2004 Aug;75(2):127-39. doi: 10.1016/j.cmpb.2003.11.005.

DOI:10.1016/j.cmpb.2003.11.005

PMID:15212855

Abstract

The target-controlled infusion (TCI) technique has been successfully and commercially used in clinical general anaesthesia with the intravenous anaesthetic agent propofol. The technique is based on a population pharmacokinetic model and is an open-loop control system. Closed-loop control requires a reliable and consistent signal for feedback utilisation. With all anaesthetic agents the somatosensory evoked potentials (SEP) have been shown to give increased latency as anaesthetic depth is increased. Using infusion rate and SEP response data from rats anaesthetised with propofol a mathematical model was derived to describe the anaesthetic process. This model was used as a design reference to develop a proportional integral (PI) closed-loop control system using SEP as the feedback measure. A serials of 10 trials were conducted to investigate the difference between continuous bolus injection and infusion, all under closed-loop control. The trials showed that the use of SEPs in closed-loop control of anaesthesia is feasible.

摘要

靶控输注（TCI）技术已成功应用于临床全身麻醉，并以静脉麻醉药丙泊酚实现了商业化。该技术基于群体药代动力学模型，是一种开环控制系统。闭环控制需要一个可靠且一致的信号用于反馈利用。已证明，随着麻醉深度增加，所有麻醉药都会使体感诱发电位（SEP）潜伏期延长。利用丙泊酚麻醉大鼠的输注速率和SEP反应数据，推导了一个数学模型来描述麻醉过程。该模型用作设计参考，以开发一种以SEP为反馈指标的比例积分（PI）闭环控制系统。在闭环控制下进行了一系列10次试验，以研究连续推注和输注之间的差异。试验表明，在麻醉的闭环控制中使用SEP是可行的。