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采用超扭曲滑模控制补偿变异性动力学的异丙酚麻醉中的催眠调节。

Hypnosis regulation in propofol anaesthesia employing super-twisting sliding mode control to compensate variability dynamics.

机构信息

Department of Electrical and Computer Engineering, COMSATS University, Islamabad, Pakistan.

Department of Electrical Engineering, FAST National University, Islamabad, Pakistan.

出版信息

IET Syst Biol. 2020 Apr;14(2):59-67. doi: 10.1049/iet-syb.2018.5080.

Abstract

Regulation of hypnosis level on bi-spectral index monitor (BIS) during a surgical procedure in propofol anaesthesia administration is a challenging task for an anaesthesiologist in multi-tasking environment of the operation theater. Automation in anaesthesia has the potential to solve issues arising from manual administration. Automation in anaesthesia is based on developing the three-compartmental model including pharmacokinetics and pharmacodynamic of the silico patients. This study focuses on regulation of the hypnosis level in the presence of surgical stimulus including skin incision, surgical diathermy and laryngoscopy as well as inter-patient variability by designing super-twisting sliding mode control (STSMC). The depth of the hypnosis level is maintained to 50 on the BIS level in the maintenance phase after improving the induction phase to 60 s using the conventional sliding mode control and 30 s with STSMC. The proposed scheme also compensates the inter-patient variability dynamics including height, age and weight of the different silico patients. Moreover, the surgical stimuli direct the hypnosis level towards the state of consciousness and stimulate the controller to provide continuous drug infusion during the interval 80-90 s. Simulation results witness that the oscillatory behaviour is observed in drug infusion to ensure the moderate level of hypnosis (40-60) for general surgery.

摘要

在丙泊酚麻醉管理中,手术过程中在双谱指数监测仪(BIS)上调节催眠水平对于手术室内多任务环境中的麻醉师来说是一项具有挑战性的任务。麻醉自动化具有解决手动管理中出现的问题的潜力。麻醉自动化基于开发包括计算机患者药代动力学和药效动力学的三腔室模型。本研究通过设计超扭曲滑模控制(STSMC),重点关注在存在手术刺激(包括皮肤切口、手术电烙和喉镜检查)以及患者间变异性的情况下调节催眠水平。通过使用传统滑模控制将诱导阶段提高到 60 秒,并使用 STSMC 将诱导阶段提高到 30 秒,在维持阶段将催眠水平维持在 BIS 水平 50。所提出的方案还补偿了不同计算机患者的身高、年龄和体重等患者间变异性动态。此外,手术刺激将催眠水平引导到意识状态,并在 80-90 秒的间隔内刺激控制器提供连续药物输注。仿真结果表明,在药物输注中观察到振荡行为,以确保全身手术的适度催眠水平(40-60)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dbc5/8687330/1d45ce29e9e8/SYB2-14-59-g001.jpg

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