Dipartimento di Ingegneria dell'Informazione, University of Brescia, Brescia, Italy.
Curtin Centre for Optimisation and Decision Science, Curtin University, Perth, Australia.
Comput Methods Programs Biomed. 2022 Jun;219:106763. doi: 10.1016/j.cmpb.2022.106763. Epub 2022 Mar 19.
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.
许多方法已被提出用于控制普通外科手术中的全静脉麻醉，因为这可以减轻麻醉师的压力并提高患者的安全性。本工作的目的是设计一种基于 PID 的控制系统，用于调节丙泊酚和瑞芬太尼联合给药时的催眠深度，该系统考虑了临床实践。
相对于标准 PID 控制系统，已经实现了附加功能，以考虑与临床实践相关的特定要求。具体来说，在诱导阶段确定并使用合适的推注量，并且在预测效应部位浓度降至安全阈值以下时，在维持阶段使用非零基线输注。
修改后的控制器已在接受择期整形手术全身麻醉的 10 名患者中进行了实验评估。该控制系统能够在没有麻醉师任何手动干预的情况下诱导和维持足够的麻醉。
结果证实了总体设计方法的有效性，特别是突出了新版本的控制系统与标准 PID 控制器相比，从临床角度来看具有显著优势。
