Assef S J, Lennon R L, Jones K A, Burke M J, Behrens T L
Department of Anesthesiology, Mayo Clinic Rochester, Minnesota 55905.
Mayo Clin Proc. 1993 Nov;68(11):1074-80. doi: 10.1016/s0025-6196(12)60901-x.
A computer-controlled, closed-loop system for continuous infusion of muscle relaxants that allows the operator to choose either atracurium besylate or vecuronium bromide to provide any desired target level of neuromuscular blockade is described. This new system offers certain advantages over computer-controlled systems described previously for continuous infusion of muscle relaxants--that is, the option to choose either of two muscle relaxants to be infused and the inclusion of monitors to provide feedback about the dosage needed to produce a target level of neuromuscular blockade. The clinical performance of this system was tested in 36 patients who were 18 to 65 years old, were classified in American Society of Anesthesiologists physical status 1 or 2, and were undergoing elective orthopedic, abdominal, or thoracic procedures. In all patients, the control algorithm rapidly induced the target level of neuromuscular blockade and maintained that level of blockade at steady state with minimal oscillation. We conclude that the automatic feedback control system described can induce and precisely maintain any predetermined target level of neuromuscular blockade.
本文描述了一种计算机控制的闭环系统，用于持续输注肌肉松弛剂，该系统允许操作人员选择苯磺顺阿曲库铵或维库溴铵，以达到任何所需的神经肌肉阻滞目标水平。与先前描述的用于持续输注肌肉松弛剂的计算机控制系统相比，这个新系统具有某些优势，即可以选择两种肌肉松弛剂中的任意一种进行输注，并配备监测器以反馈产生目标水平神经肌肉阻滞所需的剂量。该系统的临床性能在36例年龄在18至65岁、美国麻醉医师协会身体状况分级为1或2级、正在接受择期骨科、腹部或胸部手术的患者中进行了测试。在所有患者中，控制算法迅速诱导出目标水平的神经肌肉阻滞，并在稳态下以最小的波动维持该阻滞水平。我们得出结论，所描述的自动反馈控制系统可以诱导并精确维持任何预定的神经肌肉阻滞目标水平。
