Kansanaho M, Olkkola K T
Department of Anaesthesia, University of Helsinki, Finland.
Int J Clin Monit Comput. 1996 Nov;13(4):217-24. doi: 10.1023/a:1016956507342.
The performance of an adaptive model-based controller for the administration of atracurium, mivacurium, rocuronium and vecuronium was compared in 159 adult surgical patients. The degree of neuromuscular block was set to 90% for atracurium, rocuronium and vecuronium and to 95% for mivacurium. Performance was assessed by calculating the median prediction error (bias), median absolute performance error (inaccuracy), divergence, wobble, the mean offset and the mean standard deviation from the setpoint. All indices of controller performance showed minimal deviation of the actual neuromuscular block from the setpoint. Although the controller appeared to be able to control rocuronium induced block at 90% and mivacurium induced block at 95% better than atracurium and vecuronium block at 90%, the differences in the controller performance between the four studied relaxants were small and have hardly any clinical significance. We conclude that a model-based adaptive controller is useful in the administration of atracurium, mivacurium, rocuronium or vecuronium.
在159例成年外科手术患者中，对基于模型的阿曲库铵、米库氯铵、罗库溴铵和维库溴铵自适应控制器的性能进行了比较。将阿曲库铵、罗库溴铵和维库溴铵的神经肌肉阻滞程度设定为90%，米库氯铵设定为95%。通过计算中位预测误差（偏差）、中位绝对性能误差（不准确性）、离散度、摆动、平均偏移量以及与设定值的平均标准差来评估性能。控制器性能的所有指标均显示实际神经肌肉阻滞与设定值的偏差最小。尽管该控制器似乎能够比90%的阿曲库铵和维库溴铵阻滞更好地控制90%的罗库溴铵诱导的阻滞和95%的米库氯铵诱导的阻滞，但四种研究的肌松药之间控制器性能的差异很小，几乎没有任何临床意义。我们得出结论，基于模型的自适应控制器在阿曲库铵、米库氯铵、罗库溴铵或维库溴铵的给药中是有用的。
