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Related Experiment Videos

Automatic arterial pressure regulation using isoflurane: comparison with manual control.

C R Monk1, R K Millard, P Hutton

  • 1Sir Humphry Davy Department of Anaesthesia, University of Bristol, Bristol Royal Infirmary.

British Journal of Anaesthesia
|July 1, 1989
PubMed
Summary

A closed-loop controller effectively regulated isoflurane concentration for controlled hypotension during surgery. This automated system achieved results comparable to manual control, ensuring patient safety and stable blood pressure management.

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Area of Science:

  • Anesthesiology
  • Medical Engineering
  • Control Systems

Background:

  • Controlled hypotension is crucial for surgical procedures, particularly in ENT surgery.
  • Maintaining target arterial pressure (AP) manually can be challenging and requires constant vigilance.
  • Automated systems offer potential for improved precision and stability in anesthetic management.

Purpose of the Study:

  • To evaluate a self-tuning, closed-loop controller for regulating inspired isoflurane concentration.
  • To assess the controller's efficacy in achieving elective reduction of arterial pressure.
  • To compare the controller's performance against manual control of arterial pressure.

Main Methods:

  • A closed-loop controller based on the Clarke and Gawthrop algorithm was implemented.

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  • 33 patients undergoing ENT surgery were randomly assigned to groups receiving varying fentanyl and labetalol doses.
  • Controller performance was assessed at two target APs, via simulated AP changes, and compared to manual control in 8 patients.

    • Main Results:

    • The controller demonstrated acceptable undershoot of AP (2.8 +/- 0.5 to 4.5 +/- 1.3 mm Hg).
    • The system maintained target AP within +/- 5 mm Hg for 83-89% of the time, comparable to manual control (90%).
    • Regulation of induced hypotension was rapid, accurate, stable, and reproducible across all groups.

    Conclusions:

    • The self-tuning, closed-loop controller provides effective and reliable regulation of isoflurane for induced hypotension.
    • The automated system's performance is comparable to manual control, offering a safe and reproducible method for blood pressure management.
    • This technology has the potential to enhance anesthetic precision and patient safety during surgical interventions.