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Open loop control of multiple drug effects in anesthesia

D R Wada¹, D S Ward

¹Department of Anesthesiology, University of California, Los Angeles 90024, USA.

IEEE Transactions on Bio-Medical Engineering

|July 1, 1995

Summary

This study introduces a new computer-controlled anesthesia drug delivery system. It aims to minimize side effects while maintaining therapeutic drug levels, improving patient safety during surgery.

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Area of Science:

Anesthesiology
Pharmacokinetics
Control Systems Engineering

Background:

Open-loop infusion pumps lack explicit control over transient adverse drug side effects during anesthesia.
Managing drug concentrations at the effect site is crucial for optimizing therapeutic outcomes and minimizing toxicity.

Purpose of the Study:

To develop and evaluate an optimal control strategy for intravenous drug administration during anesthesia.
To regulate drug concentrations at the desired effect site while penalizing excessive concentrations of side-effect drugs.

Main Methods:

Utilized optimal control principles to synthesize a single-input multiple-output controller.
Incorporated model-based predictions of future effect-site concentrations and anesthesiologist input into the cost function.
Evaluated the controller via computer simulation using a physiologically based pharmacokinetic model for alfentanil.

Main Results:

The developed controller effectively regulates drug concentrations, aiming to minimize adverse side effects.
Compared to alternative strategies, multiple-effect control limits overshoot in side-effect concentrations.
This approach may increase the time required to achieve the desired drug effect.

Conclusions:

Multiple-effect control provides an analytic method for managing intravenous drug infusion during anesthesia.
This strategy balances therapeutic goals with the mitigation of adverse side effects.
Further research can refine this approach for enhanced perioperative patient safety.

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