Event-Based control of depth of hypnosis in anesthesia. (August 2017)

• Record Type: Journal Article
• Authors: Merigo, Luca; Beschi, Manuel; Padula, Fabrizio; Latronico, Nicola; Paltenghi, Massimiliano; Visioli, Antonio
• Is Part Of: Computer methods and programs in biomedicine. Volume 147(2017)
• Page Start: 63
• Page End: 83
• Publication Date: 2017-08
• Subjects: Depth of hypnosis control -- PID Control -- Event-based control -- Noise filtering; AEP auditory evoked potential -- BIS bispectral index scale -- BIS-NADIR lowest value of the bispectral index scale -- DoH depth of hypnosis -- EEG electroencephalogram -- IAE integrated absolute error -- MDPE median performance error -- MDAPE median absolute performance error -- PE performance error -- PID proportional-integral-derivative -- PD pharmacodynamics -- PK pharmacokinetics -- PSD power spectral density -- Q quantity of administered drug -- SOD send-on-delta -- ST10 10% settling time -- ST20 20% settling time -- TCI target controlled infusion -- TIVA total intravenous anesthesia -- TT time to target -- TV total variation -- US undershoot; Medicine -- Computer programs -- Periodicals; Biology -- Computer programs -- Periodicals; Computers -- Periodicals; Medicine -- Periodicals; Médecine -- Logiciels -- Périodiques; Biologie -- Logiciels -- Périodiques; Biology -- Computer programs; Medicine -- Computer programs; Periodicals; Electronic journals; 610.28
• DOI: 10.1016/j.cmpb.2017.06.007
• Languages: English
• ISSNs: 0169-2607

Abstract

Highlights: The use of an event-based control strategy is applied to the closed-loop control of the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. A new event generator with high noise-filtering properties is employed in addition to a PIDPlus controller. The effectiveness and robustness of the method is verified in simulation by considering a set of patients representative of a large population to address the inter-patient variability and by implementing a Monte Carlo method to address the intra-patient variability. Abstract: Background and Objective: In this paper, we propose the use of an event-based control strategy for the closed-loop control of the depth of hypnosis in anesthesia by using propofol administration and the bispectral index as a controlled variable. Methods: A new event generator with high noise-filtering properties is employed in addition to a PIDPlus controller. The tuning of the parameters is performed off-line by using genetic algorithms by considering a given data set of patients. Results: The effectiveness and robustness of the method is verified in simulation by implementing a Monte Carlo method to address the intra-patient and inter-patient variability. A comparison with a standard PID control structure shows that the event-based control system achieves a reduction of the total variation of the manipulated variable of 93% in the induction phase and of 95% in the maintenance phase. Conclusions: The use of event based automatic control in anesthesia yields a fast induction phase with bounded overshoot and an acceptable disturbance rejection. A comparison with a standard PID control structure shows that the technique effectively mimics the behavior of the anesthesiologist by providing a significant decrement of the total variation of the manipulated variable.