Key result
Model-predictive and RTDA controllers improve BIS regulation vs PID and cascade controllers during simulated isoflurane hypnosis.
Why the study?
There is a need for a comprehensive evaluation of closed-loop anesthesia control systems to establish their safety, reliability, and efficacy across a range of patients and conditions.
Do model-predictive and RTDA controllers improve the regulation of hypnosis (measured by BIS) compared to PID and cascade controllers in simulated patients?
Do model-predictive and RTDA controllers improve the regulation of hypnosis (measured by BIS) compared to PID and cascade controllers in simulated patients?
In simulated anesthesia models, model-predictive and RTDA controllers outperform standard PID and cascade controllers for regulating hypnosis.
Closed-loop anesthesia systems need rigorous prospective trials before adoption; Level 5 evidence leaves optimal controller selection and outcome benefits open.
Although manual control of anesthesia is still the dominant practice during surgery, an increasing number of studies have been conducted to investigate the possibility of automating this procedure. Several clinical studies that compare closed-loop to manual anesthesia control performance have been reported. These studies used proportional−integral−derivative (PID) controllers, as well as model-based controllers. However, there is a need for a comprehensive evaluation of closed-loop systems, to establish their safety, reliability, and efficacy for anesthesia regulation. This requires a detailed evaluation of promising and/or recent controllers for a range of patients and conditions via simulation. The present study investigates the performance of single-loop PID, cascade, model-predictive, and RTDA ( R obustness, set point T racking, D isturbance rejection, A ggressiveness) controllers for closed-loop regulation of hypnosis using isoflurane with bispectral index (BIS) as the controlled variable. Extensive simulations are performed using a model that simulates patient responses to the drug, surgical stimuli, and unexpected surgical events. Results of this comprehensive evaluation show that model-predictive and RTDA controllers provide better regulation of BIS, compared to the other controllers tested.
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Sreenivas et al. (2009) studied Anesthesia regulation. Model-predictive and RTDA controllers vs. Single-loop PID and cascade controllers was evaluated on Regulation of bispectral index (BIS). Model-predictive and RTDA controllers provided better regulation of bispectral index during simulated isoflurane hypnosis compared to single-loop PID and cascade controllers.
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