title: Model-based adaptive closed-loop feedback control of atracurium-induced neuromuscular blockade.
abstract: Closed-loop control of atracurium-induced neuromuscular blockade by a model-based adaptive feedback algorithm is described. Mean offsets (+/- s.d.) from setpoints at 50, 70 and 90% neuromuscular blocks using the Relaxograph were 1.1 +/- 1.3, 0.2 +/- 0.7 and 0.1 +/- 0.4%, respectively. Correspondingly, the mean steady-state rates of infusion of atracurium were 0.20 +/- 0.06, 0.25 +/- 0.03 and 0.39 +/- 0.10 mg.kg-1.h-1. The described controller provides reasonable control of atracurium dosing at different degrees of neuromuscular blockade. It gives a solution to the problem of adapting pharmacokinetic and pharmacodynamic data to individuals when using population mean data as starting values for drug therapy.
authors.affiliation: Department of Clinical Pharmacology, University of Helsinki, Finland.
authors.forename: K T
authors.initials: KT
authors.lastname: Olkkola
authors.forename: H
authors.initials: H
authors.lastname: Schwilden
authors.forename: C
authors.initials: C
authors.lastname: Apffelstaedt
mesh_terms: D000465:Algorithms; D001279:Atracurium / Q000008:administration & dosage*; D005246:Feedback / Q000502:physiology; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D007262:Infusions, Intravenous; D008297:Male; D009469:Neuromuscular Junction / Q000187:drug effects*; D013514:Surgical Procedures, Operative
chemical_list: D001279:Atracurium