[Feedback control of depth of anesthesia during propofol administration. Bispectral index as the controlled variable].
BACKGROUND
The objective of this study was to evaluate the performance of a new system for closed-loop control of propofol administration using the bispectral index (BIS) under total intravenous anesthesia in the index values of middle-to-deep depth of anaesthesia.


METHODS
In this study 20 adult patients anesthetized with propofol and remifentanil were investigated. The propofol infusion was carried out using a fuzzy-PD+I controller with a target BIS value of 40.


RESULTS
Closed-loop control was able to provide maintenance of anesthesia and adequate operating conditions for all patients. The following quality control criteria were calculated: median performance error (MDPE; 0.16%, SD +/-1.4%), median absolute performance error (MDAPE; 6.9%, SD +/-2.8%) and wobble (6.8%, SD +/-2.5%).


CONCLUSIONS
The present study showed the clinical feasibility of the controller compared to existing devices regarding a high level of quality criteria of a model with an implemented fuzzy-PD+I structure controlling depth of hypnosis.
Janda
M
M
Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universität Rostock, Schillingallee 35, 18055 Rostock, Deutschland. matthias.janda@uni-rostock.de
Bajorat
J
J
Simanski
O
O
Kähler
R
R
Pohl
B
B
Nöldge-Schomburg
G F E
GF
Hofmockel
R
R
D000328:Adult; D000771:Anesthesia, Intravenous; D018686:Anesthetics, Intravenous; D056805:Consciousness Monitors; D004569:Electroencephalography; D005240:Feasibility Studies; D005246:Feedback; D005260:Female; D017143:Fuzzy Logic; D006801:Humans; D008297:Male; D008875:Middle Aged; D010880:Piperidines; D015742:Propofol; D011786:Quality Control; D011880:Radiotherapy Planning, Computer-Assisted; D000077208:Remifentanil
D018686:Anesthetics, Intravenous; D010880:Piperidines; D000077208:Remifentanil; D015742:Propofol
Anesthesiology. 1997 Apr;86(4):836-47
9105228
IEEE Trans Biomed Eng. 2001 Aug;48(8):874-89
11499525
Anaesthesist. 2004 Jan;53(1):66-72
14749879
Anesthesiology. 2001 Jul;95(1):1-2
11465546
Anesthesiology. 2006 Apr;104(4):686-95
16571963
Anesthesiology. 2004 Sep;101(3):591-602
15329583
Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):211-20
16634427
Anesthesiology. 2004 Jun;100(6):1373-81
15166554
Artif Intell Med. 2005 Nov;35(3):207-13
16011892
Anesthesiology. 2006 Apr;104(4):847-64
16571982
Anesth Analg. 2008 Oct;107(4):1200-10
18806028
Electroencephalogr Clin Neurophysiol. 1951 Feb;3(1):83-6
14822927
Anesthesiology. 2003 Jul;99(1):9-17
12826836
Anesth Analg. 2004 Sep;99(3):781-787
15333411
Anesthesiology. 2004 Mar;100(3):640-7
15108980
Anesthesiology. 2002 Jan;96(1):67-73
11753004
Br J Anaesth. 1997 Feb;78(2):180-4
9068338
Anesth Analg. 2000 Jan;90(1):161-7
10624998
Anaesthesist. 2008 Mar;57(3):223-30
18322665
Anesthesiology. 2001 Jul;95(1):6-17
11465585
Best Pract Res Clin Anaesthesiol. 2006 Mar;20(1):81-99
16634416