Progress of automatic drug delivery in anaesthesia—The 'Rostock assistant system for anaesthesia control (RAN)'

摘要

The main goals of general anaesthesia should include (not exclusively) adequate hypnosis, analgesia and maintenance of vital functions. In addition, neuromuscular blockade (NMB) may be needed for a number of surgical procedures. Patient safety and cost reductions via the minimization of drug consumption and the shortening of post-operative recovery represent some of the main issues and motivations of automation of anaesthesia.rnSince the early eighties engineers and physicians joined efforts towards the development of sophisticated closed-loop control systems for drug delivery in the operating theatre and post-operatively.rnFirst, this paper should be seen as a review about the automatic drug delivery in anaesthesia. A summary is given about the methods of measurement, modelling and general progress of closed-loop control systems in anaesthesia. In particular, the development of the 'Rostock assistant system for anaesthesia control (RAN)' is also described. This system has been developed during the last 15 years at the University of Rostock and various systems and control-based ideas have been integrated since. With this system the multiple-input-multiple-output (MIMO) control of the depth of hypnosis and NMB has been shown to be possible as well as the closed-loop control of a deep arterial hypotension. Promising results have already been obtained from a first study, which has so far included as many as 22 patients using MIMO control.