Closed-loop control of anesthesia using bispectral index - Performance assessment in patients undergoing major orthopedic surgey under combined general and regional anesthesia

被引:142
作者
Absalom, AR [1 ]
Sutcliffe, N [1 ]
Kenny, GN [1 ]
机构
[1] Glasgow Royal Infirm, Dept Anaesthesia, Glasgow, Lanark, Scotland
关键词
D O I
10.1097/00000542-200201000-00017
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: The Bispectral Index (BIS) is an electroencephalogram-derived measure of anesthetic depth. A closed-loop anesthesia system was built using BIS as the control variable, a proportional-integral-differential control algorithm, and a propofol target-controlled infusion system as (lie control actuator. Closed-loop performance was assessed in 10 adult patients. Methods: Ten adult patients scheduled to undergo elective hip or knee surgery were enrolled. An epidural cannula was inserted, and 0.5% bupivacaine was used to provide anesthesia to T8 before general anesthesia was Induced using (lie propofol target-controlled infusion system under manual control. After the start of surgery, when anesthesia was clinically adequate, automatic control of anesthesia was commenced using the BIS as the control variable. Adequacy of anesthesia during closed-loop control was assessed clinically and by calculating the median performance error, the median absolute performance error, and the mean offset of the control variable. Results: The median performance error and the median absolute performance error were 2.2 and 8.0%, respectively. Mean offset of the BIS from the set point was 0.9. Cardiovascular parameters were stable during closed-loop control. operating conditions were adequate in all patients but one, who began moving after 45 min of stable anesthesia. No patients reported awareness or recall of Intraoperative events. hi three patients, there was oscillation of the measured BIS around the set point. Conclusions: The system was able to provide clinically adequate anesthesia in 9 of 10 patients. Further studies are required to determine whether control performance can be improved by alterations to the gain factors or by using an effect site-targeted, target-controlled infusion propofol system.
引用
收藏
页码:67 / 73
页数:7
相关论文
共 22 条
  • [11] Auditory evoked potential index: a quantitative measure of changes in auditory evoked potentials during general anaesthesia
    Mantzaridis, H
    Kenny, GNC
    [J]. ANAESTHESIA, 1997, 52 (11) : 1030 - 1036
  • [12] Closed loop controlled administration of propofol using bispectral analysis
    Mortier, E
    Struys, M
    De Smet, T
    Versichelen, L
    Rolly, G
    [J]. ANAESTHESIA, 1998, 53 (08) : 749 - 754
  • [13] A primer for EEG signal processing in anesthesia
    Rampil, IJ
    [J]. ANESTHESIOLOGY, 1998, 89 (04) : 980 - 1002
  • [14] MIDAZOLAM-ALFENTANIL - AN ANESTHETIC - AN INVESTIGATION USING THE ISOLATED FOREARM TECHNIQUE
    RUSSELL, IF
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 1993, 70 (01) : 42 - 46
  • [15] The influence of age on propofol pharmacodynamics
    Schnider, TW
    Minto, CF
    Shafer, SL
    Gambus, PL
    Andresen, C
    Goodale, DB
    Youngs, EJ
    [J]. ANESTHESIOLOGY, 1999, 90 (06) : 1502 - 1516
  • [16] EFFECTIVE THERAPEUTIC INFUSIONS PRODUCED BY CLOSED-LOOP FEEDBACK-CONTROL OF METHOHEXITAL ADMINISTRATION DURING TOTAL INTRAVENOUS ANESTHESIA WITH FENTANYL
    SCHWILDEN, H
    STOECKEL, H
    [J]. ANESTHESIOLOGY, 1990, 73 (02) : 225 - 229
  • [17] CLOSED-LOOP FEEDBACK-CONTROL OF METHOHEXITAL ANESTHESIA BY QUANTITATIVE EEG ANALYSIS IN HUMANS
    SCHWILDEN, H
    SCHUTTLER, J
    STOECKEL, H
    [J]. ANESTHESIOLOGY, 1987, 67 (03) : 341 - 347
  • [18] CLOSED-LOOP FEEDBACK-CONTROL OF PROPOFOL ANESTHESIA BY QUANTITATIVE EEG ANALYSIS IN HUMANS
    SCHWILDEN, H
    STOECKEL, H
    SCHUTTLER, J
    [J]. BRITISH JOURNAL OF ANAESTHESIA, 1989, 62 (03) : 290 - 296
  • [19] A multicenter study of bispectral electroencephalogram analysis for monitoring anesthetic effect
    Sebel, PS
    Lang, E
    Rampil, IJ
    White, PF
    Cork, R
    Jopling, M
    Smith, NT
    Glass, PSA
    Manberg, P
    [J]. ANESTHESIA AND ANALGESIA, 1997, 84 (04) : 891 - 899
  • [20] Struys MMRF, 2000, ANESTHESIOLOGY, V93, pU146