Estrategias de Control en la Práctica de Anestesia

Juan Albino Méndez Pérez, Santiago Torres, José Antonio Reboso, Héctor Reboso

Resumen

Este artículo se centra en el modelado y control de la hipnosis durante la anestesia de pacientes sometidos a intervenciones quirúrgicas. Por un lado en este trabajo se aborda el problema del modelado del proceso presentando resultados validados con pacientes reales. Asimismo, se propone un controlador avanzado para regular el estado hipnótico. El algoritmo empleado se basa en combinar una acción nominal obtenida a partir de la dinámica inversa juntamente con una acción correctora que se obtiene a partir de un controlador predictivo. El trabajo persigue desarrollar una técnica que permita la regulación del estado del paciente y que tenga características de adaptabilidad a los diferentes individuos. Se muestran resultados preliminares de la estrategia propuesta para demostrar la eficiencia del sistema.

Palabras clave

Anestesia; BIS; Propofol; Control; Control PID; Control Predictivo; Control Adaptativo

Texto completo:

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Referencias

Absalom, A.R., Sutcliffe, Kenny, G.N.C., (2002(1)). Closed-loop Control of Anesthesia Using Bispectral Index. Performance Assessment in Patients Undergoing Major Orthopedic Surgery under Combined General and Regional Anesthesia. Anesthesiology; 96:67–73.

Absalom, A.R., Leslie, K., Kenny, G. N. C. (2002(2)). Closed loop control of sedation for colonoscopy using the Bispectral Index. Anaesthesia, 57: 690–709.

Absalom, A.R., Kenny, G. N. C. (2003). Closed-loop control of propofol anaesthesia using bispectral indexTM: performance assessment in patients receiving computer controlled propofol and manually controlled remifentanil infusions for minor surgery. British Journal of Anaesthesia 90 (6): 737-741 (2003).

Box, G.E.P., Jenkins, G.M., and Reinsel, G.C. (1994). Time Series Analysis: Forecasting and Control. Third edition. Prentice-Hall.

Dumont, G. A., Martinez, A. and Ansermino, J.M. (2009). Robust control of depth of anesthesia. International Journal of Adaptive Control and Signal Processing 23:435–454.

Furutani, E., Sawaguchi, Y., Shirakami, G., Araki, M. and Fukuda, K. (2005). A hypnosis control system using a model predictive controller with online identification of individual parameters. Proceedings of the 2005 IEEE Conference on Control Applications. Toronto, Canada, August 28-31.

Gentillini, A. L. (2001), Feedback Control of Hypnosis and Analgesia in Humans, Tesis Doctoral, Diss. ETH No. 14070, ETH, Zurich.

Hemmerling, T.M. (2007). Automated Anesthesia. Advances in Anesthesia, 25, 17–39.

Ionescu, C.M., De Keyser, R., Torrico, B.C., De Smet, T., Struys, M.M. and Normey-Rico, J.E. (2008). Robust Predictive Control Strategy Applied for Propofol Dosing Using BIS as a Controlled Variable During Anesthesia. IEEE Transactions On Biomedical Engineering, 55, No. 9, 2161-2170.

Kenny G. N. C., Mantzaridis, H. (1999). Closed-loop control of propofol anaesthesia. British Journal of Anaesthesia 83 (2): 223-8.

Liu, N., Chazot, T., Genty, A., Landais, A., Restoux, A., McGee, K., Laloë, P.A., Trillat, B., Barvais, L., Fischler, M. (2006). Titration of Propofol for Anesthetic Induction and Maintenance Guided by the Bispectral Index: Closed-loop versus Manual Control. A Prospective, Randomized, Multicenter Study. Anesthesiology; 104:686–95 © 2006 American Society of Anesthesiologists, Inc. Lippincott Williams & Wilkins, Inc.

Marsh, B., White, M., Morton, N., Kenny, G.N.C. (1991). Pharmacokinetic model driven infusion of Propofol in children. Br J Anaesth., 67: 41-8.

Mayo, C.W., Bickford, R.G., Faulconer, A. (1950) Electroencephalographically controlled anesthesia in abdominal surgery. - Journal of the American Medical Association; 144(13): 1081– 1083.

Méndez, J.A., Torres, S., Reboso, J.A., Reboso, H. (2009(1)). Adaptive Computer Control of Anesthesia in Humans. Computer Methods in Biomechanics and Biomedical Engineering (6): 727–734.

Méndez, J.A., Torres, S., Reboso, J.A., Reboso, H. (2009(2)). Modelbased controller for anesthesia automation. Proceedings of the IEEE Conference on Automation Science and Engineering, Bangalore, India.

Morley, A., Derrick, J., Mainland, P., Lee, B. B. and Short, T. G. (2000). Closed loop control of anaesthesia: an assessment of the bispectral index as the target of control. Anaesthesia, 55 953-959.

Niño J., De Keyser, R., Syafiie S., Ionescu, C. and Struys, M.M. (2009). EPSAC-controlled anesthesia with online gain adaptation International Journal of Adaptative Control and Signal Processing; 23:455–471.

Reboso J.A., Méndez, J.A., Reboso, H., González-Miranda, F. (2007). Closed-Loop Control of Propofol Infusion using the BIS: Preliminary Results. Book of Abstracts of the First World Congress of Total Intravenous Anesthesia-TC, Venice (Italy).

Sakai, T., Matsuki A, White P.F. & Giesecke A.H. (2000). Use of an EEG-bispectral closed-loop delivery system for administering propofol. Acta Anaesthesiologica Scandinavica; 44: 1007-1010.

Sawaguchi, Y., Purutani, E., Shirakami, G., Araki, M. and Fukuda, K. (2003). A model predictive sedation control system under total intravenous anesthesia. Proc. of the IEEE EMBS Asian-Pacific Conference on Biomedical Engineering, pp. 358- 359.

Schnider, T.W., Minto, C.F., Gambus, P.L., Anderson, C., Goodale, D.B., Shafer, S.L. and Youngs, E.J (1998). The Influence of method of administration and covariates on the pharmacokinetics of propofol in adult volunteer. Anesthesiology, 88:1170-1182.

Sigl, J.C., Chamoun, N.G. (1994). An introduction to bispectral analysis for the electroencephalogram. - Journal of Clinical Monitoring 10(6):392-404.

Söderström, T., and Stoica, P. (1989). System Identification. Prentice Hall International.

Sreenivas, Y., Samavedham, L. and Rangaiah, G. P. (2008). Advanced Regulatory Controller for Automatic Control of Anesthesia. Proceedings of the 17th World Congress The International Federation of Automatic Control Seoul, Korea, July 6-11.

Sreenivas, Y., Samavedham, L. and Rangaiah, G. P. (2009). Advanced Control Strategies for the Regulation of Hypnosis with Propofol., Ind. Eng. Chem. Res., 48:3880–3897.

Struys, M.M., De Smet, T., Depoorter, B., Versichelen, L.F., Mortier, E.P., Dumortier, F.J., Shafer, S.L., Rolly, G. (2000), Comparison of plasma compartment versus two methods for effect compartmentcontrolled target controlled infusion for Propofol, Anesthesiology 92(2):399–406.

Struys, M.M., De Smet, T., Versichelen, L.F., Van De Velde, S., Van den Broecke, R., Mortier, E.P. (2001). A Comparison of Closed-loop Controlled Administration of Propofol Using Bispectral Index as the Controlled Variable versus “Standard Practice” Controlled Administration. Anesthesiology; 95: 6–17.

Syafiie, S., Niño, J., Ionescu, C., and De Keyser, R. (2009). NMPC for Propofol Drug Dosing during Anesthesia Induction. L. Magni et al. (Eds.): Nonlinear Model Predictive Control, LNCIS 384, pp. 501–509.

Torrico, B. C., De Keyser, R., Ionescu, C., Normey-Rico, J.E. (2007). Predictive Control with Robust Dead-Time Compensation: Application to drug dosing during Anesthesia. Prepints of the 7th IFAC Symposium on Nonlinear Control Systems. 21-24 August, 2007, Pretoria, South Africa.

Vanluchene, A.L.G., Vereecke, H., Thas, O., Mortier, E.P., Shafer, S.L. and Struys, M.M. (2004), Spectral Entropy as an electroencephalographic measure of anesthetic drug effect. Anesthesiology, 101:34–42.

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1. One-Class-Based Intelligent Classifier for Detecting Anomalous Situations During the Anesthetic Process
Alberto Leira, Esteban Jove, Jose M Gonzalez-Cava, José-Luis Casteleiro-Roca, Héctor Quintián, Francisco Zayas-Gato, Santiago Torres Álvarez, Svetlana Simić, Juan-Albino Méndez-Pérez, José Luis Calvo-Rolle
Logic Journal of the IGPL  año: 2020  
doi: 10.1093/jigpal/jzaa065



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Universitat Politècnica de València     https://doi.org/10.4995/riai

e-ISSN: 1697-7920     ISSN: 1697-7912