Computer-Assisted Continuous Infusion of the Intravenous Analgesic Fentanyl During General Anesthesia-An Interactive System

Alvis, J. M.; Reves, J. G.; Spain, J. A.; Sheppard, Louis C.

doi:10.1109/tbme.1985.325545

Cited by 41 publications

(11 citation statements)

References 10 publications

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“…Furthermore computer controlled infusion techniques have been developed for a wide variety of di erent drugs which allow one to control carefully the plasma concentration. (Alvis et al, 1985;Ausems et al, 1985;BuÈ hrer et al, 1987;Martin & Ahuja, 1988;Tackley et al, 1989). It has therefore become possible to design infusion regimens and to administer drugs in such a way that it results in a linear increase of the blood concentration at a prede®ned rate.…”

Section: Introductionmentioning

confidence: 99%

Rate of change of blood concentrations is a major determinant of the pharmacodynamics of midazolam in rats

Cleton

Mazee

Voskuyl³

et al. 1999

British J Pharmacology

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1 The objective of this investigation was to characterize quantitatively the in¯uence of the rate of increase in blood concentrations on the pharmacodynamics of midazolam in rats. The pharmacodynamics of midazolam were quanti®ed by an integrated pharmacokinetic-pharmacodynamic modelling approach. 2 Using a computer controlled infusion technique, a linear increase in blood concentrations up to 80 ng ml 71 was obtained over di erent time intervals of 1 ± 6 h, resulting in rates of rise of the blood concentrations of respectively, 1.25, 1.00, 0.87, 0.46, 0.34 and 0.20 ng ml 71 min 71 . In one group of rats the midazolam concentration was immediately brought to 80 ng ml 71 and maintained at that level for 4 h. Immediately after the pretreatment an intravenous bolus dose was given to determine the time course of the EEG e ect in conjunction with the decline of midazolam concentrations. 3 The increase in b activity (11.5 ± 30 Hz) of the EEG was used as pharmacodynamic endpoint. For each individual animal the relationship between blood concentration and the EEG e ect could be described by the sigmoidal E max model. After placebo, the values of the pharmacodynamic parameter estimates were E max =82+5 mV, EC 50,u =6.4+0.8 ng ml 71 and Hill factor=1.4+0.1. A bell-shaped relationship between the rate of change of midazolam concentration and the value of EC 50,u was observed with a maximum of 21+5.0 ng ml 71 at a rate of change of 0.46 ng ml 71 min 71 ; lower values of EC 50,u were observed at both higher and lower rates. 4 The ®ndings of this study show that the rate of change in plasma concentrations is an important determinant of the pharmacodynamics of midazolam in rats.

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Section: Introductionmentioning

confidence: 99%

Rate of change of blood concentrations is a major determinant of the pharmacodynamics of midazolam in rats

Cleton

Mazee

Voskuyl³

et al. 1999

British J Pharmacology

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show abstract

“…Several manual infusion schemes have been proposed for use in adults, based either on the concept of minimum infusion rate [1] or on approximations to computer generated infusion regimens [2]. Alternatively, delivery may be effected automatically by a pharmacokinetic model driven computer controlled device [3,4]. This latter approach allows anaesthetic drugs to be administered to a theoretical target plasma concentration calculated mathematically by the delivery system algorithm.…”

mentioning

confidence: 99%

Pharmacokinetic Model Driven Infusion of Propofol in Children

Marsh

White

Morton

et al. 1991

British Journal of Anaesthesia

1,045

661

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A computer controlled infusion device for propofol was used to induce and maintain general anaesthesia in 20 children undergoing minor surgical procedures. The device was programmed with an adult pharmacokinetic model for propofol. During and after anaesthesia, blood samples were taken for measurement of propofol concentrations and it was found that the values obtained were systematically overpredicted by the delivery system algorithm. New pharmacokinetic microconstants were derived from our data which reflected more accurately the elimination and distribution of propofol in a prospective study involving another 10 children.

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“…The initial bolus, loading dose (LD), is calculated according to Equation (6) where ( ) 1 V l is the volume of central compartment represented on Figure 2. The LD bolus will ensure the Cpt is achieved however it needs to be followed by a continuous infusion, ( ) r t , defined by Equation (7) to ensure Cpt is maintained due to elimination and compartmental transfer of the drug [32]. 1 , TCI systems are also able to deal with Cpt changes.…”

Section: Target Controlled Infusion Systemmentioning

confidence: 99%

Design of Type-1 and Interval Type-2 Fuzzy PID Control for Anesthesia Using Genetic Algorithms

Araujo¹,

Xiao²,

Liu³

et al. 2014

JILSA

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This paper presents the automatic drug administration for the regulation of bispectral (BIS) index in the anesthesia process during the clinical surgery by controlling the concentration target of two drugs, namely, propofol and remifentanil. To realize the automatic drug administration, real clinical data are collected for 42 patients for the construction of patients' models consisting of pharmacokinetic and pharmacodynamic models describing the dynamics reacting to the input drugs. A nominal anesthesia model is obtained by taking the average of 42 patients' models for the design of control scheme. Three PID controllers are employed, namely linear PID controller, type-1 (T1) fuzzy PID controller and interval type-2 (IT2) fuzzy PID controller, to regulate the BIS index using the nominal patient's model. The PID gains and membership functions are obtained using genetic algorithm (GA) by minimizing a cost function measuring the control performance. The best trained PID controllers are tested under different scenarios and compared in terms of control performance. Simulation results show that the IT2 fuzzy PID controller offers the best control strategy regulating the BIS index while the T1 fuzzy PID controller comes the second.

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Computer-Assisted Continuous Infusion of the Intravenous Analgesic Fentanyl During General Anesthesia-An Interactive System

Cited by 41 publications

References 10 publications

Rate of change of blood concentrations is a major determinant of the pharmacodynamics of midazolam in rats

Rate of change of blood concentrations is a major determinant of the pharmacodynamics of midazolam in rats

Pharmacokinetic Model Driven Infusion of Propofol in Children

Design of Type-1 and Interval Type-2 Fuzzy PID Control for Anesthesia Using Genetic Algorithms

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