A Synthesis Method for Automatic Handling of Inter-patient Variability in Closed-loop Anesthesia

This paper presents a convex-optimization-based technique to obtain parameters for a PID feedback controller, used to control the infusion rate of the anesthetic drug propofol. The controller design is based on a set of identified patient models, relating propofol infusion to an EEG-based conciousness index. The main contribution lies in the method automatically taking inter-patient variability into account, i.e., it guarantees robustness (sensitivity peak) and performance (disturbance rejection) over a set of patient models, without the need for manual intervention. The method is demonstrated using a clinically relevant design example. A controller designed using the proposed method is currently scheduled for clinical evaluation

Automation of the anesthetic process: New computer-based solutions to deal with the current frontiers in the assessment, modeling and control of anesthesia

The current trend in automating the anesthetic process focuses on developing a system for fully controlling the different variables involved in anesthesia. To this end, several challenges need to be addressed first. The main objective of this thesis is to propose new solutions that provide answers to the current problems in the field of assessing, modeling and controlling the anesthetic process. Undoubtedly, the main handicap to the development of a comprehensive proposal lies in the absence of a reliable measure of analgesia. This thesis proposes a novel fuzzy-logic-based scheme to evaluate the impact of including a new variable in a decision-making process. This scheme is validated by way of a preliminary analysis of the Analgesia Nociception Index (ANI) monitor on analgesic drug titration. Furthermore, the capacity of the ANI monitor to provide information to replicate the decisions of the experts in different clinical situations is studied. To this end, different artificial intelligence-based algorithms are used: specifically, the suitability of this index is evaluated against other variables commonly used in clinical practice. Regarding the modeling of anesthesia, this thesis presents an adaptive model that allows characterizing the pharmacological interaction effects between the hypnotic and analgesic drug on the depth of hypnosis. In addition, the proposed model takes into account both inter- and intra-patient variabilities observed in the response of the subjects. Finally, this work presents the synthesis of a robust optimal PID controller for regulating the depth of hypnosis by considering the effect of the uncertainties derived from the patient's pharmacological response. Moreover, a study is conducted on the limitations introduced when using a PID controller versus the development of higher order solutions under the same clinical and technical considerations