British Journal of Anaesthesia, Vol 83, Issue 2 223-228, Copyright © 1999 by The Board of Management and Trustees of the British Journal of Anaesthesia
GNC. Kenny and H. Mantzaridis
We describe the use of a closed-loop system to control depth of propofol
anaesthesia automatically. We used the auditory evoked potential index
(AEPindex) as the input signal of this system to validate it as a true
measure of depth of anaesthesia. Auditory evoked potentials were acquired
and processed in real time to provide the AEPindex. The AEPindex was used
in a proportional integral (PI) controller to determine the target blood
concentration of propofol required to induce and maintain general
anaesthesia automatically. We studied 100 spontaneously breathing patients.
The mean AEPindex before induction of anaesthesia was 73.5 (SD 17.6),
during surgical anaesthesia 37.8 (4.5) and at recovery of consciousness
89.7 (17.9). Twenty-two patients required assisted ventilation before
incision. After incision, ventilation was assisted in four of these 22
patients for more than 5 min. There was no incidence of intraoperative
awareness and all patients were prepared to have the same anaesthetic in
future. Movement interfering with surgery was minimal. Cardiovascular
stability and overall control of anaesthesia were satisfactory.
CLINICAL INVESTIGATIONS
Closed-loop control of propofol anaesthesia
University Department of Anaesthesia, Glasgow Royal Infirmary, 8-16 Alexandra Parade, Glasgow G31 2ER, UK; Department of Anaesthetics, Victoria Infirmary NHS Trust, Langside, Glasgow G42 9TY, UK
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