Closed-Loop Anesthesia Delivery Using Indirect Analgesia Feedback
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Solution Overview
Problem
Current clinical anesthesia systems lack reliable measures for controlling the administration of analgesic and hypnotic agents, leading to inadequate analgesia, which can result in sub-optimal hypnosis control and potential adverse effects due to drug interactions and dosage inconsistencies.
Innovation Solution
A closed-loop control system that incorporates feedback from indirect measures of analgesia, such as the WAVCNS index, to automatically adjust the infusion rates of hypnotic and analgesic agents, using pharmacokinetic-pharmacodynamic models to predict effect site concentrations and ensure robust stability.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If manual monitoring and adjustment of drug infusion rates is used, then the anesthesiologist can respond to patient needs, but the time and attention required is costly and labor-intensive
Solution Approach 1:
The control system automatically monitors patient physiological parameters and adjusts drug infusion rates without requiring continuous manual intervention by the anesthesiologist. The system serves itself by using feedback from patient monitoring to autonomously control the infusion pumps, thereby freeing the anesthesiologist from routine adjustment tasks while maintaining appropriate levels of care.
2Extent of automation
If closed-loop automatic control system is implemented, then drug administration is automated and anesthesiologist attention is reduced, but reliable measures for analgesia control are lacking
Solution Approach 1:
The system implements closed-loop feedback control by continuously monitoring patient physiological parameters (such as heart rate, blood pressure, and other indicators of nociceptive response) and using this feedback to automatically adjust analgesic infusion rates. The feedback mechanism allows the system to respond to changes in patient status and maintain appropriate analgesia levels without manual intervention.
Solution Approach 2:
The system uses indirect physiological measures as intermediary indicators to infer the level of analgesia and nociceptive response. Since direct measurement of analgesia is not available, the system employs intermediate physiological parameters that correlate with pain response and analgesic effect, serving as mediators between the patient's actual pain state and the control system's adjustment decisions.
3Reliability
If hypnotic and analgesic agents are administered in combination, then comprehensive anesthesia is achieved, but drug interactions may cause cardiovascular collapse or respiratory depression
Solution Approach 1:
The system continuously monitors cardiovascular and respiratory parameters as feedback signals to detect early signs of adverse effects from drug interactions. When physiological parameters indicate potential harm (such as dropping blood pressure or respiratory depression), the feedback loop automatically adjusts or reduces drug infusion rates to prevent further deterioration, thereby maintaining safe operating margins even when multiple drugs are administered in combination.
Data Source
AI summary
The invention involves the administration of clinical anesthesia. Particular embodiments provide systems and methods for controlled delivery of a combination of an analgesic agent and a hypnotic agent. More specifically, the invention involves closed-loop control systems/methods for automatically controlling the administration of a combination of a hypnotic agent and an analgesic agent in a clinical anesthesia setting which incorporate feedback based on one or more indirect measures/indicia of analgesia. The invention further includes such control systems/methods that account for limitations of such indirect measures/indicia of analgesia.