[Methods of automatic feedback regulation for anesthesia. Concepts and clinical use]. 1986

H Stoeckel, and H Schwilden

Dosing of drugs used in general anaesthetic practice is largely based on experience and trial-and-error. From the very beginning, anaesthesiological research has always attempted to supply a rational description of the rules governing the dose-response relationship. During the last few decades it became possible to identify pharmacokinetics as a main constituent of the relationship, since the rate of efficacy is primarily governed by the kinetics of the drug and the dose. On the other hand, the complete nonlinearity of the dose-response relationship can be demonstrated by means of a pharmacodynamic model. Control of anaesthesia by pharmacokinetic-dynamic models may be considered satisfactory as long as there is no pronounced scatter of the model parameters within a given population. Closed-loop feedback control is contrasted to feedforward control that attempts to monitor a given variable within a preset range by feeding back a measured signal to the drug delivery system. The present article reviews the experience and application of automatic feedback control systems used in anaesthesia. It was shown in all cases that adaptive, model-based feedback control is superior to non-adaptive methods. Pharmacokinetic and/or pharmacodynamic models were successfully applied to the servocontrol of volatile anaesthetics, intravenous hypnotics and neuromuscular blocking agents. Over and above these three applications, directly related to anaesthesia, the impact of feedback control on the regulation of blood pressure and blood glucose is reviewed.

UI MeSH Term Description Entries
D009126 Muscle Relaxation That phase of a muscle twitch during which a muscle returns to a resting position. Muscle Relaxations,Relaxation, Muscle,Relaxations, Muscle
D001786 Blood Glucose Glucose in blood. Blood Sugar,Glucose, Blood,Sugar, Blood
D001794 Blood Pressure PRESSURE of the BLOOD on the ARTERIES and other BLOOD VESSELS. Systolic Pressure,Diastolic Pressure,Pulse Pressure,Pressure, Blood,Pressure, Diastolic,Pressure, Pulse,Pressure, Systolic,Pressures, Systolic
D003201 Computers Programmable electronic devices designed to accept data, perform prescribed mathematical and logical operations at high speed, and display the results of these operations. Calculators, Programmable,Computer Hardware,Computers, Digital,Hardware, Computer,Calculator, Programmable,Computer,Computer, Digital,Digital Computer,Digital Computers,Programmable Calculator,Programmable Calculators
D004305 Dose-Response Relationship, Drug The relationship between the dose of an administered drug and the response of the organism to the drug. Dose Response Relationship, Drug,Dose-Response Relationships, Drug,Drug Dose-Response Relationship,Drug Dose-Response Relationships,Relationship, Drug Dose-Response,Relationships, Drug Dose-Response
D004569 Electroencephalography Recording of electric currents developed in the brain by means of electrodes applied to the scalp, to the surface of the brain, or placed within the substance of the brain. EEG,Electroencephalogram,Electroencephalograms
D004576 Electromyography Recording of the changes in electric potential of muscle by means of surface or needle electrodes. Electromyogram,Surface Electromyography,Electromyograms,Electromyographies,Electromyographies, Surface,Electromyography, Surface,Surface Electromyographies
D005246 Feedback A mechanism of communication within a system in that the input signal generates an output response which returns to influence the continued activity or productivity of that system. Feedbacks
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000768 Anesthesia, General Procedure in which patients are induced into an unconscious state through use of various medications so that they do not feel pain during surgery. Anesthesias, General,General Anesthesia,General Anesthesias

Related Publications

H Stoeckel, and H Schwilden
May 2015, Journal of medical systems,
H Stoeckel, and H Schwilden
January 1987, Annals of biomedical engineering,
H Stoeckel, and H Schwilden
February 1975, L'union medicale du Canada,
H Stoeckel, and H Schwilden
January 1970, Eksperimental'naia khirurgiia i anesteziologiia,
H Stoeckel, and H Schwilden
January 1966, Eksperimental'naia khirurgiia i anesteziologiia,
H Stoeckel, and H Schwilden
April 2018, Current opinion in systems biology,
H Stoeckel, and H Schwilden
March 2012, Genes & cancer,
H Stoeckel, and H Schwilden
January 1968, Postepy biochemii,
H Stoeckel, and H Schwilden
February 1953, Der Anaesthesist,
Copied contents to your clipboard!