Drug Delivery for Neuromuscular Blockade With Supervised Multimodel Adaptive Control

A major issue in drug delivery systems is the high level of uncertainty due to inter- and intrapatient variations in the dynamics of drug absorption and metabolism. This paper proposes an approach to tackle this problem based on supervised multimodel adaptive control (SMMAC). Although the specific case of neuromuscular-blockade-level control of patients subject to general anesthesia is considered, the overall procedure can be applied to the control of other physiological variables. Design guidelines to implement SMMAC are presented, together with clinical cases of patients undergoing general anesthesia, where atracurium is used as the blocking agent. The important role played by the selection of the observer polynomial in the supervisor is demonstrated.