New aspects of the rostocker assistant system of anesthesia control: Invited Paper for the session ‘Current trends and challenges in closed loop anesthesia’

The research group medical control at the Universities of Rostock (Germany) and Wismar has developed an assistant system for anesthesia to support anesthetists in controlling and maintaining the state of the patient in the operating theatre. The main objectives during general anesthesia are adequate level of hypnosis, analgesia, relaxation, and stable vital functions. During the last 20 years many controllers for the automatic drug delivery in anesthesia were developed. Starting with controllers for keeping a constant level of neuromuscular blockade, controllers for the hypnosis and analgesia were performed. Our research group developed a control system with an adaptive Generalized Controller for the neuromuscular blockade, a fuzzy controller for the control of the level of hypnosis and a fuzzy-system for analgesia control. The current contribution summarizes two studies, the MIMO control of the neuromuscular blockade and the depth of anesthesia which was done with 22 patients and the MIMO control of the depth of anesthesia and the level of analgesia. A model-based predictor for the level of neuromuscular blockade (NMB), to predict the level of NMB after stopping the drug infusion was integrated as a new feature for improving the clinical benefit.