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Development of a remote-controlled, automated total intravenous anesthesia system

远程控制、自动化全静脉麻醉系统的开发

基本信息

批准号：
10557136
负责人：
YAMAMOTO Hirotoshi
金额：
$ 7.1万
依托单位：
The University of Tokyo
依托单位国家：
日本
项目类别：
Grant-in-Aid for Scientific Research (B).
财政年份：
1998
资助国家：
日本
起止时间：
1998 至 2000
项目状态：
已结题

项目摘要

The object of this study is to develop a remote computer-controlled system for total intravenous anesthesia (TIVA) using three anesthetic drugs : propofol for hypnosis, fentanyl for analgesia, and vecuronium for muscle relaxation.We initially developed a target-controlled infusion (TCI) system of a drug that includes a personal computer, a computer-controlled infusion pump, and a self-made software. This system calculates estimated blood concentration or estimated effect-site concentration based on the pharmacokinetic and pharmacodynamic model, and controls the infusion rate to maintain a desired concentration. We added a 4-serial-port PCI-card to control three infusion pumps by one computer.As the information from a patient, the Bispectral Index for hypnotic level and the single twitch height for muscle relaxation were used. Then we developed a system to control infusion rates of three drugs. For propofol, that calculates the relation between the Bispectral Index and the estimated effect-site concentration by real-time processing and controls the propofol infusion rate to maintain a desired Bispectral Index value. For vecuronium, the system feedbacks the single twitch height and controls the vecuronium infusion rate. Adding the TCI of fentanyl, this, one computer three pumps system were used in actual anesthesia practice and produced stable anesthesia.Finally we remote-controlled the former system by other personal computer via LAN within our hospital using remote-control software. We used this final system to some patients and could induce and maintain stable anesthesia. We expect that in the near future, many clinicians will use a completely automated anesthesia system that integrating other physiological information and controlling ventilators, fluid infusion, etc.

本研究的目的是开发一种用于丙泊酚催眠、芬太尼镇痛和维库溴铵三种麻醉药用于全凭静脉麻醉(TIVA)的远程计算机控制系统。该系统根据药代动力学和药效学模型计算估计的血药浓度或估计的效应点浓度，并控制输液速度以维持所需的浓度。增加一个4串口PCI卡，由一台计算机控制三个输液泵，以双频指数代表催眠水平，单次抽动高度代表肌肉松弛。然后我们开发了一个系统来控制三种药物的输液速度。对于异丙酚，它通过实时处理计算脑电双频指数和估计的效应点浓度之间的关系，并控制异丙酚输注速率以保持所需的脑电双频指数值。对于维库溴铵，系统反馈单次抽动高度并控制维库溴铵的输注速度。再加上芬太尼的TCI，将这种一机三泵系统应用于实际麻醉实践中，产生了稳定的麻醉效果，最后利用远程控制软件，通过医院内的局域网，由其他个人计算机对前一系统进行远程控制。我们将这个最终的系统应用于一些患者，并可以诱导和维持稳定的麻醉。我们预计，在不久的将来，许多临床医生将使用集成其他生理信息并控制呼吸机、输液等的全自动麻醉系统。