A New Control Scheme for Neuromuscular Blockade with Optimal Initialization Time

A new strategy is proposed for the automatic control of the neuromuscular blockade during general anesthesia by means of the continuous infusion of rocuronium. This strategy is based on the reduced parameter Wiener model proposed in M. M. Da Silva, T. Mendonca, and T. Wigren, "Nonlinear adaptive control of the NeuroMuscular Blockade in anesthesia," Proc. IEEE Conf. Decis. Control December 2011, pp. 41-46, 2011, https://doi.org/10.1109/CDC.2011.616 0227. One of its most important features is taking into account the usual clinical procedures, namely, the administration of an initial bolus at the beginning of the surgery prior to the delivery of the anesthetic by continuous infusion. The proposed controller for the continuous drug infusion process is designed in order to track a desired reference level of neuromuscular blockade. It is based on steady-state model inversion with suitable pole placement in order to accelerate convergence. Moreover, the controller is put into action at an optimal initialization time in order to minimize the tracking error.