Anesthesia in Closed Loop

Computer controlled, or automatic, drug delivery is the process of administering a therapeutic regime to a patient with computer assistance for calculation of optimal dose and delivery schedules. Computer control can improve drug therapy by reducing drug usage and costs, by permitting health care staff to work more efficiently and to provide better standard of care, by allowing the safe use of drugs that are difficult to administer, and by compensation for human failings with computer strengths, such as unlimited attention span and patience, and capacity for quick, accurate and redundant calculation. Our goal is to develop an automatic control system for anesthesia and to demonstrate its efficacy, safety and benefits in an operating room. Although closed-loop anesthesia has previously been proposed and tested, it has yet to have a significant impact on clinical practice. Recent developments in sensing for anesthesia have opened new possibilities for closing the loop. Our research will focus on the deployment of new sensors optimized for controlled drug delivery, robust control methodology and extensive clinical validation.Clinical partner in the project is the Department of Anesthesia at the British Columbia Children's Hospital (BCCH), Vancouver, Canada, where patient modeling data is collected and clinical trials of the control system are conducted.

During 2018, we have hosted a PhD student from Spain, who has collaborated with local PhD students and department faculty, to compare simple and optimal controllers for closed-loop drug delivery. The conclusion of this work is in the presence of inter-patient variability and model parameter uncertainties stemming from high signal-to-noise ratio and lack of excitation in available identification data, there is little to gain on using more advances strategies. A journal manuscript is in preparation. During the year, the UBC group with whom e collaborate have authored and submitted journal manuscript, in which we disclose and discuss the approach and metodology, which was used in the development and clinical evaluation of the closed-loop controlled anesthesia delivery system, around which this project is based.