Comparative Analysis of Pharmacokinetic-Pharmacodynamic Models for Propofol and Remifentanil Using Model Predictive Control

This study aims to compare the effectiveness of different Pharmacokinetic-Pharmacodynamic (PK-PD) models for administering Propofol and Remifentanil, two critical agents in anesthesia. Initially, different PK models were introduced: one for Propofol based on the Schnider model and another for Remifentanil using the Minto model. Alternatively, both drugs were modeled using the Eleveld models. The PK-PD models were integrated into a closed-loop control system using model predictive control (MPC) with disturbances to control the Bispectral index (BIS) and the Richmond Agitation Sedation Scale (RASS). The methodology involved simulating the anesthetic agents in the open-source patient simulator (2 inputs, 2 outputs) with 12 patient datasets in a controlled environment to simulate the patient response variability, allowing for a detailed analysis of the model's performance in maintaining optimal drug concentrations. The primary focus was on the system's ability to adapt to surgical disturbances, a key challenge in anesthesia management, and whether a different modeling of drugs can have an impact on their effects. The results indicated significant differences in the performance of the two models configurations. The Eleveld model for Propofol showed less usage of drugs to maintain the desired BIS value. Concluding that this comparative analysis offers a valuable reference for selecting appropriate modeling approaches in the development of advanced control strategies in anesthesia.