General anesthesia is a crucial component of invasive medical procedures. Our primary focus is the optimization of the simultaneous infusion of propofol and remifentanil during induction. In particular, we compute a feedforward infusion rate that minimizes the time for bringing the Bispectral Index (BIS) value below an assigned threshold, while ensuring that the BIS remains above an assigned minimum value. We consider a two-drug model, that takes into account the synergistic effect of the two drugs. Due to the expression of the Hill function, the constraint of maintaining the BIS in a given interval is non-convex. We propose a convex tightening to formulate the overall optimal control task as a convex optimization problem. Through simulation experiments, we show that this hybrid feedforward-feedback strategy quickly achieves the BIS target, while maintaining safe and clinically acceptable infusion rates.

Optimized Feedforward Control for the Co-Administration of Propofol and Remifentanil for Induction of Hypnosis in General Anesthesia

Milanesi, Marco;Schiavo, Michele;Visioli, Antonio
2025-01-01

Abstract

General anesthesia is a crucial component of invasive medical procedures. Our primary focus is the optimization of the simultaneous infusion of propofol and remifentanil during induction. In particular, we compute a feedforward infusion rate that minimizes the time for bringing the Bispectral Index (BIS) value below an assigned threshold, while ensuring that the BIS remains above an assigned minimum value. We consider a two-drug model, that takes into account the synergistic effect of the two drugs. Due to the expression of the Hill function, the constraint of maintaining the BIS in a given interval is non-convex. We propose a convex tightening to formulate the overall optimal control task as a convex optimization problem. Through simulation experiments, we show that this hybrid feedforward-feedback strategy quickly achieves the BIS target, while maintaining safe and clinically acceptable infusion rates.
2025
UE
PE7_1 Control engineering
PE8_14 Industrial bioengineering
Esperti anonimi
Inglese
Internazionale
ELETTRONICO
9
745
750
6
Biomedical; optimization; PID control
   Automatic Control of Total IntraVenous Anesthesia
   ACTIVA
   Ministero dell'Università e della Ricerca
   European Union - Next Generation EU
   CUP D53D23001180006
Goal 3: Good health and well-being
7
info:eu-repo/semantics/article
262
Laurini, Mattia; Llopis, Téo; Naz, Nadia; Consolini, Luca; Milanesi, Marco; Schiavo, Michele; Visioli, Antonio
1 Contributo su Rivista::1.1 Articolo in rivista
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11379/635749
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