Journal of Clinical Monitoring and Computing

, Volume 28, Issue 6, pp 501–512 | Cite as

Automatic control of the NMB level in general anaesthesia with a switching total system mass control strategy

  • Miguel TeixeiraEmail author
  • Teresa Mendonça
  • Paula Rocha
  • Rui Rabiço
Original Research


This paper presents a model based switching control strategy to drive the neuromuscular blockade (NMB) level of patients undergoing general anesthesia to a predefined reference. A single-input single-output Wiener system with only two parameters is used to model the effect of two different muscle relaxants, atracurium and rocuronium, and a switching controller is designed based on a bank of total system mass control laws. Each of such laws is tuned for an individual model from a bank chosen to represent the behavior of the whole population. The control law to be applied at each instant corresponds to the model whose NMB response is closer to the patient’s response. Moreover a scheme to improve the reference tracking quality based on the analysis of the patient’s response, as well as, a comparison between the switching strategy and the Extended Kalman Kilter (EKF) technique are presented. The results are illustrated by means of several simulations, where switching shows to provide good results, both in theory and in practice, with a desirable reference tracking. The reference tracking improvement technique is able to produce a better reference tracking. Also, this technique showed a better performance than the (EKF). Based on these results, the switching control strategy with a bank of total system mass control laws proved to be robust enough to be used as an automatic control system for the NMB level.


Automatic delivery system Switching control Positive control system Minimally parameterized parsimonious models 



This work was supported in part by FEDER funds through COMPETE - Operational Programme Factors of Competitiveness ("Programa Operacional Factores de Competitividade") and by Portuguese funds through the Center for Research and Development in Mathematics and Applications and the Portuguese Foundation for Science and Technology ("FCT - Fundação para a Ciência e a Tecnologia”), within project PEst-C/MAT/UI4106/2011 with COMPETE number FCOMP-01-0124-FEDER-022690.


  1. 1.
    Almeida J, Silva MM, Mendonça T, Rocha P. A compartmental model based control strategy for neuromuscular blockade level. IFAC World Congr 2011;18:599-604.Google Scholar
  2. 2.
    Alonso H, Mendonça T, Rocha P. A hybrid method for parameter estimation and its application to biomedical systems. Comput Methods Programs Biomed 2008;89:112-122.CrossRefPubMedGoogle Scholar
  3. 3.
    Bastin G, Provost A, Feedback stabilisation with positive control of dissipative compartmental systems, Proceedings of the 15th internationol symposium on mathematical theory of networks ans systems (2002).Google Scholar
  4. 4.
    Godfrey K. Compartmental models and their application. Salt Lake City: Academic Press; 1983.Google Scholar
  5. 5.
    Kalman RE. A new approach to linear filtering and prediction problems. Transactions of the ASME. J Basic Eng 1960;82:35-45.CrossRefGoogle Scholar
  6. 6.
    Morse AS. Supervisory control of families of linear set-point controllers part 2: robustness. IEEE Trans Autom Control 1997;42:1500-1515.CrossRefGoogle Scholar
  7. 7.
    Rocha C, Mendonça T, Silva ME. Modelling neuromuscular blockade: a stochastic approach based on clinical data. Math Comput Model Dyn Syst 2013;19(6):540–556.Google Scholar
  8. 8.
    Silva MM, Wigren T, Mendonça T. Nonlinear identification of a minimal neuromuscular blockade model in anaesthesia. IEEE Trans. Control Syst Technol 2012;20:181-188.Google Scholar
  9. 9.
    Silva MM, Sousa C, Sebastião R, Gama J, Mendonça T, Rocha P, Esteves S. Total mass TCI driven by parametric estimation, 17th mediterranean conference on control and automation, Makedonia Palace, Thessaloniki, Greece. 2009.Google Scholar
  10. 10.
    Weatherley B, Williams S, Neill E. Pharmacokinetics, pharmacodynamics and dose-response relationships of atracurium administered i. v. Br. J. Anaesth. 1983;55:39-45.Google Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Miguel Teixeira
    • 1
    Email author
  • Teresa Mendonça
    • 1
  • Paula Rocha
    • 2
  • Rui Rabiço
    • 3
  1. 1.Faculdade de CiênciasUniversidade do PortoPortoPortugal
  2. 2.Faculdade de EngenhariaUniversidade do PortoPortoPortugal
  3. 3.Department of AnesthesiologyUnidade Local de Saúde de Matosinhos-Hospital Pedro HispanoSenhora da HoraPortugal

Personalised recommendations