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A microcomputer based controller for neuromuscular block during surgery

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Abstract

A microcomputer based control system has been developed to automatically induce and maintain neuromuscular block during surgery. The system repeatedly adjusts the infusion rate of a muscle relaxant, succinylcholine, based on the evoked, rectified, and integrated electromyogram (EMG). The system was tested in 12 patients for a 30-min infusion period with a setpoint of 80% depression of the evoked, rectified, and integrated thenar EMG. The mean time to reach the setpoint for 10 of the patients was 5.5 (±1.87 SD) min and the mean time for 95% recovery after infusion was stopped was 5.4 (±0.83 SD) min. Average overshoot was 9.9% of the baseline (±3.1% SD), and the average time within ±10% of the setpoint was 22.1 min (±7.26 SD). The total dose of succinylcholine for these 10 patients ranged from 1.21 to 3.77 mg/kg with a mean of 1.92 mg/kg. The other two patients were relatively insensitive to the drug and the controller was unable to bring the response to the set-point due to a ceiling placed on infusion rate by the control algorithm.

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Authors and Affiliations

  1. Department of Biomedical Engineering, The University of Alabama in Birmingham The Medical Center, 619 19th St. S., 35294, Birmingham, Alabama

    Thomas C. Jannett & Louis C. Sheppard

  2. Department of Anesthesiology, The University of Alabama in Birmingham The Medical Center, 619 19th St. S., 35294, Birmingham, Alabama

    Gilbert Ritchie M.S., John P. Ebert & Igor Kissin

Authors
  1. Gilbert Ritchie M.S.
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  2. John P. Ebert
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  3. Thomas C. Jannett
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  4. Igor Kissin
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  5. Louis C. Sheppard
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Ritchie, G., Ebert, J.P., Jannett, T.C. et al. A microcomputer based controller for neuromuscular block during surgery. Ann Biomed Eng 13, 3–15 (1985). https://doi.org/10.1007/BF02371246

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  • DOI: https://doi.org/10.1007/BF02371246

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