Advanced Signal Processing and Control in Anaesthesia

This thesis comprises three major stages: classification of depth of anaesthesia (DOA); modelling a typical patient’s behaviour during a surgical procedure; and control of DOAwith simultaneous administration of propofol and remifentanil. Clinical data gathered in theoperating theatre was used in this project.
Multiresolution wavelet analysis was used to extract meaningful features from the auditory evoked potentials (AEP). These features were classified into different DOA levels using a fuzzy relational classifier (FRC). The FRC uses fuzzy clustering and fuzzy relational composition. The FRC had a good performance and was able to distinguish between the DOA levels.
A hybrid patient model was developed for the induction and maintenance phase of anaesthesia. An adaptive network-based fuzzy inference system was used to adapt Takagi-Sugeno-Kang (TSK) fuzzy models relating systolic arterial pressure (SAP), heart rate (HR), and the wavelet extracted AEP features with the effect concentrations of propofol and remifentanil. The effect of surgical stimuli on SAP and HR, and the analgesic properties of remifentanil were described by Mamdani fuzzy models, constructed with anaesthetist cooperation. The model proved to be adequate, reflecting the effect of drugs and surgical stimuli.
A multivariable fuzzy controller was developed for the simultaneous administration of propofol and remifentanil. The controller is based on linguistic rules that interact with three decision tables, one of which represents a fuzzy PI controller. The infusion rates of the two drugs are determined according to the DOA level and surgical stimulus. Remifentanil is titrated according to the required analgesia level and its synergistic interaction with propofol. The controller was able to adequately achieve and maintain the target DOA level, under different conditions.
Overall, it was possible to model the interaction between propofol and remifentanil, and to successfully use this model to develop a closed-loop system in anaesthesia.