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Optimal control of midazolam infusion for post operative patients in intensive care units

The critical task of anesthesia administration demands minimal drug titration by considering patient specific features and sedation requirements. Though there exist several sedation assessment monitors, physicians still largely rely on subjective sedation scoring systems. This paper presents an optimal infusion controller for the continuous infusion of midazolam along with the analgesic fentanyl. Specifically, we extend the convex optimization-based optimal drug dosing regimen for propofol presented in [1] to midazolam. We also propose an alternative optimization approach using the Kullback-Leibler divergence measure of two probability distributions. A stochastic pharmacodynamic model is used that utilizes the modified Ramsay sedation scoring method to link the plasma drug concentration and the effective probabilistic sedation level.