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Model Development for Propofol and Remifentanil Management during ICU Anesthesia

This paper presents the development of a MISO (multiple-input single-output) patient model for sedation and analgesia components used in ICU. The two inputs are Propofol and Remifentanil and the output is the Bispectral Index. The MISO model consists of two well-known PK-PD models for Propofol and Remifentanil, and an interaction model which describes the synergistic effect of these two drugs on the Bispectral Index. The interaction model parameters were identified using a nonlinear least squares method. Data collected during clinical trials in ICU at Ghent University Hospital have been used for model development. The final purpose is to use this model for prediction in a model based predictive control strategy.