System for controlling injectors of anaesthetics or sedatives with a view to inducing anaesthesia or sedation
Inventors
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Assignees
MemberMedsteerMedsteerMedsteer is a France-based medical technology company developing software and systems for anesthesia regulation. Its work focuses on closed-loop adjustment of intravenous anesthetic infusions using real-time patient brain-monitor data, with anesthesiologist supervision. The company also develops simulation tools and supports technical integration, clinical evaluation, collaboration, and licensing.
Medsteer is a France-based medical technology company developing software and systems for anesthesia regulation. Its work focuses on closed-loop adjustment of intravenous anesthetic infusions using real-time patient brain-monitor data, with anesthesiologist supervision. The company also develops simulation tools and supports technical integration, clinical evaluation, collaboration, and licensing.
Publication Number
US-10537677-B2
Publication Date
2020-01-21
Expiration Date
Abstract
This disclosure relates to a system that comprises means for obtaining a signal representative of the electrocortical activity of the patient, means for analyzing this signal in order to derive from it a signal of depth of anaesthesia, means for monitoring the value and development over time of this signal of depth of anaesthesia, these means being associated with means for calculation of control commands of the injection means, in order to automatically bring the signal of depth of anaesthesia to below a predetermined value during at least one predetermined period of time, in that the means for injection of anaesthetics comprise first means for injection of a hypnotic and second means for injection of a morphinomimetic, in that the means for calculation of the control commands of the injection means comprise means allowing an operator to input a type of induction of anaesthesia chosen from a group of types of induction that differ in terms of the initial concentration of hypnotic, and in that the means for inputting the type of induction comprise means for establishing the initial concentration of hypnotic, which is associated with an initial concentration of morphinomimetic predetermined according to the chosen type of induction.
Core Innovation
A system is disclosed for inducing and maintaining anesthesia or sedation in a patient in an intravenous anesthesia or sedation mode with a concentration or mass flow rate target. The system uses a first injector configured to inject a hypnotic agent and a second injector configured to inject a morphinomimetic agent, acquires a signal representative of electrocortical activity of the patient, and analyzes this signal to extract an anesthetic depth signal and track its value and time-dependent evolution.
A computer computes control signals for a first phase for induction of anesthesia and a second phase for maintenance of anesthesia. The control signals are computed only based on the anesthetic depth signal obtained from the electrocortical activity signal and a first concentration of the hypnotic agent, and during induction injection of the hypnotic agent and the morphinomimetic agent is triggered based on the tracked anesthetic depth signal to automatically bring the anesthetic depth signal below a predetermined value for at least 30 seconds, where the predetermined value is equal to 60.
During maintenance, the system automatically closed-loop regulates the anesthetic depth signal within a predetermined range around a target value. The system further includes a data input device that receives operator input of a type of anesthesia induction selected from a plurality of discrete induction types corresponding to a health state of the patient, and the computer determines an initial concentration of the morphinomimetic agent and intermediate concentrations of the morphinomimetic agent and the hypnotic agent to define induction plateaus, with a time between each induction plateau between 15 and 120 seconds.
Claims Coverage
The identified independent claims cover two inventive features: an intravenous anesthesia or sedation injector control system based on an anesthetic depth signal, and discrete operator-selected induction types that define induction plateaus and plateau timing.
Closed-loop two-agent induction and maintenance based on electrocortical anesthetic depth signal
A system for inducing and maintaining anesthesia or sedation in an intravenous anesthesia or sedation mode with a concentration or mass flow rate target, with a first injector for a hypnotic agent and a second injector for a morphinomimetic agent, comprising a detector to acquire a signal representative of electrocortical activity, an analyzer to extract an anesthetic depth signal, and a tracker to track the value and time-dependent evolution of the anesthetic depth signal, wherein a computer computes control signals for induction and maintenance phases based only on the anesthetic depth signal and a first concentration of the hypnotic agent to trigger injection during induction and closed-loop regulate within a range around a target value during maintenance.
Discrete operator-selected induction types defining induction plateaus and intermediate concentrations
The system includes a data input device configured to receive input from an operator regarding a type of anesthesia induction selected from a plurality of discrete induction types distinguished by waiting delay times after reaching a target concentration equilibrium of each agent and by thresholds of index values that determine a change of plateau, the discrete induction types also differing by an initial concentration of the hypnotic agent, and wherein the computer determines an initial concentration of the morphinomimetic agent and intermediate concentrations of the morphinomimetic agent and the hypnotic agent to define intermediate target values for the anesthetic depth signal and induction plateaus, with a time between each induction plateau being between 15 and 120 seconds.
The claims cover an intravenous anesthesia or sedation control system that derives an anesthetic depth signal from electrocortical activity, computes induction and maintenance control signals for two injectors using only the anesthetic depth signal and a first hypnotic-agent concentration, and implements discrete, operator-selected induction types that set waiting-delay and index-threshold plateau changes, including initial and intermediate concentrations and plateau timing between 15 and 120 seconds.
Stated Advantages
automatically brings the anesthetic depth signal below a predetermined value for at least 30 seconds during induction phase
automatically closed-loop regulates the anesthetic depth signal within a predetermined range around a target value during the maintenance phase
defines induction plateaus based on an operator-selected type of anesthesia induction corresponding to a health state
determines intermediate target values for the anesthetic depth signal using initial and intermediate concentrations of the morphinomimetic agent and the hypnotic agent
Documented Applications
Inducing and maintaining anesthesia or sedation in a patient in an intravenous anesthesia or sedation mode using injectors controlled by an electrocortical anesthetic depth signal
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