Closed-loop control of anesthesia and mean arterial pressure using reinforcement learning

Abstract

General anesthesia is required for patients undergoing surgery as well as for some patients in the intensive care units with acute respiratory distress syndrome. How-ever, most anesthetics affect cardiac and respiratory functions. Hence, it is important to monitor and control the infusion of anesthetics to meet sedation requirements while keeping patient vital parameters within safe limits. The critical task of anesthesia administration also necessitates that drug dosing be optimal, patient specific, and robust. In this paper, the concept of reinforcement learning (RL) is used to develop a closed-loop anesthesia controller using the bispectral index (BIS) as a control variable while concurrently accounting for mean arterial pressure (MAP). In particular, the proposed framework uses these two parameters to control propofol infusion rates to regulate the BIS and MAP within a desired range. Specifically, a weighted combination of the error of the BIS and MAP signals is considered in the proposed RL algorithm. This reduces the computational complexity of the RL algorithm and consequently the controller processing time.