System and method for guidance of anesthesia, analgesia and amnesia

• US 9,357,965 B2
• Filed: 01/07/2013
• Issued: 06/07/2016
• Est. Priority Date: 10/23/2002
• Status: Expired due to Term

• Current Assignee: New York University
• Original Assignee: New York University
• Inventors: John, Erwin R., Prichep, Leslie S.
• Primary Examiner(s): JANG, CHRISTIAN YONGKYUN
• Application Number:
  US13/735,628
• Publication Number:
  US 20130144183A1
• Time in Patent Office: 1,247 Days
• Field of Search: 600544-545
• US Class Current: 1/1
• CPC Class Codes: A61B 5/01 Measuring temperature of body parts ; Diagnostic temperature sensing, e.g. for malignant or inflamed tissue clinical contact thermometers G01K13/20
• CPC Class Codes: A61B 5/02028 Determining haemodynamic parameters not otherwise provided for, e.g. cardiac contractility or left ventricular ejection fraction
• CPC Class Codes: A61B 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/08 Detecting, measuring or recording devices for evaluating the respiratory organs A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/374 Detecting the frequency distribution of signals, e.g. detecting delta, theta, alpha, beta or gamma waves
• CPC Class Codes: A61B 5/38 Acoustic or auditory stimuli
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• CPC Class Codes: A61B 5/4839 combined with drug delivery
• CPC Class Codes: A61B 5/7225 Details of analog processing, e.g. isolation amplifier, gain or sensitivity adjustment, filtering, baseline or drift compensation A61B5/30, A61B5/316 take precedence; transformers for specific applications H01F38/00; amplifiers H03F
• CPC Class Codes: A61B 5/7257 using Fourier transforms
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: A61B 5/7405 using sound
• CPC Class Codes: A61B 5/742 using visual displays A61B5/339 takes precedence
• CPC Class Codes: A61B 5/7455 characterised by tactile indication, e.g. vibration or electrical stimulation
• CPC Class Codes: A61B 5/746 Alarms related to a physiological condition, e.g. details of setting alarm thresholds or avoiding false alarms alarms per se G08B
• CPC Class Codes: A61M 16/01 specially adapted for anaesthetising A61M16/104, A61M16/18 take precedence
• CPC Class Codes: A61M 16/06 Respiratory or anaesthetic masks
• CPC Class Codes: A61M 16/0683 Holding devices therefor
• CPC Class Codes: A61M 16/12 by mixing different gases
• CPC Class Codes: A61M 16/18 : Vaporising devices for anaesthetic preparations
• CPC Class Codes: A61M 16/201 : Controlled valves
• CPC Class Codes: A61M 2016/0661 : with customised shape
• CPC Class Codes: A61M 2202/048 : Anaesthetics
• CPC Class Codes: A61M 2210/0618 : Nose
• CPC Class Codes: A61M 2230/10 : Electroencephalographic signals
• CPC Class Codes: A61M 5/00 : Devices for bringing media into the body in a subcutaneous, intra-vascular or intramuscular way; Accessories therefor, e.g. filling or cleaning devices, arm-rests vaccination appliances for veterinary use A61D1/025 ; tube connectors, tube couplings, valves or branch units specially adapted for medical use A61M39/00; containers specially adapted for medical or pharmaceutical purposes A61J1/00; combinations of vial and syringe for mixing or transferring their contents A61J1/20; holders for containers for collecting, storing or administering blood or medical fluids A61J1/16
• CPC Class Codes: A61M 5/1407 : Infusion of two or more substances
• CPC Class Codes: A61M 5/142 : Pressure infusion, e.g. using pumps
• CPC Class Codes: A61M 5/1723 : using feedback of body parameters, e.g. blood-sugar, pressure measurement of body parameters A61B5/00

Abstract

Method for determining anesthesia dosage includes following steps. First Interventional Agent (“FIA”) is administered to Patient at a first rate to achieve First Predetermined Plane of Anesthesia (“FPPA”). Brain waves of Patient are analyzed to formulate First Set of Data (“FSD”) corresponding to a self-norm during administration of FIA. First transfer function corresponding to patient biochemical reactions to FIA is computed from FSD. Rate of administration of FIA to Patient is altered by a selected amount after achievement of FPPA for first time required for Patient to deviate from FPPA by predetermined degree. An altered amount of FIA required to cause the predetermined deviation is determined as difference between amount of FIA that would have been delivered to Patient during first time at the first rate and an amount delivered to Patient during the first time at the altered rate. Patient is administered the altered amount of FIA.

Claims

1. A method of determining a desired anesthesia dosage for a patient via a perturbation analysis, comprising:

administering to the patient a first interventional agent at a first rate selected to achieve a first predetermined plane of anesthesia;

analyzing brain waves of the patient to formulate a first set of data corresponding to a self-norm during administration of the first interventional agent;

computing from the first set of data a first transfer function corresponding to patient biochemical reactions to the first interventional agent;

altering the rate of administration of the first interventional agent to the patient by a selected amount after achievement of the first plane of anesthesia for a first time required for the patient to deviate from the first plane of anesthesia by a predetermined degree;

determining an altered amount of the first interventional agent required to cause the predetermined deviation from the first plane of anesthesia as a difference between an amount of the first interventional agent that would have been delivered to the patient during the first time at the first rate and an amount delivered to the patient during the first time at the altered rate; and

administering to the patient one of the altered amount of the first interventional agent and a portion of the altered amount of the first interventional agent.

2. The method of claim 1, wherein the alteration corresponds to one of a decrease of the first rate and a termination of the delivery.

3. The method of claim 1, wherein the alteration corresponds to an increase of the first rate.

4. The method of claim 1, further comprising analyzing, at predetermined time intervals, brain waves of the patient to formulate a first further set of data corresponding and computing from the further set of data a first further transfer function corresponding to patient biochemical reactions to the first interventional agent.

5. The method of claim 1, further comprising:

administering to the patient a second interventional agent at a second rate selected to achieve a second predetermined plane of anesthesia;

analyzing brain waves of the patient to formulate a second set of data corresponding to a self-norm during administration of the second interventional agent;

computing from the second set of data a second transfer function corresponding to patient biochemical reactions to the second interventional agent;

altering the rate of administration of the second interventional agent to the patient by a selected amount after achievement of the second plane of anesthesia for a second time required for the patient to deviate from the second plane of anesthesia by a predetermined degree;

determining an altered amount of the second interventional agent required to cause the predetermined deviation from the second plane of anesthesia as a difference between an amount of the second interventional agent that would have been delivered to the patient during the second time at the second rate and an amount delivered to the patient during the second time at the altered rate; and

administering to the patient one of the altered amount of the second interventional agent and a portion of the altered amount of the second interventional agent.

6. The method of claim 5, wherein the predetermined degree of deviation corresponds to 2.5 standard deviations from the self-norm.

7. The method of claim 5, further comprising analyzing, at predetermined time intervals, brain waves of the patient to formulate a second further set of data corresponding and computing from the further set of data a second further transfer function corresponding to patient biochemical reactions to the second interventional agent.

8. The method of claim 1, further comprising the step of controlling a pump to one of increase and decrease a supply of the first interventional agent to the patient.

9. The method of claim 5, wherein the first predetermined plane of anesthesia is in a first one of a Depth Index (DI), a Memory Index (MI) and a Pain Index (PI), wherein the DI corresponds to a depth of anesthesia of the patient, the PI corresponds to a sensitivity of the patient to pain and the MI corresponds to an ability of the patient to form and store memories.

10. The method of claim 9, wherein the second predetermined plane of anesthesia is in a second of the DI, MI and PI.

11. A method of determining a desired anesthesia dosage for a patient comprising:

administering to the patient a first interventional agent at a first rate selected to achieve a first plane of anesthesia;

receiving data from the patient corresponding to the first plane of anesthesia of the patient;

altering, after the patient has achieved the first plane of anesthesia, a rate of delivery of the first interventional agent to an altered rate for a first time required for the patient to deviate from the first plane of anesthesia by a predetermined degree;

determining an altered amount of the first interventional agent required to cause the predetermined deviation from the first plane of anesthesia as a difference between an amount of the first interventional agent that would have been delivered to the patient during the first time at the first rate and an amount delivered to the patient during the first time at the altered rate; and

administering to the patient one of the altered amount of the first interventional agent and a portion of the altered amount of the first interventional agent.

12. The method of claim 11, wherein the data corresponds to brain waves of the patient.

13. The method of claim 12, wherein the first predetermined plane of anesthesia is in a first one of a Depth Index (DI), a Memory Index (MI) and a Pain Index (PI), wherein the DI corresponds to a depth of anesthesia of the patient, the PI corresponds to a sensitivity of the patient to pain and the MI corresponds to an ability of the patient to form and store memories.