METHOD AND DEVICE TO ADMINISTER ANESTHETIC AND OR VOSACTIVE AGENTS ACCORDING TO NON-INVASIVELY MONITORED CARDIAC AND OR NEUROLOGICAL PARAMETERS

• US 20090124867A1
• Filed: 11/13/2007
• Published: 05/14/2009
• Est. Priority Date: 11/13/2007
• Status: Abandoned Application

• Current Assignee: Cooper Health System
• Original Assignee: Cooper Health System
• Inventors: Torjman, Marc C., Hirsh, Robert A.
• Application Number:
  US11/939,376
• Publication Number:
  US 20090124867A1
• Time in Patent Office: Days
• US Class Current: 600/301
• CPC Class Codes: A61M 16/0051 with alarm devices
• CPC Class Codes: A61M 16/01 specially adapted for anaesthetising A61M16/104, A61M16/18 take precedence
• CPC Class Codes: A61M 16/024 including calculation means, e.g. using a processor
• CPC Class Codes: A61M 16/18 Vaporising devices for anaesthetic preparations
• CPC Class Codes: A61M 2016/1025 the O2 concentration
• CPC Class Codes: A61M 2016/103 the CO2 concentration
• CPC Class Codes: A61M 2202/0241 Anaesthetics; Analgesics
• CPC Class Codes: A61M 2202/0275 Nitric oxide [NO]
• CPC Class Codes: A61M 2202/048 Anaesthetics see also A61M19/00
• CPC Class Codes: A61M 2205/13 with means for the detection of operative contact with patient, e.g. lip sensor
• CPC Class Codes: A61M 2205/17 with redundant control systems
• CPC Class Codes: A61M 2205/3569 sublocal, e.g. between console and disposable
• CPC Class Codes: A61M 2205/3592 using telemetric means, e.g. radio or optical transmission
• CPC Class Codes: A61M 2205/502 User interfaces, e.g. screens or keyboards
• CPC Class Codes: A61M 2205/52 with memories providing a history of measured variating parameters of apparatus or patient
• CPC Class Codes: A61M 2205/581 by audible feedback
• CPC Class Codes: A61M 2230/04 Heartbeat characteristics, e.g. ECG, blood pressure modulation
• CPC Class Codes: A61M 2230/10 Electroencephalographic signals
• CPC Class Codes: A61M 2230/202 partial carbon oxide pressure, e.g. partial dioxide pressure (P-CO2)
• CPC Class Codes: A61M 2230/205 partial oxygen pressure (P-O2)
• CPC Class Codes: A61M 2230/65 : Impedance, e.g. conductivity, capacity
• 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
• CPC Class Codes: G16H 20/17 : delivered via infusion or injection
• CPC Class Codes: G16H 50/50 : for simulation or modelling of medical disorders

Abstract

A method of and a device for non-invasively measuring the neurological depressed state and the hemodynamic state of a human patient and involving steps and units of non-invasively measuring EEG, cardiac cycle period, electrical-mechanical interval, mean arterial pressure, and ejection interval and converting the EEG into a neurological index as well as converting the measured electrical-mechanical interval, mean arterial pressure and ejection interval into the cardiac parameters such as Preload, Afterload and Contractility, which are the common cardiac parameters used by an anesthesiologist. A general anesthetic is administered based upon the converted neurological index. A vasoactive agent is independently administered based upon the converted cardiac parameters as necessary in order to restore cardiovascular homeostasis in the patient. The converted neurological and hemodynamic state of a patient are displayed on a screen as an index value and a three-dimensional vector with each of its three coordinates respectively representing Preload, Afterload and Contractility. Therefore, a medical practitioner looks at the screen and quickly obtains the important and necessary information.

Claims

1. A method of administering a general anesthetic, comprising the steps of:

non-invasively measuring a set of predetermined non-invasive cardiac and neurological parameters from a subject;

converting the non-invasive cardiac parameters into a plurality of invasive cardiac analogues based upon a first set of predetermined conversion equations;

converting the non-invasive neurological parameters into a neurological index based upon a second set of predetermined conversion equations;

administering a general anesthetic based upon neurological index to maintain a desirable level of neurological depression in the subject; and

independently administering a vasoactive agent based upon the converted invasive cardiac analogues to restore cardiovascular homeostasis in the subject.

2. The method of administering a general anesthetic according to claim 1 wherein the subject is a human.

3. The method of administering a general anesthetic according to claim 1 wherein the subject is an animal.

4. The method of administering a general anesthetic according to claim 1 wherein the predetermined non-invasive cardiac parameters include heart rate as denoted by HR, ejection interval as denoted by EI, mean arterial pressure as denoted by MAP and electrical-mechanical interval as denoted by E-M, which is an interval between an electrical event E and a mechanical event M.

5. The method of administering a general anesthetic according to claim 4 wherein the predetermined invasive cardiac analogues include preload as denoted by P, afterload as denoted by A and contractility as denoted by C.

6. The method of administering a general anesthetic according to claim 5 wherein the predetermined conversion equations include

P=k1(EI*MAP*E-M)+c1 or P=k4(DI*MAP*E-M)+c4,

A=k2(MAP*E-M)+c2, and

ln(C)=k3(1/E-M)+c3

where k1, k2, k3, k4, c1, c2, c3 and c4 are empirical proportionality constants.

7. The method of administering a general anesthetic according to claim 6 wherein the M in the E-M is defined as a time when a second derivative with respect to time, M″

(t), reaches a maximum value.

8. The method of administering a general anesthetic according to claim 6 wherein the electrical event in determining the E-M is selected from the group consisting of a Q-wave, a R-wave, an S-wave, and an artificial ventricular pacemaker spike.

9. The method of administering a general anesthetic according to claim 6 wherein the electrical event in determining the E-M interval is determined by double differentiating an EKG voltage curve which corresponds to ventricular depolarization, V(t), with respect to time and defining the electrical event as a time when V″

(t) reaches a maximum positive value.

10. The method of administering a general anesthetic according to claim 6 wherein the second mechanical event in determining the E-M is selected from the group consisting of arterial blood pressure and flow velocity upstroke.

11. The method of administering a general anesthetic according to claim 5 wherein the predetermined conversion equations include

P=k1′

((T-EI)*MAP*E-M)+c1′

or P=k4′

(DI*MAP*E-M)+c4′

,

A=k2′

(MAP*E-M)+c2′

, and

ln(C)=k3′

(1/E-M)+c3′

where k1′

, k2′

, k3′

, k4′

, c1′

, c2′

, c3′ and

c4′

are empirical proportionality constants for a particular one of the subjects and T is a time period of the cardiac cycle for the particular one of the subjects.

12. The method of administering a general anesthetic according to claim 11 wherein the M in the E-M is defined as a time when a second derivative with respect to time, M″

(t), reaches a maximum value.

13. The method of administering a general anesthetic according to claim 11 wherein the electrical event in determining the E-M is selected from the group consisting of a Q-wave, a R-wave, an S-wave, and an artificial ventricular pacemaker spike.

14. The method of administering a general anesthetic according to claim 11 wherein the electrical event in determining the E-M interval is determined by double differentiating an EKG voltage curve which corresponds to ventricular depolarization, V(t), with respect to time and defining the electrical event as a time when V″

(t) reaches a maximum positive value.

15. The method of administering a general anesthetic according to claim 13 wherein a mechanical event in determining the E-M includes a time of an arterial blood pressure upstroke as denoted by TA and a time of a blood flow velocity upstroke as denoted by TF.

16. The method of administering a general anesthetic according to claim 5 wherein the predetermined conversion equations include

P=k1′

((T-EI)*MAP*E-M)+c1′

or P=k4′

(DI*MAP*E-M)+c4′

,

A=k2′

*MAP/[K+exp(1/E-M)]+c2′

, and

ln(C)=k3′

(1/E-M)+c3′

where k1′

, k2′

, k3′

, k4′

, c1′

, c2′

, c3′

, c4′ and

K are empirical proportionality constants for a particular one of the subjects and T is a time period of the cardiac cycle for the particular one of the subjects.

17. The method of administering a general anesthetic according to claim 4 wherein the EI is measured by placing a Doppler ultrasound device over the suprasternal notch near the ascending aorta.

18. The method of administering a general anesthetic according to claim 4 wherein the electrical event E in the E-M is determined by electrocardiograph as denoted by EKG.

19. The method of administering a general anesthetic according to claim 4 wherein the E-M is determined by electrocardiograph as denoted by EKG and by placing a Doppler ultrasound device over a major artery.

20. The method of administering a general anesthetic according to claim 4 wherein the E-M is determined by electrocardiograph as denoted by EKG and by placing a fiberoptic device over a major artery.

21. The method of administering a general anesthetic according to claim 5 further comprising the step of displaying the invasive cardiac analogues in three dimensional coordinate space that is defined by a first axis indicative of the P, a second axis indicative of the A and a third axis indicative of the C.

22. The method of administering a general anesthetic according to claim 21 further comprising an additional step of displaying a three dimensional object defining a safe zone indicative of a safe hemodynamic state.

23. The method of administering a general anesthetic according to claim 22 wherein the first axis, the second axis, the third axis and the three dimensional object are each displayed with a predetermined color.

24. The method of administering a general anesthetic according to claim 1 further comprising an additional step of displaying a vector cross product between a first vector indicating an amount of physiologic stress in a current certain situation and a second vector indicating an amount of physiologic stress under a normal condition.

25. The method of administering a general anesthetic according to claim 1 further comprising an additional step of displaying information on vital signs of the subject.

26. The method of administering a general anesthetic according to claim 1 further comprising an additional step of displaying identification information on the subject.

27. The method of administering a general anesthetic according to claim 1 wherein said neurological parameter is measured in EEG and converted into a BIS index.

28. The method of administering a general anesthetic according to claim 1 wherein said administering step for the general anesthetic further comprises additional steps of:

retrieving dosage information for the general anesthetic;

selecting the general anesthetic;

determining a dose of the selected general anesthetic based upon the retrieved dosage information;

generating an anesthetic delivery command including the determined dose and the selected general anesthetic;

delivering the selected general anesthetic to the subject according to the anesthetic delivery command; and

recording information contained in the anesthetic delivery command.

29. The method of administering a general anesthetic according to claim 28 wherein said dosage information includes any combination of physical characteristics of the subject, a dosage and an algorithm for modifying the dosage.

30. The method of administering a general anesthetic according to claim 28 wherein said dosage determining step further comprises additional steps of:

comparing the neurological index to comparison information to generate a comparison result;

generating a warning signal if a critical condition exists in the subject based upon the comparison result; and

displaying the warning signal.

31. The method of administering a general anesthetic according to claim 30 wherein said comparison information includes a pair of threshold values and past ones of the neurological values.

32. The method of administering a general anesthetic according to claim 31 wherein said comparing step compares the neurological index to the threshold values to see if the neurological index exceeds either of the threshold values.

33. The method of administering a general anesthetic according to claim 31 wherein said comparing step compares the neurological index to the past ones of the neurological values to see if the neurological index has changed over a predetermined amount of time.

34. The method of administering a general anesthetic according to claim 30 wherein said delivering step for the general anesthetic is stopped based upon the warning signal without human intervention.

35. The method of administering a general anesthetic according to claim 1 further comprising an additional step of displaying a value of the neurological index.

36. The method of administering a general anesthetic according to claim 1 further comprising an additional step of stopping said administering the general anesthetic.

37. The method of administering a general anesthetic according to claim 36 further comprising an additional step of resuming said administering the general anesthetic.

38. The method of administering a general anesthetic according to claim 1 wherein said administering step for the vasoactive agent further comprises additional steps of:

retrieving dosage information for the vasoactive agent, selecting the vasoactive agent;

determining a dose of the selected vasoactive agent based upon the retrieved dosage information;

generating a vasoactive agent delivery command including the determined dose and the selected vasoactive agent;

delivering the selected vasoactive agent to the subject according to the vasoactive agent delivery command; and

recording information contained in the vasoactive agent delivery command.

39. The method of administering a general anesthetic according to claim 38 wherein said dosage information includes any combination of physical characteristics of the subject, a dosage and an algorithm for modifying the dosage.

40. The method of administering a general anesthetic according to claim 38 wherein said dosage determining step further comprises additional steps of:

comparing each of the converted invasive cardiac analogues to comparison information to generate a comparison result;

generating a warning signal if a critical condition exists in the subject based upon the comparison result; and

displaying the warning signal.

41. The method of administering a general anesthetic according to claim 40 wherein said comparison information includes pairs of threshold values and past ones of the converted invasive cardiac analogues.

42. The method of administering a general anesthetic according to claim 41 wherein said comparing step compares each of the converted invasive cardiac analogues to a corresponding to one of the pairs of the threshold values to see if any of the converted invasive cardiac analogues exceeds either of the corresponding pair of the threshold values.

43. The method of administering a general anesthetic according to claim 41 wherein said comparing step compares each of the converted invasive cardiac analogues to corresponding ones of the past converted invasive cardiac analogues to see if any of the converted invasive cardiac analogues has changed over a predetermined amount of time.

44. The method of administering a general anesthetic according to claim 40 wherein said delivering step for the vasoactive agent is stopped based upon the warning signal without human intervention.

45. The method of administering a general anesthetic according to claim 1 further comprising an additional step of displaying values of the converted invasive cardiac analogues.

46. The method of administering a general anesthetic according to claim 1 further comprising an additional step of stopping said administering the vasoactive agent.

47. The method of administering a general anesthetic according to claim 46 further comprising an additional step of resuming said administering the vasoactive agent.

48. The method of administering a general anesthetic according to claim 1 further comprising additional steps of monitoring respiratory parameters of the subject;

and determining if the subject is properly respired based upon the monitored respiratory parameters before the vasoactive agent is considered to be administered based upon the converted invasive cardiac analogues.

49. The method of administering a general anesthetic according to claim 48 wherein said monitored respiratory parameters include a CO₂ wave, a CO₂ level, a pulse oximeter measured value and an oxygen concentration.

137. The method of administering a general anesthetic according to claim 5 wherein the predetermined conversion equations include

SV=k6′

EIe^(1/E-M)+c6′

where k6′

and c6′

are empirical proportionality constants.

138. The method of administering a general anesthetic according to claim 4 wherein the EI and DI are measured by placing a Doppler ultrasound device on the chest over the left ventricle or by measuring a transthoracic electrical impedance waveform.

50. A system for administering a general anesthetic, comprising:

a non-invasive neurological parameter measuring unit for non-invasively measuring at least a predetermined neurological parameter from the subject;

a neurological parameter conversion unit connected to said non-invasive neurological parameter measuring unit for converting the non-invasive neurological parameter into a neurological index based upon a first set of predetermined conversion equations;

a general anesthetic administering unit connected to said neurological parameter conversion unit for administering a general anesthetic based upon the neurological index to maintain a desirable level of neurological depression in the subject;

a non-invasive cardiac parameter measuring unit for non-invasively measuring a plurality of predetermined non-invasive cardiac parameters from the subject;

a cardiac parameter conversion unit connected to said non-invasive cardiac parameter measuring unit for converting the non-invasive cardiac parameters into a plurality of invasive cardiac analogues based upon a second set of predetermined conversion equations; and

a vasoactive agent administering unit connected to said cardiac parameter conversion unit for administering a vasoactive agent based upon the invasive cardiac analogues to restore cardiovascular homeostasis in the subject.

51. The system for administering a general anesthetic according to claim 50 wherein said non-invasive cardiac parameter measuring unit measures the predetermined non-invasive cardiac parameters from a human.

52. The system for administering a general anesthetic according to claim 50 wherein said non-invasive cardiac parameter measuring unit measures the predetermined non-invasive cardiac parameters from an animal.

53. The system for administering a general anesthetic according to claim 50 wherein said non-invasive cardiac parameter measuring unit further comprises a heart rate monitor for measuring heart rate as denoted by HR, an ultrasonic flow measuring device or electrical impedance measuring device for measuring an ejection interval as denoted by EI and a mechanical event M of an electrical-mechanical interval as denoted by E-M, a blood pressure measuring device for measuring mean arterial pressure as denoted by MAP and an electrocardiogram measuring device for measuring an electrical event E of the electrical-mechanical interval.

54. The system for administering a general anesthetic according to claim 53 wherein said vibration sensing device comprises at least one of a Doppler ultrasound device and a fiber optic device.

55. The system for administering a general anesthetic according to claim 50 wherein said cardiac parameter conversion unit outputs the predetermined invasive cardiac analogues including preload as denoted by P, afterload as denoted by A and contractility as denoted by C.

56. The system for administering a general anesthetic according to claim 55 wherein said cardiac parameter conversion unit determines the P, the A and the C based upon the predetermined conversion equations including

P=k1(EI*MAP*E-M)+c1,

A=k2(MAP*E-M)+c2, and

ln(C)=k3(1/E-M)+c3

where k1, k2, k3, c1, c2 and c3 are empirical proportionality constants.

57. The system for administering a general anesthetic according to claim 55 wherein said cardiac parameter conversion unit determines the P, the A and the C based upon the predetermined conversion equations including

P=k1′

((T-EI)*MAP*E-M)+c1′

,

A=k2′

(MAP*E-M)+c2′

, and

ln(C)=k3′

(1/E-M)+c3′

where k1′

, k2′

, k3′

, c1′

, c2′ and

c3′

are empirical proportionality constants for a particular one of the subjects and T is a time period of the cardiac cycle for the particular one of the subjects.

58. The system for administering a general anesthetic according to claim 55 wherein said cardiac parameter conversion unit determines the P, the A and the C based upon the predetermined conversion equations including

P=k1′

(DI*MAP*E-M)+c1′

,

A=k2′

(MAP*E-M)+c2′

, and

ln(C)=k3′

(1/E-M)+c3′

where k1′

, k2′

, k3′

, c1′

, c2′ and

c3′

are empirical proportionality constants for a particular one of the subjects, DI is a diastolic filling interval, and T is a time period of the cardiac cycle for the particular one of the subjects.

59. The system for administering a general anesthetic according to claim 57 wherein said cardiac parameter conversion unit obtains the mechanical event M in the E-M by determining a time when a second derivative with respect to time, M″

(t) reaches a maximum value.

60. The system for administering a general anesthetic according to claim 59 wherein said non-invasive cardiac parameter measuring unit measures an electrical event in determining the E-M, the electrical event being selected from the group consisting of a Q-wave as denoted by Q, a R-wave as denoted by R, a S-wave as denoted by S and an artificial ventricular pacemaker spike.

61. The system for administering a general anesthetic according to claim 59 wherein said non-invasive cardiac parameter measuring unit measures an electrical event in determining the E-M interval by double differentiating an EKG voltage curve which corresponds to ventricular depolarization, V(t), with respect to time and defining the electrical event as a time when V″

(t) reaches a maximum positive value.

62. The system for administering a general anesthetic according to claim 60 wherein said non-invasive cardiac parameter measuring unit measures the mechanical event in determining the E-M, the second mechanical event including a time of an arterial blood pressure upstroke as denoted by TA and a time of a flow velocity upstroke as denoted by TF.

63. The system for administering a general anesthetic according to claim 55 wherein said cardiac parameter conversion unit determines the P, the A and the C based upon the predetermined conversion equations including

P=k1′

((T-EI)*MAP*E-M)+c1′

or P=k4′

(DI*MAP*E-M)+c4′

,

A=k2′

*MAP/[K+exp(1/E-M)]+c2′

, and

ln(C)=k3′

(1/E-M)+c3′

where k1′

, k2′

, k3′

, k4′

, c1′

, c2′

, c3′

, c4′ and

K are empirical proportionality constants for a particular one of the subjects and T is a time period of the cardiac cycle for the particular one of the subjects.

64. The system for administering a general anesthetic according to claim 55 further comprising a display unit connected to said cardiac parameter conversion unit for displaying the invasive cardiac analogues in three dimensional coordinate space that is defined by a first axis indicative of the P, a second axis indicative of the A and a third axis indicative of the C.

65. The system for administering a general anesthetic according to claim 64 wherein said display unit additionally displays a three dimensional object defining a safe zone indicative of a safe hemodynamic state.

66. The system for administering a general anesthetic according to claim 65 wherein said display unit displays the first axis, the second axis, the third axis and the safe zone respectively in a predetermined color.

67. The system for administering a general anesthetic according to claim 65 wherein said display unit additionally displays a vector cross product indicative of an amount of physiologic stress.

68. The system for administering a general anesthetic according to claim 50 further comprising a display unit connected to said cardiac parameter conversion unit for displaying information on vital signs of the subject.

69. The system for administering a general anesthetic according to claim 50 further comprising a display unit for displaying identification information on the subject.

70. The system for administering a general anesthetic according to claim 50 wherein said non-invasive neurological parameter measuring unit measures the neurological parameter in EEG and said neurological parameter conversion unit converts the EEG into a BIS index.

71. The system for administering a general anesthetic according to claim 50 wherein said general anesthetic administering unit further comprises:

a neurological control unit for retrieving dosage information for the general anesthetic, selecting the general anesthetic, determining a dose of the selected general anesthetic based upon the retrieved dosage information and generating an anesthetic delivery command including the determined dose and the selected general anesthetic; and

an anesthetic agent delivery unit connected to said neurological control unit for delivering the selected general anesthetic to the subject according to the anesthetic delivery command and recording information in the anesthetic delivery command in a database.

72. The system for administering a general anesthetic according to claim 71 wherein said dosage information includes any combination of physical characteristics of the subject, a dosage and an algorithm for modifying the dosage.

73. The system for administering a general anesthetic according to claim 71 wherein said neurological control unit compares the neurological index to comparison information to generate a comparison result and generates a warning signal if a critical condition exists in the subject based upon the comparison result.

74. The system for administering a general anesthetic according to claim 73 further comprising a display unit connected to said neurological control unit for displaying the warning signal.

75. The system for administering a general anesthetic according to claim 73 wherein the comparison information includes a pair of threshold values and past ones of the neurological values.

76. The system for administering a general anesthetic according to claim 75 wherein said neurological control unit compares the neurological index to the threshold values to see if the neurological index exceeds either of the threshold values.

77. The system for administering a general anesthetic according to claim 75 wherein said neurological control unit compares the neurological index to the past ones of the neurological values to see if the neurological index has changed over a predetermined amount of time.

78. The system for administering a general anesthetic according to claim 73 wherein said anesthetic agent delivery unit is disengaged based upon the warning signal without human intervention.

79. The system for administering a general anesthetic according to claim 50 wherein said general anesthetic administering unit further comprises:

a neurological control unit connected to said non-invasive neurological parameter measuring unit for selecting a first general anesthetic and determining a first dose for the general anesthetic based upon the neurological index value;

a central monitoring and delivering control unit connected to said neurological control unit for retrieving dosage information for the general anesthetic, selecting a second general anesthetic, independently determining a second dose of the selected general anesthetic based upon the retrieved dosage information, resolving between the first general anesthetic and the second general anesthetic, resolving between the first dose and the second dose, and generating an anesthetic delivery command including the resolved dose and the resolved general anesthetic; and

an anesthetic agent delivery unit connected to said neurological control unit and said central monitoring and delivering control unit for delivering the general anesthetic to the subject according to the anesthetic delivery command and recording information contained in the anesthetic delivery command in a database.

80. The system for administering a general anesthetic according to claim 79 wherein the dosage information includes any combination of physical characteristics of the subject, a dosage and an algorithm for modifying the dosage.

81. The system for administering a general anesthetic according to claim 79 wherein said central monitoring and delivering control unit compares the neurological index to comparison information to generate a comparison result and generates a warning signal if a critical condition exists in the subject based upon the comparison result.

82. The system for administering a general anesthetic according to claim 81 further comprising a display unit connected to said central monitoring and delivering control unit for displaying the warning signal.

83. The system for administering a general anesthetic according to claim 79 wherein the comparison information includes a pair of threshold values and past ones of the neurological values.

84. The system for administering a general anesthetic according to claim 83 wherein said central monitoring and delivering control unit compares the neurological index to the threshold values to see if the neurological index exceeds either of the threshold values.

85. The system for administering a general anesthetic according to claim 83 wherein said central monitoring and delivering control unit compares the neurological index to the past ones of the neurological values to see if the neurological index has changed over a predetermined amount of time.

86. The system for administering a general anesthetic according to claim 81 wherein said anesthetic agent delivery unit is disengaged based upon the warning signal without human intervention.

87. The system for administering a general anesthetic according to claim 50 further comprising a display unit connected to said neurological parameter conversion unit for displaying a value of the neurological index.

88. The system for administering a general anesthetic according to claim 71 wherein said general anesthetic administering unit stops said anesthetic agent delivery unit.

89. The system for administering a general anesthetic according to claim 88 wherein said general anesthetic administering unit resumes said anesthetic agent delivery unit.

90. The system for administering a general anesthetic according to claim 50 wherein said vasoactive agent administering unit further comprises:

a cardiovascular control unit for retrieving dosage information for the vasoactive agent, selecting the vasoactive agent, determining a dose of the selected vasoactive agent based upon the retrieved dosage information and generating a vasoactive agent delivery command including the determined dose and the selected vasoactive agent; and

a vasoactive agent delivery unit connected to said cardiovascular control unit for delivering the selected vasoactive agent to the subject according to the vasoactive agent delivery command and recording information in the vasoactive agent delivery command in a database.

91. The system for administering a general anesthetic according to claim 90 wherein said dosage information includes any combination of physical characteristics of the subject, a dosage and an algorithm for modifying the dosage.

92. The system for administering a general anesthetic according to claim 90 wherein said cardiovascular control unit compares each of the converted invasive cardiac analogues to comparison information to generate a comparison result and generates a warning signal if a critical condition exists in the subject based upon the comparison result.

93. The system for administering a general anesthetic according to claim 92 further comprising a display unit connected to said cardiovascular control unit for displaying the warning signal.

94. The system for administering a general anesthetic according to claim 92 wherein the comparison information includes pairs of threshold values and past ones of the converted invasive cardiac analogues.

95. The system for administering a general anesthetic according to claim 94 wherein said cardiovascular control unit compares each of the converted invasive cardiac analogues to one of the corresponding pairs of the threshold values to see if any of the converted invasive cardiac analogues exceeds either of the corresponding pair of the threshold values.

96. The system for administering a general anesthetic according to claim 94 wherein said cardiovascular control unit compares each of the converted invasive cardiac analogues to corresponding ones of the past converted invasive cardiac analogues to see if any of the converted invasive cardiac analogues has changed over a predetermined amount of time.

97. The system for administering a general anesthetic according to claim 92 wherein said vasoactive agent delivery unit is disengaged based upon the warning signal without human intervention.

98. The system for administering a general anesthetic according to claim 50 further comprising a display unit connected to said cardiac parameter conversion unit for displaying values of the converted invasive cardiac analogues.

99. The system for administering a general anesthetic according to claim 50 wherein said vasoactive agent administering unit further comprises:

a cardiovascular control unit connected to said non-invasive cardiac parameter measuring unit for selecting a first vasoactive agent and determining a first dose for the vasoactive agent based upon the non-invasive cardiac parameters;

a central monitoring and delivering control unit connected to said cardiovascular control unit for retrieving dosage information for the vasoactive agent, selecting a second vasoactive agent, independently determining a second dose of the selected vasoactive agent based upon the retrieved dosage information, resolving between the first vasoactive agent and the second vasoactive agent, resolving between the first dose and the second dose, and generating a vasoactive agent delivery command including the resolved dose and the resolved vasoactive agent; and

a vasoactive agent delivery unit connected to said cardiovascular control unit and said central monitoring and delivering control unit for delivering the vasoactive agent to the subject according to the vasoactive agent delivery command and recording information contained in the vasoactive agent delivery command in a database.

100. The system for administering a general anesthetic according to claim 99 wherein the dosage information includes any combination of physical characteristics of the subject, a dosage and an algorithm for modifying the dosage.

101. The system for administering a general anesthetic according to claim 99 wherein said central monitoring and delivering control unit compares the invasive cardiac analogues to comparison information to generate a comparison result and generates a warning signal if a critical condition exists in the subject based upon the comparison result.

102. The system for administering a general anesthetic according to claim 101 further comprising a display unit connected to said central monitoring and delivering control unit for displaying the warning signal.

103. The system for administering a general anesthetic according to claim 101 wherein the comparison information includes pairs of threshold values and past ones of the invasive cardiac analogues.

104. The system for administering a general anesthetic according to claim 103 wherein said central monitoring and delivering control unit compares each of the invasive cardiac analogues to a corresponding pair of the threshold values to see if the invasive cardiac analogue exceeds either of the threshold values.

105. The system for administering a general anesthetic according to claim 103 wherein said central monitoring and delivering control unit compares each of the invasive cardiac analogues to a corresponding one of the past ones of the cardiac values to see if the invasive cardiac analogues have changed over a predetermined amount of time.

106. The system for administering a general anesthetic according to claim 101 wherein said vasoactive agent delivery unit is disengaged based upon the warning signal without human intervention.

107. The system for administering a general anesthetic according to claim 50 wherein said vasoactive agent administering unit stops said vasoactive agent delivery unit.

108. The system for administering a general anesthetic according to claim 107 wherein said vasoactive agent administering unit resumes said vasoactive agent delivery unit.

109. The system for administering a general anesthetic according to claim 50 further comprising a respiratory monitoring unit connected to said vasoactive agent administering unit for monitoring respiratory parameters of the subject and for determining if the subject is properly respired based upon the monitored respiratory parameters before said vasoactive agent administering unit considers the vasoactive agent to be administered based upon the converted invasive cardiac analogues.

110. The system for administering a general anesthetic according to claim 109 wherein the monitored respiratory parameters include a CO₂ wave, a CO₂ level, a pulse oximeter measured value and an oxygen concentration.

111. A method of performing equipotency assays on anesthetizing agents, comprising the steps of:

a) anesthetizing a subject with a first anesthetizing agent to a certain predetermined level;

b) maintaining a level of neurological depression by a predetermined procedure;

c) monitoring a cardiovascular state of the patient;

d) achieving cardiovascular equilibrium in the cardiovascular state;

e) assaying a concentration of the first anesthetizing agent in blood of the patient; and

f) repeating the above steps a) through e) with a second anesthetizing agent with the same subject to determine whether or not the first anesthetizing agent and second anesthetizing agent achieve a substantially identical hemodynamic state.

112. The method of performing equipotency assays on anesthetizing agents according to claim 111 wherein the second anesthetizing agent is a different formulation of the first anesthetizing agent.

113. The method of performing equipotency assays on anesthetizing agents according to claim 111 wherein the second anesthetizing agent is a different drug from the first anesthetizing agent.

114. The method of performing equipotency assays on anesthetizing agents according to claim 111 wherein said steps c) and d) of monitoring the cardiovascular state and achieving cardiovascular equilibrium further comprise steps of:

non-invasively measuring a set of predetermined non-invasive cardiac parameters from the subject;

converting the non-invasive cardiac parameters into a plurality of invasive cardiac analogues based upon a first set of predetermined conversion equations; and

administering a vasoactive agent based upon the converted invasive cardiac analogues to restore cardiovascular equilibrium in the subject.

115. The method of performing equipotency assays on anesthetizing agents according to claim 111 wherein said step b) of maintaining the level of neurological depression further comprises steps of:

non-invasively measuring a set of predetermined non-invasive neurological parameters from the subject;

converting the non-invasive neurological parameters into a neurological index based upon a second set of predetermined conversion equations; and

administering the anesthetizing agent based upon the neurological index to maintain a desirable level of neurological depression in the subject.

116. The method of performing equipotency assays on anesthetizing agents according to claim 111 wherein said step c) of monitoring the cardiovascular state is indicated by a hemodynamic state vector with respect to Preload, Contractility and Afterload.

117. A system for performing equipotency assays on anesthetizing agents, comprising:

a general anesthetic administering unit for anesthetizing a subject separately with a first anesthetizing agent and a second anesthetizing agent to a certain predetermined level;

a non-invasive neurological parameter measuring unit connected to said general anesthetic administering unit for non-invasively measuring at least a predetermined neurological parameter from the subject, wherein said general anesthetic administering unit maintains a level of neurological depression by a predetermined procedure;

a non-invasive cardiac parameter measuring unit for non-invasively measuring cardiac parameters and monitoring a cardiovascular state of the patient;

a vasoactive agent administering unit connected to said non-invasive cardiac parameter measuring unit for achieving cardiovascular equilibrium; and

a central monitoring and delivering unit for recording respective concentrations of the first anesthetizing agent and the second anesthetizing agent in blood of the patient and for determining whether or not the first anesthetizing agent and second anesthetizing agent achieve a substantially identical hemodynamic state.

118. The system for performing equipotency assays on anesthetizing agents according to claim 117 wherein the second anesthetizing agent is a different formulation of the first anesthetizing agent.

119. The system for performing equipotency assays on anesthetizing agents according to claim 117 wherein the second anesthetizing agent is a different drug from the first anesthetizing agent.

120. The system for performing equipotency assays on anesthetizing agents according to claim 117 wherein said general anesthetic administering unit further comprises a cardiac parameter conversion unit connected to said non-invasive cardiac parameter measuring unit for converting the non-invasive cardiac parameters into a plurality of invasive cardiac analogues based upon a first set of predetermined conversion equations, wherein said vasoactive agent administering unit administers a vasoactive agent based upon the converted invasive cardiac analogues to restore cardiovascular equilibrium in the subject.

121. The system for performing equipotency assays on anesthetizing agents according to claim 117 wherein said general anesthetic administering unit further comprise a neurological parameter conversion unit connected to said non-invasive neurological parameter measuring unit for converting the non-invasive neurological parameters into a neurological index based upon a second set of predetermined conversion equations, wherein said general anesthetic administering unit administers the anesthetizing agent based upon the neurological index to maintain a desirable level of neurological depression in the subject.

122. The system for performing equipotency assays on anesthetizing agents according to claim 117 wherein said non-invasive cardiac parameter measuring unit monitors the cardiovascular state of the patient as indicated by a hemodynamic state vector with respect to Preload, Contractility and Afterload.

123. A method of simulating cardiovascular and neurological conditions of a patient under a general anesthetic, comprising the steps of:

inputting first data representing characteristics of a patient;

inputting second data representing an anesthetic agent;

simulating neurological conditions and cardiovascular conditions in response the second data based upon the first data;

displaying information representing at least some of the simulated neurological conditions and the simulated cardiovascular conditions;

audio-visually warning any undesirable condition; and

allowing human intervention if the undesirable condition exists.

124. The method of simulating cardiovascular and neurological conditions according to claim 123 wherein the information optionally includes description of underlying physiological events involved in the simulated cardiovascular conditions.

125. The method of simulating cardiovascular and neurological conditions according to claim 123 wherein the simulated cardiovascular conditions include a pulse, an EKG, an E-M interval, an EI or DI interval and a blood pressure or a mean arterial pressure.

126. The method of simulating cardiovascular and neurological conditions according to claim 123 wherein the simulated neurological conditions include an EEG.

127. The method of simulating cardiovascular and neurological conditions according to claim 123 wherein said inputting the second data is interactively performed.

128. The method of simulating cardiovascular and neurological conditions according to claim 123 further comprising additional steps of:

inputting third data representing a vasoactive agent to restore cardiovascular equilibrium in the patient; and

further simulating the cardiovascular conditions in response the third data based upon the first data.

129. The method of simulating cardiovascular and neurological conditions according to claim 123 wherein the cardiovascular conditions of the patient are indicated by a hemodynamic state vector with respect to Preload, Contractility and Afterload.

130. A system for simulating cardiovascular and neurological conditions of a patient under a general anesthetic, comprising:

a patient characteristic database for storing first data representing characteristics of a patient and second data representing an anesthetic agent;

a simulation module connected to said patient characteristic database for inputting the first data and the second data, said simulation module simulating neurological conditions and cardiovascular, conditions in response the second data based upon the first data; and

a display unit connected to said simulation module for displaying information representing at least some of the simulated neurological conditions and the simulated cardiovascular conditions, said display unit audio-visually warning any undesirable condition and allowing to receive an input indicative of human intervention if the undesirable condition exists.

131. The system for simulating cardiovascular and neurological conditions according to claim 130 wherein the information optionally includes description of underlying physiological events involved in the simulated cardiovascular conditions.

132. The system for simulating cardiovascular and neurological conditions according to claim 130 wherein the simulated cardiovascular conditions include a pulse, an EKG, an E-M interval, an EI or DI interval and a blood pressure or a mean arterial pressure.

133. The system for simulating cardiovascular and neurological conditions according to claim 130 wherein the simulated neurological conditions include an EEG.

134. The system for simulating cardiovascular and neurological conditions according to claim 130 wherein said inputting of the second data is interactively performed.

135. The system for simulating cardiovascular and neurological conditions according to claim 130 wherein said patient characteristic database stores third data representing a vasoactive agent for restoring cardiovascular equilibrium in the patient, said simulation module inputting third data and further simulating the cardiovascular conditions in response to the third data based upon the first data.

136. The system for simulating cardiovascular and neurological conditions according to claim 130 wherein the cardiovascular conditions of the patient are indicated by a hemodynamic state vector with respect to Preload, Contractility and Afterload.