Use of a pharmacokinetic-dynamic model for the automatic feedback control of atracurium.

A control algorithm for the closed-loop control of atracurium-induced neuromuscular blockade based on pharmacokinetic-dynamic model-based adaptive feedback is described. Mean offset from setpoint at 90% neuromuscular block was 0.04% and the mean standard deviation from mean neuromuscular block was 1.9%. The mean average atracurium requirement was 0.37 mg.kg-1.h-1. The model-based adaptive closed-loop control of atracurium infusion provided reasonable control of muscle relaxation. It offers a solution to the problem of adapting pharmacokinetic and pharmacodynamic data to individuals when using mean data as starting values for drug therapy.