Adaptive closed-loop feedback control of vecuronium-induced neuromuscular relaxation.

An adaptive closed-loop control of neuromuscular block by pharmacokinetic dynamic model-based feedback is described. Mean (+/- SD) offsets from setpoints at 70, 80 and 90% neuromuscular blockade were 2.2 +/- 1.1, 1.8 +/- 0.6 and 0.4 +/- 0.4%, respectively. Correspondingly, the mean standard deviations from mean neuro-muscular blockade were 3.9 +/- 2.3, 2.7 +/- 0.6 and 1.3 +/- 0.2% and the mean average vecuronium requirements 0.5 +/- 0.2, 0.7 +/- 0.2 and 1.0 +/- 0.5 micrograms kg-1 min-1. The described closed-loop vecuronium administration system gives a solution to the problem of adapting pharmacokinetic and pharmacodynamic data to individuals when using mean data as starting values for drug therapy.