Clinical Performance of a Bispectral Index Controlled Closed-Loop Administration System for Simultaneous Administration of Propofol and Remifentanil

Closed-loop administration of propofol during general anesthesia has been extensively researched in recent years due to the availability of depth of hypnosis monitors. Conversely, due to the absence of a reliable indicator of analgesia, closed-loop administration of remifentanil has not been widely investigated yet. We evaluated the clinical performance of Automatic Control of Total Intravenous Anesthesia (ACTIVA), a fully automatic closed-loop total intravenous anesthesia (TIVA) system that implements a novel design to automatically administer both propofol and remifentanil by using solely the bispectral index (BIS) as controlled variable.