Journal of Clinical Monitoring and Computing manuscript No. (will be inserted by the editor) Automatic control of the NMB level in general anaesthesia with a switching total system mass control strategy Miguel Teixeira · TeresaMendon¸ca · Paula Rocha · RuiRabi¸co Received: date / Accepted: date Abstract This paper presents a model based switching control strategy to drive the neuromuscular blockade (NMB) level of patients undergoing general anesthe- sia to a predefined reference. A single-input single-output Wiener system with only two parameters is used to model the effect of two different muscle relaxants, atracurium and rocuronium, and a switching controller is designed based on a bank of total system mass control laws. Each of such laws is tuned for an individ- ual model from a bank chosen to represent the behavior of the whole population. The control law to be applied at each instant corresponds to the model whose NMB response is closer to the patient’s response. Moreover a scheme to improve the reference tracking quality based on the analysis of the patient’s response, as well as, a comparison between the switching strategy and the Extended Kalman Filter EKF technique are presented. The results are illustrated by means of several simulations, where switching shows to provide good results, both in theory and in practice, with a desirable reference tracking. The reference tracking improve- ment technique is able to produce a better reference tracking. Also, this technique showed a better performance than the ( EKF). Based on these results, the switch- M. Teixeira Faculdade de Ciˆ encias da Universidade do Porto Rua Campo Alegre 687, 4169-007, Porto E-mail: teixeira.mrt@fc.up.pt T.Mendon¸ca Faculdade de Ciˆ encias da Universidade do Porto Rua Campo Alegre 687, 4169-007, Porto E-mail: tmendo@fc.up.pt P. Rocha Faculdade de Engenharia da Universidade do Porto Rua Dr. Roberto Frias, 4200-465 Porto, Portugal E-mail: mprocha@fe.up.pt R.Rabi¸co Department of Anesthesiology Unidade Local de Sa´ ude de Matosinhos - Hospital Pedro Hispano Rua Dr. Eduardo Torres, 4464-513 Senhora da Hora E-mail: rrabico@gmail.com Manuscript Click here to download Manuscript: JCMC Article.tex JOURNAL OF CLINICAL MONITORING AND COMPUTING Vol. 28 p. 501-512 DOI: 10.1007/s10877-013-9500-3