# US 12,178,602 B2 · Nociception stimulus feedback control for drug titration during surgery > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 12,178,602 B2 - Document ID: US12178602B2 - Status: Granted - Kind: B2 - Application number: 16/933,745 - Filed: 2020-07-20 - Published: 2022-01-20 - Granted: 2024-12-31 - Earliest claimed: 2020-07-20 - Assignees: Covidien LP - Applicants: Covidien LP - Inventors: Paul S. Addison; Dean Montgomery - Web page: https://patentgrep.com/patent/US12178602B2 ## CPC - A61B 5/4821: {Determining level or depth of anaesthesia (based on movements A61B5/1106)} - G16H 40/60: for the operation of medical equipment or devices - A61B 5/14551: {for measuring blood gases} - A61B 5/7282: {Event detection, e.g. detecting unique waveforms indicative of a medical condition (cough events A61B5/0823; seizures A61B5/4094; sleep apnoea A61B5/4818)} - A61B 34/10: Computer-aided planning, simulation or modelling of surgical operations - A61B 34/25: {User interfaces for surgical systems} - A61B 34/30: Surgical robots - G16H 20/10: relating to drugs or medications, e.g. for ensuring correct administration to patients - G16H 20/17: delivered via infusion or injection - G16H 40/63: for local operation - A61B 5/021: Measuring pressure in heart or blood vessels - A61B 2505/05: Surgical care - A61B: DIAGNOSIS; SURGERY; IDENTIFICATION (usefulness limited to only animals A61D) - G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA ## Abstract A patient monitoring system may include processing circuitry configured to receive an indication of a surgical event, obtain a nociception parameter of a patient, compare the nociception parameter of the patient to a nociception threshold to detect a nociception event, determine whether the surgical event corresponds to the nociception event, and in response to determinizing whether the surgical event corresponds to the nociception event, provide an indication to adjust an amount of analgesic administered to the patient. ## Claims ### Claim 1 A method comprising: receiving, by processing circuitry, an indication of an occurrence of a surgical event during a period of time; setting, by the processing circuitry, a surgical event flag during the period of time based on receiving the indication of the occurrence of the surgical event; receiving, by the processing circuitry, a nociception parameter of a patient during the period of time; determining, by the processing circuitry, a nociception event based on comparing the nociception parameter of the patient to a nociception threshold; and providing, by the processing circuitry, an indication to adjust an amount of analgesic administered to the patient based on the surgical event corresponding to the nociception event during the period of time. ### Claim 2 (depends on 1) The method of claim 1, comprising determining, by the processing circuitry, that the surgical event corresponds to the nociception event based on the nociception parameter of the patient being greater than or equal to the nociception threshold while the surgical event flag is set during the period of time. ### Claim 3 (depends on 2) The method of claim 2, comprising outputting, by the processing circuitry for display at a display device, the nociception parameter of the patient over time and a value of the surgical event flag over time. ### Claim 4 (depends on 1) The method of claim 1, wherein the indication of the occurrence of the surgical event comprises an indication of an amount of force associated with the surgical event, and wherein the method comprises determining, by the processing circuitry, an adjustment amount associated with the indication to adjust the amount of analgesic administered to the patient based at least in part on the amount of force associated with the surgical event. ### Claim 5 (depends on 1) The method of claim 1, wherein the indication of the occurrence of the surgical event comprises an indication of a physiological feature of the patient being incised by a robotic surgical system, and wherein the method comprises determining, by the processing circuitry, an adjustment amount associated with the indication to adjust the amount of analgesic administered to the patient based at least in part on the physiological feature of the patient being incised by the robotic surgical system. ### Claim 6 (depends on 1) The method of claim 1, comprising sending, by the processing circuitry to an analgesia administration device, the indication to adjust the amount of analgesic administered to the patient. ### Claim 7 (depends on 1) The method of claim 1, comprising, in response to providing the indication to adjust the amount of analgesic administered to the patient, sending, by the processing circuitry to a robotic surgical system, an indication to make an incision. ### Claim 8 (depends on 1) The method of claim 1, comprising determining, by the processing circuitry, to provide the indication to_adjust the amount of analgesic administered to the patient based on a total amount of analgesic administered to the patient during surgery. ### Claim 9 (depends on 1) The method of claim 1, comprising determining, by the processing circuitry, the nociception event based on an increase over time in the nociception parameter of the patient during the period of time. ### Claim 10 A system comprising: memory configured to store a nociception threshold; and processing circuitry configured to: receive an indication of an occurrence of a surgical event during a period of time; set a surgical event flag during the period of time based on receiving the indication of the occurrence of the surgical event; receive a nociception parameter of a patient during the period of time; determine a nociception event based on comparing the nociception parameter of the patient to the nociception threshold; and provide an indication to adjust an amount of analgesic administered to the patient based on determining that the surgical event corresponds to the nociception event during the period of time. ### Claim 11 (depends on 10) The system of claim 10, wherein the processing circuitry is configured to determine that the surgical event corresponds to the nociception event based on the nociception parameter of the patient being greater than or equal to the nociception threshold while the surgical event flag is set during the period of time. ### Claim 12 (depends on 11) The system of claim 11, wherein the processing circuitry is configured to output, for display at a display device, the nociception parameter of the patient over time and a value of the surgical event flag over time. ### Claim 13 (depends on 10) The system of claim 10, wherein the indication of the occurrence of the surgical event comprises an indication of an amount of force associated with the surgical event, and wherein the processing circuitry is configured to determine an adjustment amount associated with the indication to adjust the amount of analgesic to administer to the patient based at least in part on the amount of force associated with the surgical event. ### Claim 14 (depends on 10) The system of claim 10, wherein the indication of the occurrence of the surgical event comprises an indication of a physiological feature of the patient being incised by a robotic surgical system, and wherein the processing circuitry is configured to determine an adjustment amount associated with the indication to adjust the amount of analgesic to administer to the patient based at least in part on the physiological feature of the patient being incised by the robotic surgical system. ### Claim 15 (depends on 10) The system of claim 10, wherein the processing circuitry is configured to send, to an analgesia administration device, the indication to adjust the amount of analgesic administered to the patient. ### Claim 16 (depends on 10) The system of claim 10, wherein the processing circuitry is configured to in response to providing the indication to adjust the amount of analgesic to administer to the patient, send, to a robotic surgical system, an indication to make an incision. ### Claim 17 (depends on 10) The system of claim 10, wherein the processing circuitry is configured to determine to provide the indication to increase the amount of analgesic administered to the patient based on a total amount of analgesic administered to the patient during surgery. ### Claim 18 (depends on 10) The system of claim 10, wherein the processing circuitry is configured to determine the nociception event based on an increase over time in the nociception parameter of the patient during the period of time. ### Claim 19 A non-transitory computer readable storage medium comprising instructions that, when executed, cause processing circuitry to: receive an indication of an occurrence of a surgical event during a period of time; set a surgical event flag during the period of time based on receiving the indication of the occurrence of the surgical event; receive a nociception parameter of a patient; determine a nociception event based on comparing the nociception parameter of the patient to a nociception threshold; and provide an indication to adjust an amount of analgesic to administer to the patient based on determining that the surgical event corresponds to the nociception event during the period of time. ### Claim 20 (depends on 19) The non-transitory computer readable storage medium of claim 19, wherein the instructions further cause the processing circuitry to determine that the surgical event corresponds to the nociception event, based on the nociception parameter of the patient being greater than or equal to the nociception threshold while the surgical event flag is set during the period of time.