On-line analysis of AEP and EEG for monitoring depth of anaesthesia

Abstract

Achieving and monitoring adequate depth of anaesthesia is a challenge to the anaesthetist. With the introduction of muscle relaxing agents, the traditional signs of awareness are often obscured or difficult to interpret. These signs include blood pressure, heart rate, pupil size, etc. However, these factors do not describe the depth of anaesthesia, (DA), in a cerebral activity sense, hence there is a desire to achieve a better measure of the DA. Auditory Evoked Potentials (AEP) provide two aspects relevant to anaesthesia: (1) they have identifiable anatomical significance and, (2) their characteristics reflect the way in which the brain reacts to a stimulus. However, AEP is embedded in noise from the ongoing EEG background activity. Hence, processing is needed to improve the signal to noise ratio. The methods applied were moving time averaging (MTA) and ARX-modeling. The EEG was collected from the left hemisphere and analysed by FFT to 1 sec epochs and the spectral edge frequency was calculated. Both the changes in ARX extracted AEP and the spectral edge frequency of the EEG correlated well with the time interval between propofol induction and onset of anaesthesia measured by clinical signs (i.e., cessation of eye-lash reflex). The MTA extracted AEP was significantly slower in tracing the transition from consciousness to unconsciousness.