Monitoring the Depth of Anesthesia Based on Phase-Amplitude Coupling of Near-Infrared Spectroscopy Signals

Abstract

Accurate monitoring of the depth of anesthesia (DOA) is essential to ensure the safety of the operation. In this study, a new index using near-infrared spectroscopy (NIRS) signal was proposed to assess the relationship between the DOA and cerebral hemodynamic variables. Methods: Four cerebral hemodynamic variables of 15 patients were collected, including left, right, proximal, distal, oxygenated (HbO $_{{2}}{)}$ and deoxygenated (Hb) hemoglobin concentration changes. The Phase-Amplitude coupling (PAC), an adaptation of cross-frequency coupling to reflect the modulation of the amplitude of high-frequency signals by the phase of low-frequency signals, was measured and the modulation index (MI) was obtained to monitor the DOA afterwards. Meanwhile, the BIS value based on electroencephalogram is also measured and compared. Results: Compared with awake period, in anesthesia maintenance period, the PAC was strengthened. The analysis of receiver operating characteristic (ROC) curve showed that the MI, especially the MI of rp-HbO2, could effectively discriminate these two periods. Additionally, during the whole anesthesia process, the BIS value was statistically consistent with the MI of cerebral hemodynamic variables, and cerebral hemodynamic variables were immune from interference by clinical electric devices. Conclusion: The MI of cerebral hemodynamic variables was appropriate to be used as a new index to monitor the DOA. Significance: This study is of great significance to the development of new modes of anesthesia monitoring and new decoding methods, and is expected to develop a high-performance anesthesia monitoring system.

Keywords

• Depth of anesthesia
• near-infrared spectroscopy
• cerebral hemodynamic variables
• phase-amplitude coupling