Awareness and the EEG power spectrum: analysis of frequencies.
BACKGROUND
Power spectral analysis is a well-established method for the analysis of EEG signals. Spectral parameters can be used to quantify pharmacological effects of anaesthetics on the brain and the level of sedation. This method, in numerous variations, has been applied to depth of anaesthesia monitoring and has been incorporated into several commercially available EEG monitors. Because of the importance of EEG spectral analysis, we evaluated the performance of each frequency in the power spectrum regarding detection of awareness.


METHODS
Ninety artefact-free EEG segments of length 8 s were obtained from a database that contains perioperatively recorded EEG data. For the present analysis, EEG data were selected from 39 patients with propofol-remifentanil or sevoflurane-remifentanil anaesthesia with a period of awareness. Half of the EEG segments were recorded during periods of awareness as defined by an adequate response to the command 'squeeze my hand'. The other half were from unresponsive patients. The power spectral density was calculated for each segment. The performance of each frequency bin of the power spectrum as a detector of awareness was assessed with a remapped prediction probability rPK, i.e. the prediction probability PK mapped to a range of 0.5-1.


RESULTS
The remapped prediction probability was high (rPK>0.8) for low frequencies (<15 Hz) and for high frequencies (>26 Hz), with a minimum (rPK<0.55) at 21 Hz. Indentations in the 'performance spectrum' occur at the power-line frequency (50 Hz) and its harmonics and at 78 Hz, probably caused by the continuous impedance measurement of another device used in parallel. With the exception of the indentations, the remapped prediction probability of the high frequencies (>35 Hz) was >0.95.


CONCLUSIONS
The best performance for the detection of awareness was achieved by EEG power spectral frequencies from >35 Hz up to 127 Hz. This frequency band may be dominated by muscle activity. The frequency band between 15 and 26 Hz may be of limited value, as reflected by lower rPK values.
Dressler
O
O
Department of Anaesthesiology, Technische Universität München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675 Munich, Germany.
Schneider
G
G
Stockmanns
G
G
Kochs
E F
EF
D019162:Anesthetics, Combined / Q000494:pharmacology; D018681:Anesthetics, General / Q000494:pharmacology*; D001364:Awareness / Q000187:drug effects*; D004569:Electroencephalography / Q000187:drug effects*; D006801:Humans; D008738:Methyl Ethers / Q000494:pharmacology; D016343:Monitoring, Intraoperative / Q000379:methods*; D010880:Piperidines / Q000494:pharmacology; D015742:Propofol / Q000494:pharmacology; D000077208:Remifentanil; D000077149:Sevoflurane; D012815:Signal Processing, Computer-Assisted
D019162:Anesthetics, Combined; D018681:Anesthetics, General; D008738:Methyl Ethers; D010880:Piperidines; D000077149:Sevoflurane; D000077208:Remifentanil; D015742:Propofol