title: Evaluation of postural steadiness before and after sedation: comparison of four nonlinear and three conventional measures.
abstract: Sedative drugs decrease postural steadiness and increase the risk of injury from falls and accidents. The recovery rate is individual, making it hard to predict the patient's steadiness and hence safe discharge time. 103 outpatients sedated with midazolam and fentanyl were measured posturographically, before (PRE) and after (POST) endoscopy. The ability of conventional and nonlinear sway measures to separate the PRE and POST conditions were compared, and the area under the receiver operating characteristics curve (AUC) was used to quantify the significance of the separation. A nonlinear measure, fuzzy sample entropy, scored the largest AUC (AUCFSE = 0.83, p < 0.0001). While the AUCFSE was not significantly larger than the AUCs of conventional sway measures which offer easy quantification of postural steadiness, nonlinear measures provide more insight into the structure of postural control, which may help understand the effect of sedation on postural steadiness. This study is a step toward developing a tester that indicates a safe discharge time.
authors.affiliation: Department of Physics, University of Helsinki, Helsinki, Finland.
authors.forename: A
authors.initials: A
authors.lastname: Tietäväinen
authors.forename: E
authors.initials: E
authors.lastname: Hæggström
authors.forename: J E
authors.initials: JE
authors.lastname: Mandel
mesh_terms: D000553:Ambulatory Care; D000758:Anesthesia; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D004856:Postural Balance / Q000187:drug effects*; D011187:Posture / Q000502:physiology*; D011312:Pressure; D012372:ROC Curve