Title | Real-time cardiorespiratory coherence detects antinociception during general anesthesia. | ||
Author | Brouse, Chris J; Karlen, Walter; Dumont, Guy A; Myers, Dorothy; Cooke, Erin; Stinson, Jonathan; Lim, Joanne; Ansermino, J Mark | ||
Journal | Annu Int Conf IEEE Eng Med Biol Soc | Publication Year/Month | 2012 |
PMID | 23366759 | PMCID | -N/A- |
Affiliation | 1.Department of Electrical & Computer Engineering, University of British Columbia, Vancouver, BC, Canada. chrisb@ece.ubc.ca. |
Heart rate variability (HRV) may provide anesthesiologists with a noninvasive tool for monitoring nociception during general anesthesia. A novel real-time cardiorespiratory coherence (CRC) algorithm has been developed to analyze the strength of linear coupling between heart rate (HR) and respiration. CRC values range from 0 (low coherence, strong nociception) to 1 (high coherence, no nociception). The algorithm uses specially designed filters to operate in real-time, minimizing computational complexity and time delay. In the standard HRV high frequency band of 0.15 - 0.4 Hz, the real-time delay is only 5.25 - 3.25 s. We have assessed the algorithm\'s response to 60 anesthetic bolus events (a large dose of anesthetics given over a short time; strongly antinociceptive) recorded in 47 pediatric patients receiving general anesthesia. Real-time CRC responded strongly to bolus events, changing by an average of 30%. For comparison, three traditional measures of HRV (LF/HF ratio, SDNN, and RMSSD) responded on average by only 3.8%, 14%, and 3.9%, respectively. Finally, two traditional clinical measures of nociception (HR and blood pressure) responded on average by only 3.9% and 0.91%, respectively. CRC may thus be used as a real-time nociception monitor during general anesthesia.