Mapping general anesthesia states based on electro-encephalogram transition phases

Neuroimage. 2024 Jan:285:120498. doi: 10.1016/j.neuroimage.2023.120498. Epub 2023 Dec 20.

Abstract

Cortical electro-encephalography (EEG) served as the clinical reference for monitoring unconsciousness during general anesthesia. The existing EEG-based monitors classified general anesthesia states as underdosed, adequate, or overdosed, lacking predictive power due to the absence of transition phases among these states. In response to this limitation, we undertook an analysis of the EEG signal during isoflurane-induced general anesthesia in mice. Adopting a data-driven approach, we applied signal processing techniques to track θ- and δ-band dynamics, along with iso-electric suppressions. Combining this approach with machine learning, we successfully developed an automated algorithm. The findings of our study revealed that the dampening of the δ-band occurred several minutes before the onset of significant iso-electric suppression episodes. Furthermore, a distinct γ-frequency oscillation was observed, persisting for several minutes during the recovery phase subsequent to isoflurane-induced overdose. As a result of our research, we generated a map summarizing multiple brain states and their transitions, offering a tool for predicting and preventing overdose during general anesthesia. The transition phases identified, along with the developed algorithm, have the potential to be generalized, enabling clinicians to prevent inadequate anesthesia and, consequently, tailor anesthetic regimens to individual patients.

Keywords: Classification; Electro-encephalography; General Anesthesia; IRASA; Iso-electric suppression; Isoflurane; Machine Learning; Spectral decomposition; State chart.

MeSH terms

  • Anesthesia, General
  • Animals
  • Brain
  • Electroencephalography
  • Humans
  • Isoflurane* / pharmacology
  • Mice
  • Unconsciousness

Substances

  • Isoflurane