• Transactions on Electrical and Electronic Materials
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• 제14권6호
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• pp.299-303
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• 2013

Anesthesia, which started being used to remove pain during surgery, has become itself one of the major concerns to be considered during surgery. While actual anesthesia is being performed, patients tend to have unpleasant experiences, due to wakening that accompanies pain, or wakening that does not accompany pain. Since this awakening during anesthesia is a most unpleasant experience in a patient's life, evaluating the depth of anesthesia during surgery is essential for patients to avoid this experience. Although there has been much effort on the understanding and measurement of the depth of anesthesia, while various researches were performed on the need of anesthesia, the development of an indicator that could objectively evaluate the depth of anesthesia, other than by using the patient's vital signs, is still inadequate. Therefore, this study was to develop an objective indicator by using EEG and ECG, which are essentially measured during the surgery, to evaluate the depth of anesthesia. The experiment was performed by taking patients who require a relatively short operation time, and general inhalation anesthetics among surgical patients in obstetrics and gynecology as the subjects of experiment, to measure the EEG and ECG signals of patients under anesthetics. The result showed that SEF using EEG and LF, HF using ECG signal and correlation dimension analysis parameter were valuable parameters that could measure the depth of anesthesia, by the stage of anesthesia.

• 대한의용생체공학회:의공학회지
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• 제30권4호
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• pp.327-332
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• 2009

In this paper, new index was developed to estimate the depth of anesthesia during general anesthesia using EEG. Analysis of the power spectral density(PSD) of EEG was used to develop new parameters because EEG signal tends to have slow wave during anesthesia. Classifier for index creator was developed by using SEF, BDR and BTR parameters, which are calculated by power spectral density. EEG data were obtained from 7 patients (ASA I, II) during general anesthesia with Sevoflurane. The anesthetic depth evaluation indexes ranged from 0 to 100. The average were $86.05{\pm}10.1$, $36.98{\pm}20.2$, $15.33{\pm}13.6$, $50.87{\pm}16.5$ and $87.72{\pm}11.7$ for the states of pre-operation, induction of anesthesia, operation, awaked and post-operation, respectively. The results show that while the depth of anesthesia was evaluated, more accurate information can be provided for anesthetician.

• 대한의용생체공학회:의공학회지
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• 제28권2호
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• pp.287-293
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• 2007

The researchers have studied for a long time about the depth of anesthesia but they don't make criteria for the depth of anesthesia. Anesthetists can't make a prediction about patient's reaction. Therefore, patients have potential risk such as poisonous side effect, late-awake, early-awake and strain reaction. In this study, the distributed characteristics on the bispectrum and bicoherence, the type of nonlinear signal processing, as a result of the coupling of EEG were presented according to depth of anesthesia. These results were consistent with a trend of delta ratio that the index of evaluation for the depth of anesthesia. The higher-order spectrum (HOS), the bispectrum and bicoherence, gives the useful information about depth of anaesthesia than other indexes.

• 한국전기전자재료학회논문지
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• 제23권2호
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• pp.103-117
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• 2010

In this study, the heart rate variability(HRV) signal of operating patient was acquired according to anesthesia progress and identified to evaluation possibility of depth of anesthesia in each anesthesia stage. The HRV signal was analyzed time-frequency domain applied to Wigner-Ville distribution method, the characteristic parameters were extracted for evaluation of depth of anesthesia in each anesthesia stage. The progress of general anesthesia was divided into the states of pre-operation, induction of anesthesia, operation, awaking and post-operation.

• 대한전기학회논문지:시스템및제어부문D
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• 제55권1호
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• pp.35-41
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• 2006

Although reachers have studied for a long time, they don't make criteria for anesthesia depth. anesthetists can't make a prediction about patient's reaction. Therefor, patients have potential risk such as poisonous side effect late-awake, early-awake and strain reaction. EEG are received from twenty-five patients who agreed to investigate themselves during operation with Enflurane-anesthesis in progress of anesthesia. EEG are divided pre-anesthesia, before incision of skin, operation 1, operation 2, awaking, post-anesthesia by anesthesia progress step. EEG is applied pre-processing, base line correct, linear detrend to get more reliable data. EEG data are handled by electronic processing and the EEG data are calculated by bicoherence. During pre-anesthesia and post anesthesia, appearance rate of bicoherence value is observed strong appearance rate in high frequency range($15\~30Hz$). During the anesthesia of patient, a strong appearance rate is revealed the low frequency area(0~10Hz). After bicoherence is calculated by percentage of a appearance rate, that is, Bicpara$\#$1, Bicpara$\#$2, Bicpara$\#$3 and Bicpara$\#$4 parameter are extracted. In result of bicoherence analysis, Bicpara$\#$2 and Bicpara#4 are considered that the best parameter showed progress of anesthesia effectively. And each separated bicoherence are calculated by average bicoherence's numerical value, divide by 2 area, appear by each BicHz$\#$1, BicHz$\#$2, and observed BicHz$\#$1/BicHz$\#$2's change. In result of bicoherence analysis, BicHz$\#$1, BicHz$\#$2 and BicHz$\#$1/BicHz$\#$2 are considered that the best parameter showed progress of anesthesia effectively. In conclusion, I confirmed the anesthesia progress phase, concluded to usefulness of parameter on bispectrum and bicoherence analysis and evaluated the depth of anesthesia. In the future, it is going to use for doctor's diagnosis and apply to protect an medical accident owing to anesthesia.

• Journal of Dental Anesthesia and Pain Medicine
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• 제18권4호
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• pp.235-244
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• 2018

Background: Patients with intellectual disability (ID) often require general anesthesia during oral procedures. Anesthetic depth monitoring in these patients can be difficult due to their already altered mental state prior to anesthesia. In this study, the utility of electroencephalographic indexes to reflect anesthetic depth was evaluated in pediatric patients with ID. Methods: Seventeen patients (mean age, $9.6{\pm}2.9years$) scheduled for dental procedures were enrolled in this study. After anesthesia induction with propofol or sevoflurane, a bilateral sensor was placed on the patient's forehead and the bispectral index (BIS) was recorded. Anesthesia was maintained with sevoflurane, which was adjusted according to the clinical signs by an anesthesiologist blinded to the BIS value. The index performance was accessed by correlation (with the end-tidal sevoflurane [EtSevo] concentration) and prediction probability (with a clinical scale of anesthesia). The asymmetry of the electroencephalogram between the left and right sides was also analyzed. Results: The BIS had good correlation and prediction probabilities (above 0.5) in the majority of patients; however, BIS was not correlated with EtSevo or the clinical scale of anesthesia in patients with Lennox-Gastaut, West syndrome, cerebral palsy, and epilepsy. BIS showed better correlations than SEF95 and TP. No significant differences were observed between the left- and right-side indexes. Conclusion: BIS may be able to reflect sevoflurane anesthetic depth in patients with some types of ID; however, more research is required to better define the neurological conditions and/or degrees of disability that may allow anesthesiologists to use the BIS.

• 한국산학기술학회논문지
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• 제10권9호
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• pp.2460-2470
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• 2009

본 연구에서는 마취 단계에서 마취 심도 평가를 위한 파라미터 추출을 수행하였다. 연구대상은 평균 나이 $42{\pm}9.13$세, 신체등급 분류상 1 또는 2 등급에 속하는 산부인과 수술 환자를 선택하였다. 투약제로는 Enflurane으로 전신 마취를 시행하였다. HRV 신호는 ECG 신호로부터 R 피크치 검출 알고리즘에 의해 획득 되었다. HRV 데이터는 전처리 단계를 거쳤고, 마취 단계별 마취심도 평가 파라미터를 개발하기 위하여 마취단계를 마취 전, 마취유도, 수술중, 각성, 마취 후 등으로 구분하여 시행하였다. 본 연구에서는 마취단계에서 웨이브렛 변환을 이용한 HRV신호 분석 알고리듬이 제안되었다. 세 종류의 웨이브렛 함수를 적용한 PSD 분석 결과 마취 단계에 따라 모두 비슷한 양상을 나타내었으나, 이들 중 Daubeches 10의 실험 결과가 보다 양호하게 관측되어 마취 단계별 마취심도를 평가할 수 있는 특징 파라미터로서 가장 적절하다는 판단하였다.

• Journal of Dental Anesthesia and Pain Medicine
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• 제16권3호
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• pp.217-222
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• 2016

Dental treatment is often performed under general anesthesia or sedation when an intellectually disabled patient has a heightened fear of treatment or has difficulty cooperating. When it is impossible to control the patient due to the severity of intellectual disability, conscious sedation is not a viable option, and only deep sedation should be performed. Deep sedation is usually achieved by propofol infusion using the target controlled infusion (TCI) system, with deep sedation being achieved at a slightly lower concentration of propofol in disabled patients. In such cases, anesthesia depth monitoring using EEG, as with a Bispectral Index (BIS) monitor, can enable dental treatment under appropriate sedation depth. In the present case, we performed deep sedation for dental treatment on a 27-year-old female patient with mental retardation and severe dental phobia. During sedation, we used BIS and a newly developed Anesthetic Depth Monitor for Sedation (ADMS$^{TM}$), in addition to electrocardiography, pulse oximetry, blood pressure monitoring, and capnometry for patient safety. Oxygen was administered via nasal prong to prevent hypoxemia during sedation. The BIS and ADMS$^{TM}$ values were maintained at approximately 70, and dental treatment was successfully performed in approximately 30 min.

• 한국산학기술학회논문지
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• 제11권7호
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• pp.2491-2496
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• 2010

EEG 신호에 내포된 상관특성을 알 수 있는 스케일 분석 기법인 DFA를 이용하여 수술 중 마취심도를 분석하고자하였다. 마취과 학회에서 제공하는 신체 분류 등급 1(건강한 환자), 2(경한 전신 질환, 기능 제한 없음) 등급의 환자를 대상으로 하였다. 정신병력이나 신경계 이상이 있는 환자는 제외하였다. 수술 중 마취 환자의 평균 연령은 $48.9{\pm}10.9$ 세이고, 평균체중은 $57.1{\pm}8.2$ kg, 평균 신장은 $158{\pm}6.6$cm 였다. 수술을 위한 마취 약제로는 Sevoflurane를 사용하였고, 수술단계는 수술전, 마취유도, 마취유도 직후, 수술중, 마취제 중지, 수술 후의 6단계로 나누어 분석하였다. DFA의 ��${\alpha}1$, ${\alpha}2$, ${\alpha}3$ 중 ${\alpha}1$, ${\alpha}3$는 수술전단계, 마취 유도 단계, 마취 유도 단계 직후, 마취제 중지 단계, 수술후 단계를 구별 할 수 있는 파라미터들로 수술 중 마취 심도를 평가 할 수 있는 파라미터로 이용될 수 있음을 확인 하였다.

• 한국정보통신학회논문지
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• 제14권9호
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• pp.2099-2104
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• 2010

본 연구에서는 마취 중 리턴맵 분석 방법을 적용하여 ECG 신호에서 R-R 간격의 변화로 표시될 수 있는 HRV 신호를 분석하였다. HRV신호는 자율신경계(autonomic nervous system : ANS)의 상태변이에 따른 심혈관계(cardio vascular system : CVS)의 변화 양상에 대한 객관적인 정보를 구할 수 있으므로 수술중 자율신경계의 변화를 관찰하여 마취심도를 평가할 수 있다. 리턴맵 분석 방법은 일련의 시계열 HRV 신호를 위상공간으로 사상하기 위해 지연시간과 매립차원을 구한 후 2차원의 위상공간에 신호를 재구성하였다. 위상공간에 재구성된 신호 분포를 타원형으로 근사화 한 후 장축과 단축의 길이를 구하여 마취심도를 구별하는데 이용하였다. 마취 단계별 마취심도를 평가하기 위하여 마취 단계를 7단계로 구분하여 분석하였다. 외부자극이 아주 강한 마취유도단계에서 장축과 단축 모두 통계적으로 유의하게 큰값을 나타내었으며, 외부 자극이 가해지지 않은 수술중 단계에서는 장축과 단축의 길이 모두 작은 값을 나타내었다. 따라서 2차원의 위상공간에 매립된 수술중의 HRV 신호를 이용하여 자율신경계의 영향을 판단하여 마취심도를 구분 할 수 있었다.