Anaesthesia control system

• US 6,934,579 B2
• Filed: 10/09/2001
• Issued: 08/23/2005
• Est. Priority Date: 09/11/1996
• Status: Expired due to Fees

• Current Assignee: University Court of the University of Glasgow (University of Glasgow)
• Original Assignee: University Court of the University of Glasgow (University of Glasgow)
• Inventors: Kenny, Gavin N. C., Mantzaridis, Haralambos
• Primary Examiner(s): Winakur, Eric F.
• Assistant Examiner(s): FOREMAN, JONATHAN M
• Application Number:
  US09/973,568
• Publication Number:
  US 20020117176A1
• Time in Patent Office: 1,414 Days
• Field of Search: 600/544, 600/54.5, 128/203.13, 128/204.23
• US Class Current: 600/544
• CPC Class Codes: A61B 2505/05 Surgical care
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• CPC Class Codes: A61B 5/6814 Head
• CPC Class Codes: A61B 5/7239 using differentiation including higher order derivatives

Abstract

An anaesthesia control system and a method of calculating an index representative of the depth of anaesthesia is disclosed. The method comprises subjecting a patient to a repetitive audio stimulus and monitoring and auditory evoked potentials (AEP) produced by the patient and then recording these auditory evoked potentials using EEG recording means and providing a signal corresponding to the coarseness of the monitored AEP signal and using this signal as an index indicative of anaesthetic depth. The raw AEP signal is divided into a series of sweeps and each sweep is synchronized with the repetitive audio stimulus and sweeps are recorded in sequence to produce a time averaged sweep from which the anaesthetic index is calculated. The anaesthetic index is constantly updated by repeatedly conducting a successive series of sweeps. The system and index signal can be used as part of an anaesthesia control system for regulating the supply of anaesthetic to the patient to maintain the anaesthetic index at a predetermined level.

Claims

1. A method of calculating an index indicative of anaesthetic depth, the method comprising:

subjecting a patient to a repetitive audio stimulus;

monitoring auditory evoked potentials (AEP) produced by the patient;

providing a signal corresponding to the coarseness of the monitored AEP signal, the coarseness of the signal being a single measure increasing and decreasing with both amplitude and frequency of variations in the signal AEP signal; and

using said signal as said index indicative of anaesthetic depth.

2. A method as claimed in claim 1 wherein the monitored or raw AEP signal is divided into a series of sweeps or frames of a given duration, each sweep being synchronised with the repetitive audio stimulus.

3. A method as claimed in claim 2 wherein a number of sweeps n are recorded in sequence and are averaged to produce a time averaged sweep and for the time averaged sweep the anaesthesia index is calculated.

4. A method as claimed in claim 3 wherein each time a new series of sweeps is recorded, a new time averaged sweep is determined from the most recent n sweeps and the anaesthesia index for that time averaged sweep calculated.

5. A method as claimed in claim 4, wherein for a moving time averaged sweep this measure is a function of the sum of the square roots of the difference between every two adjacent sample points in the time averaged sweep.

6. A method as claimed in claim 2 wherein the raw AEP signal is sampled at regular intervals to produce a digitized AEP signal.

7. A method as claimed in claim 2 wherein an indication of coarseness is obtained by measuring the differences between neighboring sample points.

8. A method as claimed in claim 3 wherein the raw AEP signal is sampled at regular intervals to produce a digitized AEP signal.

9. A method as claimed in claim 3 wherein an indication of coarseness is obtained by measuring the differences between neighboring sample points.

10. A method as claimed in claim 3, wherein said index is calculated and used without reference to a measured amplitude of the time averaged sweep.

11. A method as claimed in claim 3, wherein said index is calculated and used without reference to a measured EEG power.

12. A method as claimed in claim 4 wherein the raw AEP signal is sampled at regular intervals to produce a digitized AEP signal.

13. A method as claimed in claim 4 wherein an indication of coarseness is obtained by measuring the differences between neighboring sample points.

14. A method as claimed in claim 1 wherein the raw AEP signal is sampled at regular intervals to produce a digitized AEP signal.

15. A method as claimed in claim 1 wherein an indication of coarseness is obtained by measuring the differences between neighboring sample points.

16. A method as claimed in claim 1, wherein said index is calculated and used without reference to a measured latency of any peak in the AEP signal.

17. A method as claimed in claim 1, wherein said index is calculated and used without relying on data measured previously for the same patient at a known depth of anaesthesia.

18. A method of maintaining closed-loop control of an anaesthesia depth, the method comprising supplying a dosage of anaesthetic to a patient, calculating an anaesthetic depth index according to claim 1, and using the value of the anaesthetic depth index to regulate the anaesthetic supply to maintain the anaesthesia depth index at or near a predetermined level.

19. A system for calculating an index of anaesthetic depth, the system comprising:

a signal generator for subjecting patient to a repetitive audio stimulus, electroencephalographic (EEG) recording means for coupling to said patient for recording auditory evoked potential (AEP) signal from the patient, and computer means for receiving said AEP signal, and for processing said AP signals and generating an index signal indicative of the coarseness of the recorded AEP signal, the coarseness of the signal being a single measure increasing and decreasing with both amplitude and frequency variations of the AEP signal, said index signal being representative of the depth of anaesthesia.

20. An anaesthetic supply control system including a system for calculating an index of anaesthetic depth for a patient as claimed in claim 19, including anaesthetic supply means and a regulator for receiving said input signal, said regulator having received a predetermined anaesthetic depth index and said regulator comparing said index signal and said predetermined signal and providing a control signal to said anaesthetic supply means for regulating the supply of anaesthetic to the patient to maintain the anaesthetic depth index at a predetermined level.

21. A system as claimed in claim 19, wherein said computer means is arranged to measure coarseness by reference to difference between neighboring samples of the AEP signal.

22. A system as claimed in claim 21 wherein said computer means is arranged to measure coarseness by summing the square roots of the differences between neighboring samples of the AEP signal.

23. A system as claimed in claim 19, wherein said index is calculated and used without reference to a measured latency of any peak in the AEP signal.

24. A system as claimed in claim 23, wherein said index is calculated and used without reference to a measured amplitude of the time averaged sweep.

25. A system as claimed in claim 24, wherein said index is calculated and used without separately measuring EEG power.

26. A system as claimed in claim 19, wherein said index is calculated an used without relying on data measured previously for the same patient at a known depth of anaesthesia.

27. A method of calculating an index indicative of anaesthetic depth, comprising:

subjecting a patient to a repetitive audio stimulus;

monitoring audio evoked potential (AEP) signals produced by the patient; and

providing a signal corresponding to the coarseness of the monitored AEP signal, and using said signal as an index indicative of anaesthetic depth, the coarseness of the signal being a measure of curvature in the AEP signal.

28. A method of calculating an index indicative of anaesthetic depth, comprising:

subjecting a patient to a repetitive audio stimulus;

monitoring audio evoked potential (AEP) signals produced by the patient; and

providing a signal corresponding to the coarseness of the monitored AEP signal, and using said signal as an index indicative of anaesthetic depth, the coarseness of the signal being obtained as a mathematical derivative with respect to time of the AEP signal.

29. A system for calculating an index of anaesthetic depth, the system comprising:

a signal generator for subjecting a patient to repetitive audio stimulus;

electroencephalographic (EEG) recording means for coupling to said patient for recording an auditory evoked potential (AEP) signal; and

a processor for processing successive AEP signals to generate and index signal by measuring the coarseness of the recorded AEP signal, the coarseness of the signal being obtained as a mathematical derivative with respect to time of the AEP signal, said index being indicative of the depth of anaesthesia of the patient.

30. A system for calculating an index of anaesthetic depth, the system comprising:

a signal generator for subjecting a patient to repetitive audio stimulus;

electroencephalographic (EEG) recording means for coupling to said patient for recording an auditory evoked potential (AEP) signal; and

a processor for processing successive AEP signals to generate and index signal by measuring the coarseness of the recorded AEP signal;

the coarseness of the signal being obtained by differentiating the AEP signal with respect to time, said index being indicative of the depth of anaesthesia of the patient.