Functional near-infrared spectroscopy as a monitor for depth of anesthesia

• US 8,798,701 B2
• Filed: 09/30/2009
• Issued: 08/05/2014
• Est. Priority Date: 09/30/2008
• Status: Active Grant

• Current Assignee: Drexel University
• Original Assignee: Drexel University, Philadelphia Health Education Corporation
• Inventors: Izzetoglu, Kurtulus, Onaral, Banu, Izzetoglu, Meltem Alkan, Pourrezaei, Kambiz, Horrow, Jay Charles, Bunce, Scott C.
• Primary Examiner(s): WINAKUR, ERIC FRANK
• Application Number:
  US12/571,145
• Publication Number:
  US 20100081903A1
• Time in Patent Office: 1,770 Days
• Field of Search: 600/310, 600/322, 600/323, 128/204.23
• US Class Current: 600/323
• CPC Class Codes: A61B 2562/0233 Special features of optical sensors or probes classified in A61B5/00
• CPC Class Codes: A61B 2562/046 in a matrix array
• CPC Class Codes: A61B 5/14552 Details of sensors specially adapted therefor
• CPC Class Codes: A61B 5/14553 specially adapted for cerebral tissue
• CPC Class Codes: A61B 5/4821 Determining level or depth of anaesthesia A61B5/1106 takes precedence
• CPC Class Codes: A61B 5/7203 for noise prevention, reduction or removal

Abstract

Disclosed are methods and devices for measuring a state of anesthesia in a noninvasive manner. Optical techniques may be used to measure changes in a functional near-infrared (fNIR) signal, where the fNIR signal is received in response to directing wavelengths of light in a near-infrared range on a patient. The optical density change may be used to obtain a change in deoxyhemoglobin (deoxy-Hb) concentration and/or a change in an oxyhemoglobin concentration (oxy-Hb). The changes in the deoxy-Hb and/or the oxy-Hb may then be compared to determine a state of anesthesia.

The effect of artifacts (e.g., strong surgery room lighting, patient-table tilting, patient intubation/extubation) on the fNIR signal may be removed using a noise removal algorithm. In selecting the noise removal algorithm, a switching technique may be used to select the component analysis algorithm, such as a principal component analysis (PCA), an independent component analysis (ICA), or the like.

Claims

1. A method comprising:

receiving a near-infrared signal in response to directing wavelengths of light in a near-infrared range on a patient;

determining, from the near-infrared signal, a relative deoxyhemoglobin concentration and oxyhemoglobin concentration;

analyzing the percentage of the deoxyhemoglobin concentration to determine a corresponding state of anesthesia; and

administering an amount of anesthetic according to the corresponding state of anesthesia.

2. The method of claim 1, wherein the near-infrared signal is indicative of a change in the light at each of the wavelengths.

3. The method of claim 2, wherein the change in the light at each of the wavelengths is due to at least one of reflection or an absorption of the light by tissue of the patient.

4. The method of claim 2, further comprising measuring the change in the light at each of the wavelengths.

5. The method of claim 4, wherein the change measured in the light is at least one of an optical density change or a light intensity change.

6. The method of claim 1, further comprising determining a total hemoglobin volume.

7. The method of claim 1, wherein the percentage of the deoxyhemoglobin concentration is a ratio of the deoxyhemoglobin concentration to at least one of the oxyhemoglobin concentration, a baseline deoxyhemoglobin concentration, or a total hemoglobin volume.

8. The method of claim 1, wherein the analyzing comprises relating a change in the percentage of deoxyhemoglobin to a changing level of cortical activity.

9. The method of claim 1, wherein the analyzing comprises relating a decrease in the percentage of deoxyhemoglobin to a level of increased cortical activity.

10. The method of claim 1, wherein the analyzing comprises relating a change in the percentage of deoxyhemoglobin to a changing state of anesthesia.

11. The method of claim 1, further comprising measuring a rate of change in the percentage of deoxyhemoglobin by comparing the change in the light at each of the wavelengths at different times.

12. The method of claim 11, wherein the analyzing comprises relating the rate of change to a state of anesthesia.

13. The method of claim 12, wherein the analyzing comprises relating a slow rate of change in the deoxyhemoglobin to a deep state of anesthesia.

14. The method of claim 12, wherein the analyzing comprises relating the rate of change to a changing state of anesthesia.

15. The method of claim 11, wherein the change in the light at each of the wavelengths is measured at a sample rate of 2 Hz.

16. The method of claim 1, wherein the corresponding the state of anesthesia comprises at least one of a deep state, a light state, or an emergence from anesthesia.

17. The method of claim 1, wherein the analyzing comprises relating a decrease in the percentage of deoxyhemoglobin to an emergence from anesthesia.

18. The method of claim 17, wherein the emergence from anesthesia is not identifiable from visual observation of the patient.

19. The method of claim 1, wherein a baseline near-infrared signal is obtained prior to an administration of anesthesia indicative of a baseline deoxyhemoglobin percentage.

20. The method of claim 19, wherein determining the state of anesthesia comprises comparing the percentage of deoxyhemoglobin to the baseline deoxyhemoglobin percentage.

21. The method of claim 19, where the baseline near-infrared signal is obtained about 20 seconds before the administration of anesthesia.

22. The method of claim 19, wherein the baseline near-infrared signal is indicative of the baseline deoxyhemoglobin percentage is obtained on a patient-by-patient basis.

23. The method of claim 1, wherein the change in the light is measured in accordance with Beer-Lambert law.

24. The method of claim 1, wherein the wavelengths comprise two wavelengths of light, each in a range between 700 nm and 900 nm.

25. The method of claim 1, wherein a first wavelength is substantially absorbed by deoxyhemoglobin and a second wavelength is substantially absorbed by oxyhemoglobin.

26. The method of claim 25, wherein the first wavelength is 730 nm and the second wavelength is 850 nm.

27. The method of claim 1, further comprising directing the wavelengths of light in the near-infrared range on the patient.

28. The method of claim 27, wherein the near-infrared light is directed at a prefrontal cortex of the patient.

29. The method of claim 27, wherein the near-infrared light is directed to pass through human tissue.

30. The method of claim 27, wherein the wavelengths of light are directed on the patient after an administration of anesthesia.

31. The method of claim 1, wherein the amount of anesthetic to be administered is determined from the percentage of deoxyhemoglobin.

32. The method of claim 1, further comprising subtracting an effect of non-cortical signals on the near-infrared signal.

33. The method of claim 1, wherein the percentage of deoxyhemoglobin is measured in real-time.

34. The method of claim 1, further comprising comparing the percentage of deoxyhemoblogin concentration to a neuromarker that indicates a percentage of deoxyhemoglobin that corresponds to a level of cortical activity.

35. The method of claim 34, further comprising relating the level of cortical activity to at least one of the state of anesthesia, a transition between states of anesthesia, or a risk level that corresponds to an emergence from anesthesia.

36. A near-infrared device for determining a state of anesthesia, the device comprising:

a light detector for receiving a near-infrared signal indicative of a change in light in response to directing wavelengths of light on a patient; and

a processor for determining, from the near-infrared signal, a relative deoxyhemoglobin concentration and oxyhemoglobin concentration, and analyzing the percentage of the deoxyhemoglobin concentration to determine a corresponding state of anesthesia.

37. The device of claim 36, wherein the device comprises a flexible portion having the light detector affixed thereto.

38. The device of claim 37, wherein the flexible portion comprises a disposable material for attaching the flexible portion to the patient.

39. The device of claim 37, wherein the flexible portion is adapted for adapting to contours of a patient'"'"'s head for maintaining the light detector in an orientation orthogonal to a surface of the patient'"'"'s head.

40. The device of claim 37, wherein the flexible portion comprises a reusable circuit board for housing the light detector.

41. The device of claim 36, further comprising a light source for directing wavelengths of light in a near-infrared range.

42. The device of claim 41, wherein the light source has a peak wavelength of at least one of 730 nm, 805 nm, or 850 nm.

43. The device of claim 41, wherein the device comprises a flexible portion having the light source affixed thereto.

44. The device of claim 36, further comprising a data acquisition board for switching between a plurality of light sources.

45. The device of claim 36, further comprising a data acquisition board for switching between a plurality of light detectors.

46. The device of claim 36, wherein the deoxyhemoglobin concentration is relative to a baseline near-infrared signal recorded prior to an administration of an anesthetic.

47. The device of claim 46, wherein the processor executes computer-executable instructions for determining the deoxyhemoglobin concentration relative to the baseline, and analyzing the percentage of the deoxyhemoglobin concentration to determine the state of anesthesia.

48. The device of claim 36,

wherein the light detector captures a non-cortical signal, the non-cortical signal indicative of an artifact,

wherein the processor implements a switch algorithm to select between a principal component analysis (PCA) and an independent component analysis (ICA) noise removal algorithm to remove an effect of the artifact from the near-infrared signal by subtracting a portion of the non-cortical signal from the near-infrared signal.