US 2018/0000409 A1Published application

Apparatus for the Assessment of the Level of Pain and Nociception During General Anesthesia Using Electroencephalogram, Plethysmographic Impedance Cardiography, Heart Rate Variability and the Concentration or Biophase of the Analgesics

AssigneeQuantium Medical S.L.

InventorsErik Weber Jensen, Luis Pedro Gambús

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Abstract

Means and methods for measuring pain and adapted for calculating the level of nociception during general anesthesia or sedation from data including electroencephalogram (EEG), facial electromyogram (EMG), heart rate variability (HRV) by electrocardiogram (ECG) and plethysmography by impedance cardiography (ICG). In a preferred embodiment of this invention the parameters derived from the EEG, the HRV, the plethysmographic curve and the analgetics concentrations are either combined into one index on a scale from 0 to 100, where a high number is associated with high probability of response to noxious stimuli, while a decreasing index is associated with decreasing probability of response to noxious stimuli. Zero (0) indicates extremely low probability of response to noxious stimuli. In an alternative embodiment, only features from the EEG and ECG will be used or only features from EEG, ECG and ICG, to define the fmal index.

Claims20

Dependent claims

An apparatus equipped with means for estimating pain and nociception while awake, during general anesthesia or sedation from data including electroencephalogram (EEG), facial electromyogram (EMG), heart rate variability (HRV) by electrocardiogram (ECG) and plethysmography by impedance cardiography (ICG), the apparatus comprising the following features:

(a) means for obtaining a signal containing EEG and facial EMG, said mean adapted for recording from a subjects scalp with three electrodes positioned at middle forehead, left (right) forehead and the left (right) cheek;
(b) means for obtaining a three leads ECG signal and adaptations for calculating the R-R interval and the HRV from said ECG signal;
(c) means for obtaining an ICG signal with four electrodes positioned at the chest of the patient;
(d) means for obtaining the plethysmographic from the ICG;
(e) adaptation for calculating the Fast Fourier Transform (FFT) and the Choi-Williams distributions for about 1-60 seconds of the EEG signal;
(f) adaptations for calculating the frequency spectrum in about 1-10 seconds EMG signal;
(g) adaptations for calculating the spectral edge frequency of the spectrum of the R-R interval of the ECG over about 2-6 minutes;
(h) adaptations for calculating the Hilbert transform of the 1CG signal from which the number of peaks over a certain threshold in the 1st derivative of the Hilbert phase, is estimated;
(i) means adapted for combining the extracted EEG, EMG, EGG, and ICG data into a final index of nociception represented by a scale from 0 to 99, where a value of 99 represents a high probability of response to light noxious stimuli and a value of close or equal to 0 corresponds to a total block of afferent noxious stimuli, for example obtained by local anesthetic drugs.

6 more elements

A method for estimating pain and for calculating the level of nociception while awake, during general anesthesia or sedation from data including electroencephalogram (EEG), facial electromyogram (EMG), heart rate variability (HRV) by electrocardiogram (ECG) and plethysmography by impedance cardiography (ICG), the method comprising the steps of:

(a) obtaining a signal recording containing EEG and facial EMG from a subjects scalp with three electrodes positioned at middle forehead, left (right) forehead and the left (right) cheek;
(b) obtaining a three leads ECG signal and calculating the R-R interval and the HRV from said ECG signal;
(c) obtaining an ICG signal with four electrodes positioned at the chest of the patient;
(d) obtaining the plethysmographic from the ICG;
(e) calculating the Fast Fourier Transform (EFT) and the Choi-Williams distributions for about 1-60 seconds of the EEG signal;
(f) calculating the frequency spectrum in a 1-10 seconds EMG signal;
(g) calculating the spectral edge frequency of the spectrum of the R-R interval of the ECG over about 2-6 minutes;
(h) calculating the Hilbert transform of the ICG signal from which the number of peaks over a certain threshold in the 1st derivative of the Hilbert phase is estimated;
(i) combining the extracted EEG, EMG, ECG, and ICG data into a final index of nociception represented by a scale from 0 to 99, where a value of 99 represents a high probability of response to light noxious stimuli and a value of close or equal to 0 corresponds to a total block of afferent noxious stimuli, for example obtained by local anesthetic drugs.

6 more elements

Dependencies are inferred from the claim text.