Multiscale rescaled range analysis of EEG recordings in sevoflurane anesthesia

ObjectiveThe Hurst exponent (HE) is a nonlinear method measuring the smoothness of a fractal time series. In this study we applied the HE index, extracted from electroencephalographic (EEG) recordings, as a measure of anesthetic drug effects on brain activity.MethodsIn 19 adult patients undergoing sevoflurane general anesthesia, we calculated the HE of the raw EEG; comparing the maximal overlap discrete wavelet transform (MODWT) with the traditional rescaled range (R/S) analysis techniques, and with a commercial index of depth of anesthesia – the response entropy (RE). We analyzed each wavelet-decomposed sub-band as well as the combined low frequency bands (HEOLFBs). The methods were compared in regard to pharmacokinetic/pharmacodynamic (PK/PD) modeling, and prediction probability.ResultsAll the low frequency band HE indices decreased when anesthesia deepened. However the HEOLFB was the best index because: it was less sensitive to artifacts, most closely tracked the exact point of loss of consciousness, showed a better prediction probability in separating the awake and unconscious states, and tracked sevoflurane concentration better – as estimated by the PK/PD models.ConclusionsThe HE is a useful measure for estimating the depth of anesthesia. It was noted that HEOLFB showed the best performance for tracking drug effect.SignificanceThe HEOLFB could be used as an index for accurately estimating the effect of anesthesia on brain activity.

► We have proposed a new index by combining of wavelet and rescaled range analysis. ► The modeling and prediction probability have been used to evaluate the proposed index. ► The proposed index can accurately track the anesthetic drug effect on brain activity.