The Influence of frontal muscle electromyography on electroencephalography-based depth of anaesthesia monitoring (Pehmeäkantinen kirja)

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During the last 15 years, monitoring the hypnotic component of general anaesthesia has become routine in clinical practise. Several commercially available methods have been introduced for this purpose. These monitors are based on either spontaneous electroencephalogram (EEG) or mid-latency auditory-evoked potentials (MLAEP). These monitors have been reported to decrease the incidence of intraoperative awareness, to reduce the amount of anaesthetic drugs given to the patient, and to reduce recovery time after anaesthesia.

The most widely used of these monitors is the Bispectral Index Scale (BIS). Another EEG-based depth of anaesthesia monitor is Entropy. The EEG analysed by these depth of anaesthesia monitors is collected from the forehead of the patient, therefore, rendering the methods vulnerable to confounding factors. One obvious confounding factor is the electromyographic (EMG) arousal caused by the frontal muscles. Also, different types of EEG arousal can produce changes in the numerical values of the depth of anaesthesia monitors without a change in the actual depth of anaesthesia, making the interpretation of depth of anaesthesia monitors very challenging for the anaesthesiologist. The aim of this doctoral thesis was to study the effect of EMG and EEG arousal on the numerical values of BIS and Entropy, and to investigate if an anaesthesiologist is able to detect EMG arousal visually on the anaesthesia monitor.
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