The narcotrend™ monitor and the electroencephalogram in propofol-induced sedation

Alfred W. Doenicke, Johann Kugler, Eberhard Kochs, Jeus Rau, Haraed Mückter, Rainer Hoernecke, Peter Conzen, Harry Bromber, Gerhard Schneider

Research output: Contribution to journalArticlepeer-review

6 Scopus citations

Abstract

BACKGROUND: The Narcotrend™ (NCT) is a one-channel electroencephalogram (EEG) monitor of the level of sedation. It is based on a visual EEG scoring system, which was developed by Loomis and modified by Kugler, to yield a visual expert classification (VEC) scheme for differentiation of six levels of sedation (A-F), which are subdivided into 16 substages. We designed the present study to test whether results of the automated classification of one-channel NCT input reflect those from VEC of five-channel EEG. METHODS: Twelve healthy male volunteers received propofol using two different infusion regimens in a randomized, crossover design with concomitant NCT monitoring and VEC. Scoring results of NCT were compared with those of VEC. RESULTS: During the infusion period, score differences of more than three substages were observed in 14 of 24 (= 58%) propofol administrations (4%-7% of total data). Often, the NCT indicated lighter sedation than VEC, which revealed more δ activity from nonfrontal leads. During recovery, NCT reported deeper sedation than VEC in 6 of 24 (= 25%) propofol administrations. Discordant trends (periods of at least five subsequent epochs with monotonic, but opposite trends for both NCT and VEC) were noted in 9 of 24 propofol administrations (37%). Furthermore, NCT had several periods when no staging information was displayed, varying from a few seconds to 10 min. CONCLUSIONS: As the algorithm of NCT is proprietary and not accessible to the public, reasons for the observed differences between NCT and VEC cannot be analyzed and explanations must remain speculative.

Original languageEnglish
Pages (from-to)982-992
Number of pages11
JournalAnesthesia and Analgesia
Volume105
Issue number4
DOIs
StatePublished - Oct 2007
Externally publishedYes

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