Nociception event identification based on a relative change in a nociception parameter
In some examples, a patient monitoring system includes processing circuitry configured to detect an occurrence of a nociception event of a patient during a medical procedure. The processing circuitry may, for example, determine, based at least in part on a nociception parameter of the patient in an interrogation window, a nociception parameter level, determine, based at least in part on the nociception parameter of the patient in a baseline window that corresponds to the interrogation window, a baseline nociception parameter level, determine a difference in nociception parameter levels between the baseline nociception parameter level and the nociception parameter level, detect, based at least in part on the difference in nociception parameter levels, an occurrence of a nociception event, and in response to detecting the occurrence of the nociception event, provide an indication to adjust an amount of analgesic administered to the patient.
1 . A system comprising:
memory configured to store a threshold rate of change of a nociception parameter; and
processing circuitry communicably coupled to the memory and configured to:
monitor the nociception parameter of a patient during a medical procedure comprising administration of analgesic to the patient;
provide a continuous measure of the nociception parameter over time during the medical procedure;
determine a rate of change of the nociception parameter and compare the rate of change to the threshold rate of change;
determine a change in the nociception parameter based on the rate of change crossing the threshold rate of change;
identify a region of interest in the nociception parameter based on the determined change;
detect an occurrence of a nociception event in the region of interest; and
in response to detecting the occurrence of the nociception event, provide an indication to adjust an amount of the analgesic administered to the patient.
2 . The system of claim 1 , wherein the threshold rate of change comprises a threshold rate of increase, and wherein the change in the nociception parameter comprises the rate of change exceeding the threshold rate of increase.
3 . The system of claim 1 , wherein the processing circuitry is further configured to:
establish an interrogation window within the region of interest,
determine a maximum nociception parameter value within the interrogation window, and
detect the occurrence of the nociception event based on the maximum nociception parameter value.
4 . The system of claim 3 , wherein the processing circuitry is further configured to establish a baseline value of the nociception parameter over a baseline window, wherein:
the baseline window has a first duration;
the interrogation window has a second duration; and
the baseline window precedes the interrogation window.
5 . The system of claim 3 , wherein the region of interest comprises a leading edge of the determined change in the nociception parameter.
6 . The system of claim 1 , further comprising a user interface, wherein the processing circuitry is further configured to:
output, via the user interface, an indication of the region of interest in the nociception parameter.
7 . The system of claim 5 , wherein the leading edge comprises the leading edge of a rise in the nociception parameter.
8 . The system of claim 5 , wherein the leading edge comprises the leading edge of a dip in the nociception parameter.
9 . The system of claim 7 , wherein the region of interest encompasses a period of time from the rise in the nociception parameter from an initial value of the nociception parameter until a return to the initial value.
10 . The system of claim 8 , wherein the region of interest encompasses a period of time from the dip in the nociception parameter from an initial value of the nociception parameter until a return to the initial value.
11 . A method comprising:
monitoring, by processing circuitry, a nociception parameter of a patient during a medical procedure comprising administration of an analgesic to the patient;
providing a continuous measure of the nociception parameter over time during the medical procedure;
determining a rate of change of the nociception parameter and comparing the rate of change to a threshold rate of change of the nociception parameter;
determining, by the processing circuitry, a change in the nociception parameter based on the rate of change crossing the threshold rate of change;
identifying a region of interest in the nociception parameter based on the determined change;
detecting, by the processing circuitry, an occurrence of a nociception event in the region of interest; and
in response to detecting the occurrence of the nociception event, providing, by the processing circuitry, an indication to adjust an amount of the analgesic administered to the patient.
12 . The method of claim 11 , wherein identifying the region of interest comprises identifying a leading edge of the change in the nociception parameter.
13 . The method of claim 11 , further comprising establishing a baseline value of the nociception parameter in a baseline window preceding the region of interest, and wherein detecting the occurrence of the nociception event comprises comparing the nociception parameter in the region of interest to the baseline value.
14 . The method of claim 11 , further comprising adjusting, by the processing circuitry, the amount of the analgesic administered to the patient.