System and method of assessing analgesic adequacy using biopotential variability
The system and method for predicting and measuring a subject's analgesic state and analgesic adequacy. Biopotential signals are obtained from a subject through electrodes. A processor will compute a measure that is representative of the subject's sedative state and/or muscle activity. A metric representative of such measures is then determined. In the case where a measure is taken of both the subject's sedative state and muscle activity the two measures are combined into an index representative of the subject's analgesic state and analgesic adequacy.
1. A system for assessing a subject's analgesic state and adequacy comprising:
a plurality of electrodes for obtaining biopotential signals from said subject at intervals over a period of time; and
a processor configured for:
computing from said biopotential signals a first measure representative of the subject's sedative state;
calculating a first metric representative of variability of said first measure;
computing from said biopotential signals a second measure representative of the subject's muscle activity;
calculating a second metric representative of variability of said second measure; and
calculating from said first and second metrics an index representative of the subject's analgesic state and analgesic adequacy.
2. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein said processor is further configured for assigning weights to at least one of said first and second metrics, and calculating an index from at least one of said first and second metrics based on said weights.
3. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein calculating the index comprises
combining said first metric and said second metric to calculate the index representative of said subject's analgesic state and analgesic adequacy.
4. The system for assessing a subject's analgesic state and adequacy of claim 3 , wherein said processor is further configured for assigning weights to said first metric and said second metric, and combining said first metric and said second metric into the index based on said weights.
5. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein said processor is further configured for time synchronizing said first measure and said second measure.
6. The system for assessing a subject's analgesic state and adequacy of claim 3 , wherein combining the first and second metrics includes combining the first and second metrics in a linear combination.
7. The system for assessing a subject's analgesic state and adequacy of claim 6 , wherein the linear combination is a logistic equation.
8. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the first metric representative of variability is based, at least in part, on standard deviation of the first measure, and the second metric representative of variability is based, at least in part, on standard deviation of the second measure.
9. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the processor is further configured for smoothing the index by averaging a plurality of index values.
10. The system for assessing a subject's analgesic state and adequacy of claim 1 further comprising a display, connected to the processor, for displaying the index representative of the subject's analgesic state and analgesic adequacy.
11. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the processor calculates a first alternate index representative of the subject's analgesic state and analgesic adequacy from the first metric representative of variability.
12. The system for assessing a subject's analgesic state and adequacy of claim 11 , wherein the processor calculates a second alternate index representative of the subject's analgesic state and analgesic adequacy from the second metric representative of variability.
13. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the first metric representative of variability is based, at least in part, on a first confidence interval associated with the first measure, and the second metric representative of variability is based, at least in part, on a second confidence interval associated with the second measure.
14. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the first metric representative of variability is based, at least in part, on a first threshold associated with the first measure, and the second metric representative of variability is based, at least in part, on a second threshold associated with the second measure.
15. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the first metric representative of variability is based, at least in part, on a first standard error associated with the first measure, and the second metric representative of variability is based, at least in part, on a second standard error associated with the second measure.
16. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the first metric representative of variability is based, at least in part, on a first range associated with the first measure, and the second metric representative of variability is based, at least in part, on a second range associated with the second measure.
17. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the intervals over a period of time comprise 15 second intervals.
18. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the processor is further configured for smoothing the index by assigning weights to each of a plurality of index values and by averaging the plurality of index values based at least in part on the weights.
19. The system for assessing a subject's analgesic state and adequacy of claim 1 , wherein the processor is further configured for determining from which of the first and second measures to determine the index.
20. The system for assessing a subject's analgesic state and adequacy of claim 19 , wherein the processor is further configured for determining from which of the first and second measures to determine the index based on the subject's EEG state.