Monitoring the depth of anesthesia using entropy features and an artificial neural network

J Neurosci Methods. 2013 Aug 15;218(1):17-24. doi: 10.1016/j.jneumeth.2013.03.008. Epub 2013 Apr 6.


Monitoring the depth of anesthesia using an electroencephalogram (EEG) is a major ongoing challenge for anesthetists. The EEG is a recording of brain electrical activity, and it contains valuable information related to the different physiological states of the brain. This study proposes a novel automated method consisting of two steps for assessing anesthesia depth. Initially, the sample entropy and permutation entropy features were extracted from the EEG signal. Because EEG-derived parameters represent different aspects of the EEG features, it would be reasonable to use multiple parameters to assess the effect of the anesthetic. The sample entropy and permutation entropy features quantified the amount of complexity or irregularity in the EEG data and were conceptually simple, computationally efficient and artifact-resistant. Next, the extracted features were used as input for an artificial neural network, which was a data processing system based on the structure of a biological nervous system. The experimental results indicated that an overall accuracy of 88% could be obtained during sevoflurane anesthesia in 17 patients to classify the EEG data into awake, light, general and deep anesthetized states. In addition, this method yielded a classification accuracy of 92.4% to distinguish between awake and general anesthesia in an independent database of propofol and desflurane anesthesia in 129 patients. Considering the high accuracy of this method, a new EEG monitoring system could be developed to assist the anesthesiologist in estimating the depth of anesthesia in a rapid and accurate manner.

Keywords: Artificial neural network; Electroencephalogram (EEG); Monitoring the depth of anesthesia; Permutation entropy; Sample Entropy.

MeSH terms

  • Adolescent
  • Adult
  • Anesthetics, Inhalation / pharmacology*
  • Brain / drug effects*
  • Brain / physiology*
  • Electroencephalography / drug effects
  • Entropy*
  • Female
  • Humans
  • Intraoperative Neurophysiological Monitoring / methods*
  • Male
  • Methyl Ethers / pharmacology
  • Middle Aged
  • Neural Networks, Computer*
  • Sevoflurane
  • Young Adult


  • Anesthetics, Inhalation
  • Methyl Ethers
  • Sevoflurane