Wrist actigraphy in anesthesia.

ABSTRACT

STUDY OBJECTIVES: To examine the use of wrist actigraphy during and following anesthesia or monitored sedation and its ability to objectively assess sleep-related events. DESIGN: Uncontrolled study. SETTING: 1100-bed tertiary care municipal, university-affiliated medical center. PATIENTS AND INTERVENTIONS: 18 patients who underwent minor to medium lower-body surgical procedures with spinal or epidural anesthesia with sedation by propofol, midazolam, or isoflurane-based general anesthesia. MEASUREMENTS AND MAIN RESULTS: Wrist actigraphy was measured and evaluated. The actigraphic recordings accurately indicated the presence and time of occurrence of all relevant perioperative events including those related to anesthesia. Actigraphic data were more precise than equivalent attending anesthesiologist's subjective observations. The anesthesiologist detected changes in the patient's activity with a delay of minutes after they had been picked up by the actigraph. The integrated areas of recorded phases of midazolam-induced sedation and the occurrence and reversal of paradoxical reactions were distinctly discernible as such, unlike the less specifically defined description of the anesthesiologist. CONCLUSIONS: Real time actigraphic monitoring can provide clear-cut and objective indications of changes in the depth of anesthesia or sedation and its associated events during surgery and recovery.