Mirra, A., Hight, D., Kovacevic, A. et al. 2023. Sedline® miscalculation of depth of anaesthesia variables in two pigs due to electrocardiographic signal contamination. Animals 13(17), 2699.

Two young (11-week-old) pigs underwent sole propofol anaesthesia as part of an experimental study. The depth of anaesthesia was evaluated both clinically and using the electroencephalography(EEG)-based monitor Sedline; in particular, the patient state index, suppression ratio, raw EEG traces, and its spectrogram were assessed. Physiological parameters and electrocardiographic activity were continuously monitored. In one pig (Case 1), during the administration of high doses of propofol, the Sedline-generated variables suddenly indicated an increased EEG activity while this was not confirmed by observation of either the raw EEG or its spectrogram. In the second pig (Case 2), a similar event was recorded during euthanasia with systemic pentobarbital. Both events happened while the EEG activity was isoelectric except for signal interferences and synchronous in rhythm and shape with the electrocardiographic activity. The suggestion of increased brain activity based on the interpretation of the Sedline variables was suspected wrong; most probably due to electrocardiographic interferences. In pigs, the patient state index and suppression ratio, as calculated by the Sedline monitor, could be influenced by the electrocardiographic activity contaminating the EEG trace, especially during otherwise isoelectric periods (strong EEG depression). Visual interpretation of the raw EEG and of the spectrogram remains necessary to identify such artefacts.