Wrist actigraphy in anesthesia

Study Objectives: To examine the use of wrist actigraphy during and followi ng anesthesia or monitored sedation and its ability to objectively assess s leep-related events. Design: Uncontrolled study. Setting: 1100-bed tertiary care municipal, university-affiliated medical ce nter. 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 an esthesiologist's subjective observations. The anesthesiologist detected cha nges in the patient's activity with a delay of minutes after they had been picked zip ly the actigraph. The integrated areas of recorded phases of mid azolam-induced sedation and the occurrence and reversal of paradoxical reac tions were distinctly discernible as such, unlike the less specifically def ined description of the anesthesiologist. Conclusions: Real time actigraphic monitoring can provide clear-cut and obj ective indications of changes in the depth of anesthesia or sedation and it s associated events during surgery and recovery. (C) 2001 by Elsevier Scien ce Inc.