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Background <p>Propofol anesthesia is widely used for gastrointestinal (GI) endoscopy, but electroencephalographic (EEG) features of anesthetic state transitions in this brief and stimulus-rich setting remain incompletely characterized. This study aimed to describe clinically interpretable EEG markers across anesthetic stages using portable polysomnography (PSG)-derived six-channel EEG.</p> Methods <p>In this prospective observational study, 31 adults undergoing GI endoscopy under propofol-based anesthesia underwent continuous portable PSG recording. EEG analyses focused on six scalp channels (F3, F4, C3, C4, O1, and O2) across four clinically defined stages: baseline, induction, maintenance, and recovery. Relative spectral power, spectral edge frequency at 95% cumulative power (SEF95), and spindle-like event metrics were quantified. Sensor-level functional connectivity was assessed using weighted phase-lag index, imaginary coherence, and amplitude envelope correlation (AEC). Spectral and spindle-like event measures were analyzed using linear mixed-effects models, and connectivity differences were assessed using permutation-based paired tests with false discovery rate correction.</p> Results <p>Relative delta power decreased from baseline and induction to maintenance and recovery, whereas theta, alpha, sigma, and beta relative power and SEF95 generally increased. Spindle-like event density differed across stages and was highest during recovery, while mean duration and peak frequency remained relatively stable within the 11–16&#xa0;Hz range. Functional connectivity showed metric-specific modulation: AEC demonstrated the most widespread stage-related differences, whereas phase-based connectivity measures showed only limited edge-specific changes after correction for multiple comparisons.</p> Conclusions <p>Portable PSG-derived six-channel EEG captured stage-related spectral, spindle-like event, and sensor-level connectivity changes during propofol anesthesia for GI endoscopy. These findings identify candidate EEG features for future evaluation of emergence detection and atypical anesthetic-state identification during procedural anesthesia. Their utility for real-time propofol titration or excessive-sedation warning requires prospective validation.</p>

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Portable polysomnography-derived multi-domain EEG markers of anesthetic state transitions during propofol anesthesia for gastrointestinal endoscopy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月25日

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  • Huimin Li,
  • Yibo Zhao,
  • Yanan Zhang,
  • Aiyue Pei,
  • Fudong Li,
  • Yaru Wang,
  • Lijia Cai,
  • Zan Wang

摘要

Background

Propofol anesthesia is widely used for gastrointestinal (GI) endoscopy, but electroencephalographic (EEG) features of anesthetic state transitions in this brief and stimulus-rich setting remain incompletely characterized. This study aimed to describe clinically interpretable EEG markers across anesthetic stages using portable polysomnography (PSG)-derived six-channel EEG.

Methods

In this prospective observational study, 31 adults undergoing GI endoscopy under propofol-based anesthesia underwent continuous portable PSG recording. EEG analyses focused on six scalp channels (F3, F4, C3, C4, O1, and O2) across four clinically defined stages: baseline, induction, maintenance, and recovery. Relative spectral power, spectral edge frequency at 95% cumulative power (SEF95), and spindle-like event metrics were quantified. Sensor-level functional connectivity was assessed using weighted phase-lag index, imaginary coherence, and amplitude envelope correlation (AEC). Spectral and spindle-like event measures were analyzed using linear mixed-effects models, and connectivity differences were assessed using permutation-based paired tests with false discovery rate correction.

Results

Relative delta power decreased from baseline and induction to maintenance and recovery, whereas theta, alpha, sigma, and beta relative power and SEF95 generally increased. Spindle-like event density differed across stages and was highest during recovery, while mean duration and peak frequency remained relatively stable within the 11–16 Hz range. Functional connectivity showed metric-specific modulation: AEC demonstrated the most widespread stage-related differences, whereas phase-based connectivity measures showed only limited edge-specific changes after correction for multiple comparisons.

Conclusions

Portable PSG-derived six-channel EEG captured stage-related spectral, spindle-like event, and sensor-level connectivity changes during propofol anesthesia for GI endoscopy. These findings identify candidate EEG features for future evaluation of emergence detection and atypical anesthetic-state identification during procedural anesthesia. Their utility for real-time propofol titration or excessive-sedation warning requires prospective validation.