Spurious electroencephalographic activity due to pulsation artifact in the depth of anesthesia monitor

Kotoe Kamata, Tarmo Lipping, Arvi Yli-Hankala, Ville Jäntti, Masanori Yamauchi

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)


Background: The depth of anesthesia (DOA) is estimated based on the anesthesia-induced electroencephalogram (EEG) changes. However, the surgical environment, as well as the patient him/herself, generates electrical interferences that cause EEG waveform distortion. Case presentation: A 52-year-old patient required general anesthesia due to the right femur necrotizing fasciitis. He had no history of epilepsy or head injury. His cardiovascular status was stable without arrhythmia under propofol and remifentanil anesthesia. The DOA was evaluated with Root® with SedLine® Brain Function Monitoring (Masimo Inc, Irvine, CA). The EEG showed a rhythmic, heart rate time-locked pulsation artifact, which diminished after electrode repositioning. Offline analysis revealed that the pulse wave-like interference in EEG was observed at the heart rate frequency. Conclusions: We experienced an anesthesia case that involves a pulsation artifact generated by the superficial temporal artery contaminating the EEG signal. Numerous clinical conditions, including pulsation artifact, disturb anesthesia EEG.

Original languageEnglish
Article number35
JournalJA Clinical Reports
Issue number1
Publication statusPublished - 2021 Dec


  • Artifact
  • Depth of anesthesia
  • Electroencephalogram
  • Intraoperative
  • Monitoring
  • Pulse wave


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