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Evaluation of entropy for monitoring the depth of anesthesia compared with bispectral index: a multicenter clinical trial

Gao Jiandong ¹ Zhao Yujie ¹ Xu Chenshi ¹ Zhao Jing ² Huang Yuguang ² Wang Tianlong ³ Pei Ling ⁴ Wang Jian ⁴ Yao Linong ⁵ Ding Qian ⁵ Tan Zhiming ⁶ Zhu Zhirong ⁷ Yue Yun ¹ ^*

文摘	Background As a new electroencephalogram (EEG) signal processing technique for monitoring the depth of anesthesia, entropy consists of two indices: reaction entropy (RE) and state entropy (SE). Our study compared entropy with classical bispectral index (BIS) in reduction of myoelectrical interference and noxious stimuli with EEG signals. Methods Two hundred and eighty patients (ASA I–II, 18–60 years old) undergoing scheduled surgeries from seven medical centers were enrolled. Anesthesia induction was managed with propofol via the target-controlled infusion (TCI) system. The results of BIS, RE, SE, mean arterial pressure (MAP) and heart rate (HR) were recorded before anesthesia induction, at the moment of unconsciousness, before and 2 minutes after administration of muscle relaxant, and before and one and three minutes after the tracheal intubation. Results The values of half maximum effective concentrations (EC50), 5% effective concentrations (EC05) and 95% effective concentrations (EC95) of propofol effect-site concentration at the onset of unconsciousness were 1.2 (1.1–1.3 μg/ml), 2.5 (2.4–2.5 μg/ml) and 3.7 (3.7–3.8 μg/ml), while those of the predicted plasma propofol concentration were 2.8 (2.7–2.9 μg/ml), 3.9 (3.8–3.9 μg/ml) and 4.9 (4.8–5.0 μg/ml), respectively. The values of BIS, SE and RE were 62, 59 and 63 when 50% of patients lost consciousness, and 79, 80, 85 and 42, 37, 44, respectively, when 5% and 95% of patients were unconscious. The values of BIS, RE and SE dropped two minutes after the injection of muscle relaxant, but there were no significant differences between RE and SE. MAP and HR increased visibly, which indicated a reaction to tracheal intubation; the values of BIS, RE and SE, however, did not display any significant changes. Conclusions This large-sample multicentric study confirmed the values of RE and SE as approximating BIS value, at the onset of unconsciousness during propofol TCI anesthesia. After elimination of myoelectrical activation, all values of RE, SE and BIS decreased significantly and the three indices were less sensitive to noxious stimuli than cardiovascular responses.
来源	Chinese Medical Journal ,2012,125(8):1389-1392 【核心库】
DOI	10.3760/cma.j.issn.0366-6999.2012.08.005
关键词	propofol ; target-controlled infusion ; unconsciousness ; bispectral index ; entropy ; dose-response relationship
地址	1. Department of Anesthesiology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020 2. Department of Anesthesiology, Chinese Academy of Medical Sciences and Peking Union Medical College Hospital, Beijing, 100730 3. Department of Anesthesiology, Xuanwu Hospital, Capital Medical University, Beijing, 100053 4. Department of Anesthesiology, First Affiliated Hospital of China Medical University, Liaoning, Shenyang, 110001 5. Department of Anesthesiology, Tangdu Hospital, Fourth Military Medical University, Shaanxi, Xi’an, 710038 6. Department of Anesthesiology, Shanghai Cancer Hospital, Fudan University, Shanghai, 200032 7. Department of Anesthesiology, Guangzhou Cancer Institute and Hospital, Guangzhou Medical University, Guangdong, Guangzhou, 510080
语种	英文
文献类型	研究性论文
ISSN	0366-6999
学科	外科学
文献收藏号	CSCD:4498353

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1 中华医学会麻醉学分会全凭静脉麻醉专家共识工作小组全凭静脉麻醉专家共识中华麻醉学杂志,2016,36(6):641-649
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