Spectral entropy as a monitor of depth of propofol induced sedation.
Kowalski, Robert G
Fitzgerald, Anthony P
Lynch, Elaine M
Boylan, Geraldine B
Shorten, George D
AffiliationDepartment of Anaesthesia and Intensive Care Medicine, Cork University Hospital, , University College Cork, Cork, Ireland. firstname.lastname@example.org
Anesthetics, Intravenous/administration & dosage
Dose-Response Relationship, Drug
Predictive Value of Tests
Propofol/*administration & dosage
Weights and Measures
MetadataShow full item record
CitationJ Clin Monit Comput. 2008 Apr;22(2):87-93. Epub 2008 Feb 6.
JournalJournal of clinical monitoring and computing
AbstractOBJECTIVE: The aim of this prospective, observational study was to evaluate State and Response entropy (Entropy(TM) Monitor, GE Healthcare, Finland), indices as measures of moderate ("conscious") sedation in healthy adult patients receiving a low dose propofol infusion. Sedation was evaluated using: (I) the responsiveness component of the OAA/S scale (Observer's Assessment of Alertness/Sedation scale) and (II) multi-channel electroencephalogram (EEG) interpretation by a clinical expert. METHODS: 12 ASA I patients were recruited. A target-controlled infusion of propofol was administered (using Schnider's pharmacokinetic model) with an initial effect site concentration set to 0.5 microg ml(-1). A 4 minute equilibrium period was allowed. This concentration was increased at 4 minute intervals by 0.5 microg ml(-1) to a maximum of 2.0 microg ml(-1). State (SE) and Response (RE), entropy values were recorded for each 4 minute epoch together with clinical sedation scores (OAA/S) and continuous multi-channel EEG. The multi-channel EEG recorded during the final minute of each 4 minute epoch or "patient/time unit" was presented to a neurophysiologist who assigned a label "sedated/not sedated". SE/RE values were compared in patient/time units with clinical or EEG evidence of sedation versus those without. RESULTS: Mean SE and RE values were less in patient/time units when clinical evidence of sedation was present, [mean = 86.8 (95% CI, 84.0-88.3) and 94.3 (95%CI, 92-96.1)], P = 0.002 and P = 0.001, respectively. In patient/time units assigned the label "sedated" by the clinical neurophysiologist assessing the multi-channel EEG, SE and RE values were less [mean = 87.5 (95% CI, 86.3-88.4) and 95.0 (95% CI, 93.8-96.1)] P = 0.001 and P < 0.001, respectively. CONCLUSIONS: A statistically significant decrease in SE and RE values was demonstrated in patient/time units in which clinical or EEG evidence of sedation was present. We conclude that spectral entropy offers potential as a monitor of propofol induced sedation.
- Behaviour of spectral entropy, spectral edge frequency 90%, and alpha and beta power parameters during low-dose propofol infusion.
- Authors: Mahon P, Greene BR, Greene C, Boylan GB, Shorten GD
- Issue date: 2008 Aug
- Comparative evaluation of the Datex-Ohmeda S/5 Entropy Module and the Bispectral Index monitor during propofol-remifentanil anesthesia.
- Authors: Schmidt GN, Bischoff P, Standl T, Hellstern A, Teuber O, Schulte Esch J
- Issue date: 2004 Dec
- The use of bispectral analysis in patients undergoing intravenous sedation for third molar extractions.
- Authors: Sandler NA, Sparks BS
- Issue date: 2000 Apr
- Assessment of recovery in patients undergoing intravenous conscious sedation using bispectral analysis.
- Authors: Sandler NA, Hodges J, Sabino M
- Issue date: 2001 Jun
- [Correlation between the Narcotrend index, the cerebral state index and the predicted effect site concentration during different state of consciousness in elderly patients with target controlled infusion of propofol].
- Authors: Liu SH, Cheng ZG, Wang YJ, Wang NR, Bai NY, Guo QL
- Issue date: 2009 Sep 8