Spectral entropy as a monitor of depth of propofol induced sedation.
Objective: 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:...
| Publicado en: | Journal of Clinical Monitoring & Computing Vol. 22; no. 2; pp. 87 - 94 |
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| Autores principales: | , , , , , , , , , , , , , |
| Formato: | clinical trial research Journal Article |
| Publicado: |
Springer Nature
Apr2008
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=105808639&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 105808639 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13871307 OHC jtl: Journal of Clinical Monitoring & Computing issn: 13871307 maglogo: N pubinfo: dt: Apr2008 vid: 22 iid: 2 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 105808639 32620283 NLM18253846 2009891471 10.1007/s10877-008-9109-0 NLM18253846 105808639 ppf: 87 ppct: 7 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Spectral entropy as a monitor of depth of propofol induced sedation. aug: au: Mahon P Kowalski RG Fitzgerald AP Lynch EM Boylan GB McNamara B Shorten GD Mahon, Padraig Kowalski, Robert G Fitzgerald, Anthony P Lynch, Elaine M Boylan, Geraldine B McNamara, Brian Shorten, George D affil: Department of Anaesthesia and Intensive Care Medicine, Cork University Hospital, University College Cork, Cork, Ireland sug: subj: Conscious Sedation Methods Consciousness Drug Effects Intraoperative Monitoring Methods Propofol Administration and Dosage Adult Anesthetics, Intravenous Administration and Dosage Clinical Trials Cognition Drug Effects Dose-Response Relationship, Drug Drug Monitoring Methods Electroencephalography Infusions, Intravenous Judgment Drug Effects Middle Age Neurophysiology Physics Predictive Value of Tests Weights and Measures Human Adult: 19-44 years Middle Aged: 45-64 years ab: Objective: 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. pubtype: Academic Journal doctype: clinical trial research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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