Does Spectral Entropy Reflect the Response to Intubation or Incision During Propofol-Remifentanil Anesthesia?

Abstract

Entropy predicted a motor response to noxious stimulations but not a hemodynamic response, which limits its usefulness for assessing the analgesic component of anesthesia in paralyzed patients. High values (RE >55) before the stimulation should be avoided in order to decrease the risk of motor response, but lower values might not prevent this response when the opioid concentration is insufficient, despite an adequate hypnosis.

A controlled thermoalgesic stimulation device to identify novel pain perception biomarkers

“…Here, we found that both left-hemisphere EEG and right-hemisphere EEG have the best discrimination of the painful stimulus in the Beta and Theta band, and then in the Alpha and Gamma bands, as seen elsewhere [41], [42], [46]. EEG responses in the two hemispheres at frequencies around 28 Hz were seen to discriminate the painful state, in agreement with a previous assessment of the adequacy of analgesia in which such oscillations were shown to participate in discriminating painful events [47].…”

Clinical effectiveness and cost-effectiveness of depth of anaesthesia monitoring (E-Entropy, Bispectral Index and Narcotrend): a systematic review and economic evaluation

“…38 Doctor and colleagues 119 asked respondents to respond using standard gamble (SG), visual analogue scale (VAS), and time trade-off (TTO) techniques, the last of which is recommended as an alternative. 38 Freed and colleagues 126 used the Short Form questionnaire-36 items (SF-36) responses from a previous study 127 and converted these to preference weighted health scores (PWHSs) using the formula developed by Brazier and colleagues. Both studies included the results of statistical models generated in order to identify predictors for worsening or improvement of utility scores.…”

Effect of landiolol on bispectral index and spectral entropy responses to tracheal intubation during propofol anaesthesia

“…RE2SE reflects the motor response to noxious stimulation. 20 Facial muscles are more resistant than other skeletal muscles to neuromuscular block, 18 21 22 and noxious stimulation increases RE before recovery from paralysis. 9 The dose at which neuromuscular block paralyses the facial muscles, however, can diminish the RE2SE response to noxious stimuli.…”

“…Non-invasive arterial pressure and heart rate (HR) were recorded every minute from the beginning of propofol infusion. BIS, RE, and SE were recorded before anaesthesia induction, just before tracheal intubation, and after tracheal intubation (10,20,30,40,50,60,120, and 180 s after tracheal intubation). The study protocol is summarized in Figure 1.…”