Impact of Entropy Monitoring on Volatile Anesthetic Uptake

Hor, Tarek El; Linden, Philippe Van der; Hert, Stefan De; Mélot, Christian; Bidgoli, Javad

doi:10.1097/aln.0b013e3182850c36

Cited by 25 publications

(17 citation statements)

References 18 publications

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“…Utilizing electroencephalography-based monitors, such as entropy, to judge the depth of general anesthesia and the level of hypnosis during surgery results in reduced sevoflurane consumption [ 11 , 12 ]. Previous studies used an automated closed circuit loop to deliver sevoflurane and state entropy to monitor the depth of anesthesia.…”

Section: Discussionmentioning

confidence: 99%

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study

Kannan

Surhonne

et al. 2018

Korean J Anesthesiol

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BackgroundBilateral superficial cervical plexus block (BSCPB) provides good postoperative analgesia, but its effect on anesthetic consumption is unknown. This study evaluated the effects of BSCPB on sevoflurane consumption during thyroid surgery.MethodsFifty patients were randomly allocated into groups A and B of 25 each in this prospective double-blind study. Group A received BSCPB with 20 ml 0.25% bupivacaine, whereas group B received 20 ml saline immediately before entropy-guided general anesthesia. Intraoperative hemodynamic parameters, end-tidal sevoflurane concentration, minimum alveolar concentration, and sevoflurane consumption were recorded. Postoperative pain was assessed using a visual analog scale, and the time of the first request for analgesia was noted. All side effects were recorded.ResultsDemographics were comparable. Mean sevoflurane consumption [for 30 min: group A = 7.2 (1.1) ml, group B = 8.8 (2.0) ml, P = 0.001; for 60 min: group A = 13.5 (1.7) ml, group B = 16.5 (3.9) ml, P = 0.002] and mean end-tidal sevoflurane concentration [for 30 min: group A = 1.2% (0.2%), group B = 1.4% (0.2%), P = 0.008; for 60 min: group A = 1.2% (0.1%), group B = 1.4% (0.2%), P = 0.010] were significantly lower in group A. Patients in group A had a longer duration of analgesia [361.6 (79.5) min vs. 151.0 (60.2) min, P < 0.001] compared to those in group B.ConclusionsPreinduction BSCPB during thyroid surgery significantly reduced sevoflurane consumption and increased the duration of postoperative analgesia.

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Section: Discussionmentioning

confidence: 99%

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study

Kannan

Surhonne

et al. 2018

Korean J Anesthesiol

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“…[46]. A similar study was developed by El Hor et al, reporting an increase in Sevoflurane consumption in the case of patients that could not benefit from advanced monitoring of the degree of hypnosis vs. patients for which Entropy monitoring was applied (5.2 ± 1.4 mL/h vs. 3.8 ± 1.5 mL/h, P < 0.05) [108]. Regarding hemodynamic stability the researchers found statistically significant differences between the groups: 10 hypertension episodes were reported in the control group vs. 7 hypertension episode in the target group, while for hypotension the ratio was 3 (control group) vs. 0 in the target group (p<0.05).…”

Section: The Impact On Drug Consumption and Recoverymentioning

confidence: 57%

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

Rogobete¹,

Bedreag²,

Păpurică³

et al. 2020

Preprint

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Worldwide, an increasing number of patients undergo complex surgeries. With the development of general anesthesia techniques and anesthetic substances, the most complex surgical techniques could be developed. In order to adapt the anesthesia according to the particularities of each patient, it is recommended the multimodal monitoring of these patients. Classically, general anesthesia monitoring consists of the analysis of vital functions and gas exchange. Multimodal monitoring refers to the concomitant monitoring of the degree of hypnosis and the nociceptive-antinociceptive balance. By titrating anesthetic drugs according to these parameters, clinical benefits can be obtained, such as hemodynamic stabilization, reduction of awakening times, reduction of post-operative complications. Also, there is an important impact on the status of inflammation and the redox balance. The purpose of this literature review is to present the most modern multimodal monitoring techniques, respectively to discuss the particularities of each technique.

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“…They have reported decreased Sevoflurane consumption in the group where general anesthesia has been optimized by using the entropy (5.2 ± 1.4 mL/h vs. 3.8 ± 1.5 mL/h, p = 0.0012). For the same group they have reported improved hemodynamic stability, with a decrease in the hypotension incidence (p = 0.03) [42].…”

Section: Discussionmentioning

confidence: 77%

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

Dinu¹,

Rogobete²,

Popovici³

et al. 2020

Preprint

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Study background and aims: Laparoscopic cholecystectomy is one of the most frequently performed interventions in departments of general surgery. One of the most important aims in achieving perioperative stability of these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact monitoring the depth of anesthesia through Entropy (state entropy – SE and response entropy -RE) has on the hemodynamic stability and on the doses of volatile anesthetic. Material and Methods: This is a prospective, observational, randomized, monocentric study carried out between January 2019 and December 2019 in the Clinic of Anesthesia and Intensive Care from the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups; patients in Group A (target group) received multimodal monitoring that included monitoring of standard parameters and of Entropy (SE and RE), while patients in Group B (control group) only received standard monitoring. Anesthetic dose in group A were optimized to achieve a target entropy of 40-60. Results: 68 patients met the inclusion criteria and were allocated to one of the two study groups, Group A (N=43) and Group B (N=25). There were no statistically significant differences identified between the two groups for both demographical and clinical data (p>0.05). Statistically significant differences have been identified for the number of hypotensive episodes (p = 0.011, 95% CI 0.1851 to 0.7042) and for the number of episodes of bradycardia (p < 0.0001, 95% CI 0.3296 to 0.7923). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI -0.3942 to 0.9047). Conclusions: The implementation of the multimodal monitoring protocol that includes the standard parameters and the measurement of Entropy for determining the depth of anesthesia (SE and RE) lead to a considerable improvement in perioperative hemodynamic stability. Optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient leads to a considerable decrease in drug consumption as well as to a lower incidence of hemodynamic side-effects.

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Impact of Entropy Monitoring on Volatile Anesthetic Uptake

Abstract: Monitoring the depth of anesthesia using M-Entropy was associated with a significant reduction in sevoflurane uptake.

Cited by 25 publications

References 18 publications

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study

Effects of bilateral superficial cervical plexus block on sevoflurane consumption during thyroid surgery under entropy-guided general anesthesia: a prospective randomized study

Multiparametric Monitoring of Hypnosis and Nociception-Antinociception Balance During General Anesthesia - A New Era in Patient Safety Standards and Healthcare Management

Impact of General Anaesthesia - Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients. A Prospective Observational Randomized Monocentric Study

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