Phase lag entropy as a hypnotic depth indicator during propofol sedation

Ki, Seunghee; Kim, K. M.; Lee, Y. H.; Bang, Ji‐Yeon; Choi, Byung‐Moon; Noh, Gyu Jeong

doi:10.1111/anae.14704

Cited by 14 publications

(20 citation statements)

References 32 publications

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“…In Lee et al's study [4] that compared recently used anesthetic depth monitors, the PLE value exhibited the highest agreement with the level of consciousness (using the modified OAA/S score) relative to other monitors such as the BIS, relative beta ratio (RBR), approximate entropy (ApEn), and permutation entropy (PeEn) values. Recently, clinical studies have been reported for PLEM™ during propofol-induced sedation [18][19][20]. Jung et al [20] reported that PLEM™ was comparable with BIS™ in correlational studies using the OAA/S score during propofol-induced sedation (Spearman's Rho: 0.755 for PLE, 0.788 for BIS).…”

Section: Discussionmentioning

confidence: 98%

“…Jung et al [20] reported that PLEM™ was comparable with BIS™ in correlational studies using the OAA/S score during propofol-induced sedation (Spearman's Rho: 0.755 for PLE, 0.788 for BIS). Ki et al [18] also reported the pharmacodynamic modeling for each OAA/S score using PLE values from the PLEM™ (Ce 50 value: 1.67 μg/ ml, 1.96 μg/ml, 2.22 μg/ml, and 2.69 μg/ml for OAA/S scores of ≤4, ≤3, ≤2, and ≤ 1, respectively). Therefore, based on the above study results, the PLEM™ may be used for monitoring anesthetic depth during propofol anesthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Phase lag entropy (PLE) is an EEG-based anesthetic depth indicator that calculates diversity in temporal patterns of the phase relationship in the brain [4,10]. The recently developed PLE monitor (PLEM™, Inbody Co., Ltd., Republic of Korea), which measures the PLE value, is a four-channel EEG anesthetic depth monitoring device [4,[18][19][20].…”

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confidence: 99%

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Monitoring of anesthetic depth and EEG band power using phase lag entropy during propofol anesthesia

et al. 2020

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Background: Phase lag entropy (PLE) is a novel anesthetic depth indicator that uses four-channel electroencephalography (EEG) to measure the temporal pattern diversity in the phase relationship of frequency signals in the brain. The purpose of the study was to evaluate the anesthetic depth monitoring using PLE and to evaluate the correlation between PLE and bispectral index (BIS) values during propofol anesthesia.Methods: In thirty-five adult patients undergoing elective surgery, anesthesia was induced with propofol using target-controlled infusion (the Schneider model). We recorded the PLE value, raw EEG, BIS value, and hemodynamic data when the target effect-site concentration (Ce) of propofol reached 2, 3, 4, 5, and 6 μg/ml before intubation and 6, 5, 4, 3, 2 μg/ml after intubation and injection of muscle relaxant. We analyzed whether PLE and raw EEG data from the PLE monitor reflected the anesthetic depth as the Ce of propofol changed, and whether PLE values were comparable to BIS values.Results: PLE values were inversely correlated to changes in propofol Ce (propofol Ce from 0 to 6.0 μg/ml, r 2 = − 0.83; propofol Ce from 6.0 to 2.0 μg/ml, r 2 = − 0.46). In the spectral analysis of EEG acquired from the PLE monitor, the persistence spectrogram revealed a wide distribution of power at loss of consciousness (LOC) and recovery of consciousness (ROC), with a narrow distribution during unconsciousness. The power spectrogram showed the typical pattern seen in propofol anesthesia with slow alpha frequency band oscillation. The PLE value demonstrated a strong correlation with the BIS value during the change in propofol Ce from 0 to 6.0 μg/ml (r 2 = 0.84). PLE and BIS values were similar at LOC (62.3 vs. 61.8) (P > 0.05), but PLE values were smaller than BIS values at ROC (64.4 vs 75.7) (P < 0.05). Conclusions: The PLE value is a useful anesthetic depth indicator, similar to the BIS value, during propofol anesthesia. Spectral analysis of EEG acquired from the PLE monitor demonstrated the typical patterns seen in propofol anesthesia. Trial registration: This clinical trial was retrospectively registered at ClinicalTrials.gov at October 2017 (NCT03299621).

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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Monitoring of anesthetic depth and EEG band power using phase lag entropy during propofol anesthesia

et al. 2020

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“…Therefore, we fixed the interindividual random variabilities at zero. This naïve pooled data approach has been used in previous studies . Thirdly, the types and progress of surgery were not identical among the patients and, therefore, a slight difference would occur in the dexmedetomidine Ce for each sedation levels and as the surgeries progressed.…”

Section: Discussionmentioning

confidence: 99%

“…This naïve pooled data approach has been used in previous studies. [22][23][24] Thirdly, the types and progress of surgery were not identical among the patients and, therefore, a slight difference would occur in the dexmedetomidine Ce for each sedation levels and as the surgeries progressed. Finally, we did not evaluate patient recovery from dexmedetomidine sedation.…”

Section: Discussionmentioning

confidence: 99%

Target‐controlled infusion of dexmedetomidine effect‐site concentration for sedation in patients undergoing spinal anaesthesia

et al. 2019

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What is known and objective Dexmedetomidine has been a preferred sedative for patients undergoing regional anaesthesia and is mostly administered via conventional zero‐order infusion. Recently, a pharmacokinetic‐pharmacodynamic (PKPD) model of dexmedetomidine has been published, but no external validation has been reported in clinical trials. We aimed to administer target‐controlled infusion (TCI) of dexmedetomidine at the effect‐site concentration (Ce) to patients undergoing spinal anaesthesia and investigate the relationship between dexmedetomidine Ce and the sedative effects. Methods Forty‐five patients scheduled for orthopaedic surgery received spinal anaesthesia with 0.5% bupivacaine. After confirmation of sensory block level, we initiated effect‐site TCI of dexmedetomidine using Colin's model and assessed sedation levels using the Modified Observer's Assessment of Alertness/Sedation (MOAA/S) scale and bispectral index (BIS) with each stepwise increase in the dexmedetomidine Ce. We used a non‐linear mixed‐effects model to determine the PD relationships between the dexmedetomidine Ce and sedation level. Results The dexmedetomidine Ce associated with 50% probability (Ce50) of the MOAA/S scale ≤4, 3 and 2 was 0.57, 0.89 and 1.19 ng/mL, respectively. Mean dexmedetomidine Ce when BIS decreased ≤70 was 0.99 ± 0.15 ng/mL. As dexmedetomidine Ce increased, the MOAA/S scale decreased significantly (correlation coefficient [r] = −.832, P < .0001). BIS decreased significantly with increasing dexmedetomidine Ce (r = −.811, P < .0001) and decreasing MOAA/S scale (r = .838, P < .0001). The most common side effects were hypertension (26.67%) and bradycardia (20%). What is new and conclusion We applied effect‐site TCI of dexmedetomidine in patients undergoing spinal anaesthesia for the first time. Dexmedetomidine Ce correlated significantly with MOAA/S scale and BIS, and was 0.89 and 1.19 ng/mL for moderate and deep sedation, respectively.

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Do epoch lengths of hypnotic depth indicators affect estimated of blood-brain equilibration rate constants of propofol?

Kim

Park

Kang

et al. 2021

J Pharmacokinet Pharmacodyn

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Phase lag entropy as a hypnotic depth indicator during propofol sedation

Cited by 14 publications

References 32 publications

Monitoring of anesthetic depth and EEG band power using phase lag entropy during propofol anesthesia

Monitoring of anesthetic depth and EEG band power using phase lag entropy during propofol anesthesia

Target‐controlled infusion of dexmedetomidine effect‐site concentration for sedation in patients undergoing spinal anaesthesia

Do epoch lengths of hypnotic depth indicators affect estimated of blood-brain equilibration rate constants of propofol?

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