Spectral entropy monitoring for adults and children undergoing general anaesthesia

Chhabra, Anjolie; Subramaniam, Rajeshwari; Srivastava, Anurag; Prabhakar, Hemanshu; Kalaivani, Mani; Paranjape, Saloni

doi:10.1002/14651858.cd010135.pub2

Cited by 33 publications

(23 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For example, using medications for neuromuscular block would lead to declines in the BIS in awake persons [ 14 ]. Concomitant monitoring with HR and MAP could be a convenient and effective alternative to the BIS, and it has been suggested that standard clinical monitoring may have effects similar to electrical monitoring in preventing the risk of awareness during surgery [ 15 16 ]. In this study, there were no significant changes in HR and MAP before or after PROM during MER.…”

Section: Discussionmentioning

confidence: 99%

Passive limb movement test facilitates subthalamic deep brain stimulation under general anesthesia without influencing awareness

et al. 2018

View full text Add to dashboard Cite

Objectives:We have shown that neuronal activity in the subthalamic nucleus (STN) in patients with Parkinson's disease can be accurately recorded during deep brain stimulation (DBS) with general anesthesia (GA). However, a vigorous passive range of motion (PROM) test might exert awakening effects on patients who are lightly anesthetized. We will explore the effects of PROM on the heart rate (HR) and mean arterial pressure (MAP) during microelectrode recording (MER) and confirm whether it facilitates identifying the sensory motor portion of the STN under GA.Materials and Methods:3T magnetic resonance image targeting of the STN was done to guide MER during frame-based stereotactic procedures for DBS. Regular induction and endotracheal intubation for GA were performed and then maintained with a volatile anesthetic agent and muscle relaxant only. The depth of anesthesia was monitored by the bispectral index (BIS).Results:A total of ten patients were enrolled in this study. Their mean age was 48.5 ± 10.8 years old with a disease duration 8.6 ± 2.4 years at the time of surgery. During MER, PROM significantly decreased recording tract numbers and still reached the STN at a recorded length at 5.5 ± 0.8 mm. Compared with baseline, PROM increased HR by a mean 0.5 beats/min and MAP by a mean 1.4 mmHg (P = 0.1178 and 0.0525). The change in BIS was −0.7 (P = 0.4941), and the mean alveolar concentration of the anesthetic agent changed little throughout surgery.Conclusions:PROM was effective in triggering and magnifying neuronal firing signal without influencing patient awareness during MER for STN-DBS under GA.

show abstract

Section: Discussionmentioning

confidence: 99%

Passive limb movement test facilitates subthalamic deep brain stimulation under general anesthesia without influencing awareness

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Thus, the EEG-based depth-of-anesthesia (DoA) monitors utilize a processed EEG signal and then translate it into simple numerical indices corresponding to the patient's level of consciousness during general anesthesia [3,4]. The Bispectral Index (BIS) was the first commercially available technique for monitoring the hypnotic level during anesthesia, exploiting a processed EEG-based BIS algorithm [5].…”

Section: Introductionmentioning

confidence: 99%

“…The Bispectral Index (BIS) was the first commercially available technique for monitoring the hypnotic level during anesthesia, exploiting a processed EEG-based BIS algorithm [5]. Assessment of the time-frequency balanced spectral entropy of the EEG is one of the techniques capable of monitoring the level of hypnosis during general anesthesia; it has been incorporated into the M-Entropy module (GE, Healthcare, Helsinki, Finland) [3,6].…”

Section: Introductionmentioning

confidence: 99%

Spectral Entropy Parameters during Rapid Ventricular Pacing for Transcatheter Aortic Valve Implantation

Musialowicz

Valtola

Hippeläinen

et al. 2017

Entropy

View full text Add to dashboard Cite

Abstract:The time-frequency balanced spectral entropy of the EEG is a monitoring technique measuring the level of hypnosis during general anesthesia. Two components of spectral entropy are calculated: state entropy (SE) and response entropy (RE). Transcatheter aortic valve implantation (TAVI) is a less invasive treatment for patients suffering from symptomatic aortic stenosis with contraindications for open heart surgery. The goal of hemodynamic management during the procedure is to achieve hemodynamic stability with exact blood pressure control and use of rapid ventricular pacing (RVP) that result in severe hypotension. The objective of this study was to examine how the spectral entropy values respond to RVP and other critical events during the TAVI procedure. Twenty one patients undergoing general anesthesia for TAVI were evaluated. The RVP was used twice during the procedure at a rate of 185 ± 9/min with durations of 16 ± 4 s (range 8-22 s) and 24 ± 6 s (range 18-39 s). The systolic blood pressure during RVP was under 50 ± 5 mmHg. Spectral entropy values SE were significantly declined during the RVP procedure, from 28 ± 13 to 23 ± 13 (p < 0.003) and from 29 ± 12 to 24 ± 10 (p < 0.001). The corresponding values for RE were 29 ± 13 vs. 24 ± 13 (p < 0.006) and 30 ± 12 vs. 25 ± 10 (p < 0.001). Both SE and RE values returned to the pre-RVP values after 1 min. Ultra-short hypotension during RVP changed the spectral entropy parameters, however these indices reverted rapidly to the same value before application of RVP.

show abstract

“…Entropy is a new, useful and popular DoA monitor, which displays a high degree of specificity and sensitivity in assessing the level of consciousness. [ 13 ] Entropy is considered to be more accurate and reliable to assess the hypnotic effects of anesthetic and sedative drugs. [ 14 ] Entropy filters EEG signals that are irregular, complex and unpredictable.…”

mentioning

confidence: 99%

“…Cochrane analysis of many studies, on the consumption of propofol, found that entropy guided drug administration was associated with lower propofol use, but the reduction was not clinically significant. [ 13 ]…”

mentioning

confidence: 99%

Depth of anesthesia monitoring in cardiac surgery—Standard of care soon?

Kapoor

2020

Ann Card Anaesth

View full text Add to dashboard Cite

Spectral entropy monitoring for adults and children undergoing general anaesthesia

Cited by 33 publications

References 53 publications

Passive limb movement test facilitates subthalamic deep brain stimulation under general anesthesia without influencing awareness

Passive limb movement test facilitates subthalamic deep brain stimulation under general anesthesia without influencing awareness

Spectral Entropy Parameters during Rapid Ventricular Pacing for Transcatheter Aortic Valve Implantation

Depth of anesthesia monitoring in cardiac surgery—Standard of care soon?

Contact Info

Product

Resources

About