The effect of spectral entropy monitoring on propofol use and recovery in children

Lee, Ji Yeon; Choi, So Ron; Chung, Chan Jong; Lee, Ji Hyeon; Park, Ji Hye; Baik, Chang Yeoul

Abstract

BACKGROUND
The evaluation of anesthetic depth using electroencephalography showed reduction in recovery time from anesthesia and decrease in the amount of anesthesia used. This research compared the dosage of propofol and the recovery characteristics when anesthesia was controlled using spectral entropy monitoring and when it was controlled by hemodynamic changes.
METHODS
Seventy children of the American Society of Anesthesiologists physical class I-II, ages 3-10, that were scheduled for general anesthesia were randomly distributed into two groups. The children were sedated with midazolam (0.15 mg/kg), and anesthesia was induced with fentanyl (2.0 microg/kg), propofol (2.5 mg/kg), and rocuronium (0.6 mg/kg). Anesthesia was maintained with propofol continuous IV infusion under N2O in O2. For the Entropy Group, the state entropy (SE) was maintained at 40-60, and for the Standard Group, anesthesia was maintained so that the heart rate and systolic blood pressure were at 20% of the standard value.
RESULTS
Last 10 minutes of the surgery, the SE and RE (Response entropy) were significantly higher for the Entropy Group when compared to the Standard Group (P < 0.05). The maintenance dose of propofol was significantly lower for the Entropy Group when compared to the Standard Group (P < 0.05). The times taken for recovery were all significantly shorter for the Entropy Group than the Standard Group (P < 0.05).
CONCLUSIONS
Entropy guided anesthetic administration was associated with reduced propofol use and faster recovery in children compared to standard practice.