Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia

Anne Vakkuri (Corresponding Author), Arvi Yli-Hankala, Rolf Sandin, Seppo Mustola, Siv Høymork, Stina Nyblom, Pia Talja, Timothy Sampson, Mark van Gils, Hanna Viertiö-Oja

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Abstract

This multicenter study evaluated the effect of a new depth of anesthesia-monitoring device based on time-frequency-balanced spectral entropy of electroencephalogram monitoring (GE Healthcare Finland, Helsinki, Finland) on consumption of anesthetic drugs and recovery times after anesthesia.

METHODS:

The study was a prospective, randomized, single-blind study performed in six hospitals in Finland, Sweden, and Norway. After institutional review board approval and written informed consent from each patient, the patients were randomly allocated to anesthesia with entropy values either shown (entropy group) or not shown (control group). Anesthesia was maintained with propofol, nitrous oxide, and alfentanil. In the entropy group, propofol was given to keep the state entropy value between 45 and 65, and alfentanil was given to keep the state entropy-response entropy difference below 10 units and heart rate and blood pressure within +/-20% of the baseline values. The control group patients were anesthetized to keep heart rate and blood pressure within +/-20% of the baseline values. Statistical methods included Mann-Whitney U test and unpaired t tests.

RESULTS:

A total of 368 patients were studied. In the entropy group, entropy values were higher during the whole operation and especially during the last 15 min (P < 0.001). Consequently, propofol consumption was smaller in the entropy group during the whole anesthesia period (P < 0.001) and especially during the last 15 min (P < 0.001). This shortened the time delay in the early recovery parameters in the entropy group.

CONCLUSION:

Entropy monitoring assisted titration of propofol, especially during the last part of the procedures, as indicated by higher entropy values, decreased consumption of propofol, and shorter recovery times in the entropy group.

Original languageEnglish
Pages (from-to)274-279
JournalAnesthesiology
Volume103
Issue number2
Publication statusPublished - 2005
MoE publication typeA1 Journal article-refereed

Fingerprint

Alfentanil
Nitrous Oxide
Entropy
Propofol
Anesthesia
Finland
Heart Rate
Blood Pressure
Single-Blind Method
Control Groups
Research Ethics Committees
Norway
Nonparametric Statistics
Informed Consent
Sweden

Cite this

Vakkuri, A., Yli-Hankala, A., Sandin, R., Mustola, S., Høymork, S., Nyblom, S., ... Viertiö-Oja, H. (2005). Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia. Anesthesiology, 103(2), 274-279.
Vakkuri, Anne ; Yli-Hankala, Arvi ; Sandin, Rolf ; Mustola, Seppo ; Høymork, Siv ; Nyblom, Stina ; Talja, Pia ; Sampson, Timothy ; van Gils, Mark ; Viertiö-Oja, Hanna. / Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia. In: Anesthesiology. 2005 ; Vol. 103, No. 2. pp. 274-279.
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title = "Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia",
abstract = "This multicenter study evaluated the effect of a new depth of anesthesia-monitoring device based on time-frequency-balanced spectral entropy of electroencephalogram monitoring (GE Healthcare Finland, Helsinki, Finland) on consumption of anesthetic drugs and recovery times after anesthesia.METHODS: The study was a prospective, randomized, single-blind study performed in six hospitals in Finland, Sweden, and Norway. After institutional review board approval and written informed consent from each patient, the patients were randomly allocated to anesthesia with entropy values either shown (entropy group) or not shown (control group). Anesthesia was maintained with propofol, nitrous oxide, and alfentanil. In the entropy group, propofol was given to keep the state entropy value between 45 and 65, and alfentanil was given to keep the state entropy-response entropy difference below 10 units and heart rate and blood pressure within +/-20{\%} of the baseline values. The control group patients were anesthetized to keep heart rate and blood pressure within +/-20{\%} of the baseline values. Statistical methods included Mann-Whitney U test and unpaired t tests.RESULTS: A total of 368 patients were studied. In the entropy group, entropy values were higher during the whole operation and especially during the last 15 min (P < 0.001). Consequently, propofol consumption was smaller in the entropy group during the whole anesthesia period (P < 0.001) and especially during the last 15 min (P < 0.001). This shortened the time delay in the early recovery parameters in the entropy group.CONCLUSION: Entropy monitoring assisted titration of propofol, especially during the last part of the procedures, as indicated by higher entropy values, decreased consumption of propofol, and shorter recovery times in the entropy group.",
author = "Anne Vakkuri and Arvi Yli-Hankala and Rolf Sandin and Seppo Mustola and Siv H{\o}ymork and Stina Nyblom and Pia Talja and Timothy Sampson and {van Gils}, Mark and Hanna Vierti{\"o}-Oja",
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journal = "Anesthesiology",
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Vakkuri, A, Yli-Hankala, A, Sandin, R, Mustola, S, Høymork, S, Nyblom, S, Talja, P, Sampson, T, van Gils, M & Viertiö-Oja, H 2005, 'Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia', Anesthesiology, vol. 103, no. 2, pp. 274-279.

Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia. / Vakkuri, Anne (Corresponding Author); Yli-Hankala, Arvi; Sandin, Rolf; Mustola, Seppo; Høymork, Siv; Nyblom, Stina; Talja, Pia; Sampson, Timothy; van Gils, Mark; Viertiö-Oja, Hanna.

In: Anesthesiology, Vol. 103, No. 2, 2005, p. 274-279.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Spectral entropy monitoring is associated with reduced propofol use and faster emergence in propofol-nitrous oxide-alfentanil anesthesia

AU - Vakkuri, Anne

AU - Yli-Hankala, Arvi

AU - Sandin, Rolf

AU - Mustola, Seppo

AU - Høymork, Siv

AU - Nyblom, Stina

AU - Talja, Pia

AU - Sampson, Timothy

AU - van Gils, Mark

AU - Viertiö-Oja, Hanna

PY - 2005

Y1 - 2005

N2 - This multicenter study evaluated the effect of a new depth of anesthesia-monitoring device based on time-frequency-balanced spectral entropy of electroencephalogram monitoring (GE Healthcare Finland, Helsinki, Finland) on consumption of anesthetic drugs and recovery times after anesthesia.METHODS: The study was a prospective, randomized, single-blind study performed in six hospitals in Finland, Sweden, and Norway. After institutional review board approval and written informed consent from each patient, the patients were randomly allocated to anesthesia with entropy values either shown (entropy group) or not shown (control group). Anesthesia was maintained with propofol, nitrous oxide, and alfentanil. In the entropy group, propofol was given to keep the state entropy value between 45 and 65, and alfentanil was given to keep the state entropy-response entropy difference below 10 units and heart rate and blood pressure within +/-20% of the baseline values. The control group patients were anesthetized to keep heart rate and blood pressure within +/-20% of the baseline values. Statistical methods included Mann-Whitney U test and unpaired t tests.RESULTS: A total of 368 patients were studied. In the entropy group, entropy values were higher during the whole operation and especially during the last 15 min (P < 0.001). Consequently, propofol consumption was smaller in the entropy group during the whole anesthesia period (P < 0.001) and especially during the last 15 min (P < 0.001). This shortened the time delay in the early recovery parameters in the entropy group.CONCLUSION: Entropy monitoring assisted titration of propofol, especially during the last part of the procedures, as indicated by higher entropy values, decreased consumption of propofol, and shorter recovery times in the entropy group.

AB - This multicenter study evaluated the effect of a new depth of anesthesia-monitoring device based on time-frequency-balanced spectral entropy of electroencephalogram monitoring (GE Healthcare Finland, Helsinki, Finland) on consumption of anesthetic drugs and recovery times after anesthesia.METHODS: The study was a prospective, randomized, single-blind study performed in six hospitals in Finland, Sweden, and Norway. After institutional review board approval and written informed consent from each patient, the patients were randomly allocated to anesthesia with entropy values either shown (entropy group) or not shown (control group). Anesthesia was maintained with propofol, nitrous oxide, and alfentanil. In the entropy group, propofol was given to keep the state entropy value between 45 and 65, and alfentanil was given to keep the state entropy-response entropy difference below 10 units and heart rate and blood pressure within +/-20% of the baseline values. The control group patients were anesthetized to keep heart rate and blood pressure within +/-20% of the baseline values. Statistical methods included Mann-Whitney U test and unpaired t tests.RESULTS: A total of 368 patients were studied. In the entropy group, entropy values were higher during the whole operation and especially during the last 15 min (P < 0.001). Consequently, propofol consumption was smaller in the entropy group during the whole anesthesia period (P < 0.001) and especially during the last 15 min (P < 0.001). This shortened the time delay in the early recovery parameters in the entropy group.CONCLUSION: Entropy monitoring assisted titration of propofol, especially during the last part of the procedures, as indicated by higher entropy values, decreased consumption of propofol, and shorter recovery times in the entropy group.

M3 - Article

VL - 103

SP - 274

EP - 279

JO - Anesthesiology

JF - Anesthesiology

SN - 0003-3022

IS - 2

ER -