Spectral Entropy Monitoring Reduces Anesthetic Dosage for Patients Undergoing Off-Pump Coronary Artery Bypass Graft Surgery

Journal of Cardiothoracic and Vascular Anesthesia, 04/19/2012

Jiahai M et al. – Entropy monitoring reduced propofol and sufentanil dosage for patients undergoing off–pump coronary artery bypass graft (OPCAB) surgery.

Methods

  • Seventy patients scheduled for OPCAB surgery were randomized to receive propofol-sufentanil anesthesia either with the entropy values visible (the entropy group, n=35) or without the entropy values visible (the control group, n=35).
  • In the entropy group, propofol and sufentanil infusion rates were titrated to maintain a state entropy (SE) value of 45 to 55 and a response entropy (RE)-SE difference below 10U.
  • In the control group, patients were anesthetized to keep the heart rate and blood pressure within 25% of the baseline values.

Results

  • The course of surgery, the consumption of anesthetics, and intraoperative recall were recorded.
  • Plasma levels of adrenocorticotropic hormone (ACTH) and cortisol were measured.
  • The average SE during anesthesia was 50±5 in the entropy group; the entropy values were lower in the control group (p<0.05).
  • Compared with the control group, propofol and sufentanil consumption were significantly less in the entropy group, which shortened the time to tracheal extubation (p<0.05).
  • Significantly, patients in the control group needed more phenylephrine to maintain arterial pressure than patients in the entropy group (p<0.05).
  • ACTH and cortisol release were prevented completely, and there was no intraoperative recall reported in the 2 groups.

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