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Bispectral index and electroencephalographic entropy in patients undergoing aortocoronary bypass grafting

Published online by Cambridge University Press:  01 September 2007

A. Lehmann ,
M. Schmidt ,
C. Zeitler ,
A.-H. Kiessling ,
F. Isgro  and
J. Boldt
A. Lehmann*
Affiliation:
Klinikum der Stadt Ludwigshafen, Department of *Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
M. Schmidt
Affiliation:
Klinikum der Stadt Ludwigshafen, Department of *Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
C. Zeitler
Affiliation:
Klinikum der Stadt Ludwigshafen, Department of *Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
A.-H. Kiessling
Affiliation:
Klinikum der Stadt Ludwigshafen, Department of †Cardiac Surgery, Ludwigshafen, Germany
F. Isgro
Affiliation:
Klinikum der Stadt Ludwigshafen, Department of †Cardiac Surgery, Ludwigshafen, Germany
J. Boldt
Affiliation:
Klinikum der Stadt Ludwigshafen, Department of *Anaesthesiology and Intensive Care Medicine, Ludwigshafen, Germany
*
Correspondence to: Dr Andreas Lehmann, Department of Anaesthesiology and Intensive Care Medicine, Klinikum der Stadt Ludwigshafen, Postfach 21 73 52, D-67073 Ludwigshafen, Germany. E-mail: lehmanna@klilu.de; Tel: +49 621 503 3000; Fax: +49 621 503 3024
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Summary

Background and objective

This study was conducted to compare bispectral index, state entropy and response entropy in patients undergoing coronary artery bypass grafting.

Methods

In 66 patients, anaesthesia was maintained at two different levels using bispectral index. Doses of sufentanil and midazolam were adjusted to achieve a bispectral index in the range of 45–55 in 33 patients (BIS 50 group) and 35–44 in another 33 patients (BIS 40 group). Simultaneously, state entropy and response entropy were recorded.

Results

The targeted values of bispectral index were achieved in both groups and the bispectral index values differed significantly during whole anaesthesia. Median response entropy and state entropy fell to 19–26 during anaesthesia in both groups. Response entropy and state entropy values in the two groups differed significantly only after induction of anaesthesia and did not differ during further anaesthesia. There was no explicit intraoperative recall in both groups. Patients in Group BIS 40 received significantly (P < 0.05) more sufentanil than the BIS 50 group (704 ± 181 μg vs. 490 ± 107 μg, respectively) and midazolam (18.5 ± 6.1 mg vs. 15.6 ± 3.8 mg, respectively). After cardiopulmonary bypass, significantly (P < 0.05) more patients in Group BIS40 needed inotropic support with dobutamine (79%) than in the BIS50 group (52%). Time to extubation did not differ between the two groups.

Conclusion

In patients undergoing coronary artery bypass grafting, no relationship was found between bispectral index levels and state entropy and response entropy at two different stages of a sufentanil–midazolam anaesthesia. A bispectral index level of 45–55 reduced anaesthetic medications used and the need for inotropic support.

Keywords

ELECTROENCEPHALOGRAPHY, bispectral index, entropySURGERY CARDIACCORONARY ARTERY GRAFTING
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 9 , September 2007 , pp. 751 - 760
Copyright
Copyright © European Society of Anaesthesiology 2007

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