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Monitoring with EEG entropy decreases propofol requirement and maintains cardiovascular stability during induction of anaesthesia in elderly patients

Published online by Cambridge University Press:  01 August 2007

W. Riad ,
M. Schreiber  and
A. B. Saeed
W. Riad*
Affiliation:
King Khaled Eye Specialist Hospital, Department of Anesthesia, Riyadh, Kingdom of Saudi Arabia
M. Schreiber
Affiliation:
King Khaled Eye Specialist Hospital, Department of Anesthesia, Riyadh, Kingdom of Saudi Arabia
A. B. Saeed
Affiliation:
King Saud, University, Department of Family and Community Medicine, Faculty of Medicine, Riyadh, Kingdom of Saudi Arabia
*
Correspondence to: Waleed Riad, Department of Anaesthesia, King Khaled Eye Specialist Hospital, P.O. Box 7191, Riyadh 11462, Kingdom of Saudi Arabia. E-mail: waleed_riad@yahoo.com; Tel: +966 1 482 1234 3215; Fax: +966 1 482 1908
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Summary

Background and objectives

Electroencephalographic entropy is used to measure the degree of brain hypnosis and anaesthesia depth. Two parameters are displayed in the monitor, state entropy (SE) and response entropy (RE). Ageing leads to reduction in liver mass as well as hepatic blood flow, which decreases clearance of propofol and increases the risk of cardiovascular adverse effects. The aim of this study is to demonstrate the effect of electroencephalographic entropy on propofol requirement and haemodynamic parameters during induction of anaesthesia in elderly patients.

Methods

We studied 72 elderly patients. Standard monitoring was performed for all patients together with entropy monitor. Patients were allocated randomly either to the control group, which were given the recommended induction dose of propofol, or to the entropy group which was induced with propofol based on entropy reading where the end-point was SE 50 and SE-RE difference less than 10. Propofol induction doses and haemodynamic changes were recorded. Anaesthesia was maintained using sevoflurane and O2 air mixture.

Results

After induction of anaesthesia, the systolic, diastolic, mean arterial pressure, RE and SE were significantly lower in the control group (P value < 0.05). Total dose of propofol and the dose kg−1 were significantly reduced by 37.1% and 31.8%, respectively, in the entropy group (P value < 0.01).

Conclusion

The use of electroencephalographic entropy during induction of anaesthesia in elderly patients reduces propofol requirements and maintains cardiovascular stability.

Keywords

ELECTROENCEPHALOGRAPHY, entropyANAESTHESIA GENERAL, monitoringGERIATRICS
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 8 , August 2007 , pp. 684 - 688
Copyright
Copyright © European Society of Anaesthesiology 2007

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