Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients
Context: Objective assessment of sedation depth is a valuable target. Spectral entropy is an anesthetic depth monitor based on the analysis of the electroencephalogram signal. Aims: To evaluate the performance of spectral entropy as an objective measure of sedation state in midazolam-premedicated pa...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2012-01-01
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| Series: | Saudi Journal of Anaesthesia |
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| Online Access: | http://www.saudija.org/article.asp?issn=1658-354X;year=2012;volume=6;issue=2;spage=131;epage=135;aulast=Mowafi |
| _version_ | 1818340847533424640 |
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| author | Hany A Mowafi |
| author_facet | Hany A Mowafi |
| author_sort | Hany A Mowafi |
| collection | DOAJ |
| description | Context: Objective assessment of sedation depth is a valuable target. Spectral entropy is an anesthetic depth monitor based on the analysis of the electroencephalogram signal. Aims: To evaluate the performance of spectral entropy as an objective measure of sedation state in midazolam-premedicated patients and to correlate it with a clinically assessed sedation score. Settings and Design: This prospective double-blind placebo-controlled study was performed in King Fahd Hospital of the university. Methods: Eighty adult ASA I-II patients were randomly assigned into 4 groups. Patients were premedicated using 0.02, 0.04, or 0.06 mg/kg midazolam or saline intramuscularly. The effect of these doses on the Observer′s Assessment of Alertness and Sedation (OAA/S) scale, hemodynamic variables, response entropy (RE), and state entropy (SE), was evaluated at 10, 20, and 30 min after premedication. Statistical analysis: Spearman Rank-order correlation analysis to examine the relation between OAA/S and entropy. The ability of spectral entropy to predict the depth of sedation was evaluated using Smith prediction probability. Results: Midazolam doses ≥0.04 mg/kg produced significant decreases in RE, SE, and OAA/S scores. There was a strong correlation between midazolam dose and OAA/S scale, RE, and SE since Spearman Rank R values were 0.792, 0.822, and 0.745, respectively (P<0.001). In addition, RE and SE were strong predictors of OAA/S level during midazolam sedation with no significant difference in prediction between the 2 entropy components. Conclusions: Spectral entropy is a reliable measure for the sedative premedication. It may be used to objectively assess the adequacy of midazolam premedication and to determine the dose requirement. |
| first_indexed | 2024-12-13T15:49:24Z |
| format | Article |
| id | doaj.art-251c506b114249e9993f61e51bce1e65 |
| institution | Directory Open Access Journal |
| issn | 1658-354X |
| language | English |
| last_indexed | 2024-12-13T15:49:24Z |
| publishDate | 2012-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Saudi Journal of Anaesthesia |
| spelling | doaj.art-251c506b114249e9993f61e51bce1e652022-12-21T23:39:35ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X2012-01-016213113510.4103/1658-354X.97025Spectral entropy as an objective measure of sedation state in midazolam-premedicated patientsHany A MowafiContext: Objective assessment of sedation depth is a valuable target. Spectral entropy is an anesthetic depth monitor based on the analysis of the electroencephalogram signal. Aims: To evaluate the performance of spectral entropy as an objective measure of sedation state in midazolam-premedicated patients and to correlate it with a clinically assessed sedation score. Settings and Design: This prospective double-blind placebo-controlled study was performed in King Fahd Hospital of the university. Methods: Eighty adult ASA I-II patients were randomly assigned into 4 groups. Patients were premedicated using 0.02, 0.04, or 0.06 mg/kg midazolam or saline intramuscularly. The effect of these doses on the Observer′s Assessment of Alertness and Sedation (OAA/S) scale, hemodynamic variables, response entropy (RE), and state entropy (SE), was evaluated at 10, 20, and 30 min after premedication. Statistical analysis: Spearman Rank-order correlation analysis to examine the relation between OAA/S and entropy. The ability of spectral entropy to predict the depth of sedation was evaluated using Smith prediction probability. Results: Midazolam doses ≥0.04 mg/kg produced significant decreases in RE, SE, and OAA/S scores. There was a strong correlation between midazolam dose and OAA/S scale, RE, and SE since Spearman Rank R values were 0.792, 0.822, and 0.745, respectively (P<0.001). In addition, RE and SE were strong predictors of OAA/S level during midazolam sedation with no significant difference in prediction between the 2 entropy components. Conclusions: Spectral entropy is a reliable measure for the sedative premedication. It may be used to objectively assess the adequacy of midazolam premedication and to determine the dose requirement.http://www.saudija.org/article.asp?issn=1658-354X;year=2012;volume=6;issue=2;spage=131;epage=135;aulast=MowafiMonitoringdepth of anaesthesiaobserver′s assessment of alertness and sedationpremedicationmidazolamsedation |
| spellingShingle | Hany A Mowafi Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients Saudi Journal of Anaesthesia Monitoring depth of anaesthesia observer′s assessment of alertness and sedation premedication midazolam sedation |
| title | Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients |
| title_full | Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients |
| title_fullStr | Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients |
| title_full_unstemmed | Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients |
| title_short | Spectral entropy as an objective measure of sedation state in midazolam-premedicated patients |
| title_sort | spectral entropy as an objective measure of sedation state in midazolam premedicated patients |
| topic | Monitoring depth of anaesthesia observer′s assessment of alertness and sedation premedication midazolam sedation |
| url | http://www.saudija.org/article.asp?issn=1658-354X;year=2012;volume=6;issue=2;spage=131;epage=135;aulast=Mowafi |
| work_keys_str_mv | AT hanyamowafi spectralentropyasanobjectivemeasureofsedationstateinmidazolampremedicatedpatients |