Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial
The clinical efficacy of spectral entropy monitoring in improving postoperative recovery remains unclear. This trial aimed to investigate the impact of M-Entropy (GE Healthcare, Helsinki, Finland) guidance on emergence from anesthesia and postoperative delirium in thoracic surgery. Adult patients un...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/6/1631 |
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| author | Jui-Tai Chen Yu-Ming Wu Tung-Yu Tiong Juan P. Cata Kuang-Tai Kuo Chun-Cheng Li Hsin-Yi Liu Yih-Giun Cherng Hsiang-Ling Wu Ying-Hsuan Tai |
| author_facet | Jui-Tai Chen Yu-Ming Wu Tung-Yu Tiong Juan P. Cata Kuang-Tai Kuo Chun-Cheng Li Hsin-Yi Liu Yih-Giun Cherng Hsiang-Ling Wu Ying-Hsuan Tai |
| author_sort | Jui-Tai Chen |
| collection | DOAJ |
| description | The clinical efficacy of spectral entropy monitoring in improving postoperative recovery remains unclear. This trial aimed to investigate the impact of M-Entropy (GE Healthcare, Helsinki, Finland) guidance on emergence from anesthesia and postoperative delirium in thoracic surgery. Adult patients undergoing video-assisted thoracoscopic surgery for lung resection at a medical center were randomly allocated into the M-Entropy guidance group (<i>n</i> = 39) and the control group (<i>n</i> = 37). In the M-Entropy guidance group, sevoflurane anesthesia was titrated to maintain response and state entropy values between 40 and 60 intraoperatively. In the control group, the dosing of sevoflurane was adjusted based on clinical judgment and vital signs. The primary outcome was time to spontaneous eye opening. M-Entropy guidance significantly reduced the time proportion of deep anesthesia (entropy value <40) during surgery, mean difference: −21.5% (95% confidence interval (CI): −32.7 to −10.3) for response entropy and −24.2% (−36.3 to −12.2) for state entropy. M-Entropy guidance significantly shortened time to spontaneous eye opening compared to clinical signs, mean difference: −154 s (95% CI: −259 to −49). In addition, patients of the M-Entropy group had a lower rate of emergence agitation (absolute risk reduction: 0.166, 95% CI: 0.005–0.328) and delirium (0.245, 0.093–0.396) at the postanesthesia care unit. M-Entropy-guided anesthesia hastened awakening and potentially prevented emergence agitation and delirium after thoracic surgery. These results may provide an implication for facilitating postoperative recovery and reducing the complications associated with delayed emergence and delirium. |
| first_indexed | 2024-03-09T19:37:44Z |
| format | Article |
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| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T19:37:44Z |
| publishDate | 2022-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-9e81be2d63944de3b98bd67bb44a487e2023-11-24T01:49:43ZengMDPI AGJournal of Clinical Medicine2077-03832022-03-01116163110.3390/jcm11061631Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled TrialJui-Tai Chen0Yu-Ming Wu1Tung-Yu Tiong2Juan P. Cata3Kuang-Tai Kuo4Chun-Cheng Li5Hsin-Yi Liu6Yih-Giun Cherng7Hsiang-Ling Wu8Ying-Hsuan Tai9Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDivision of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology and Perioperative Medicine, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Unit 409, Houston, TX 77030, USADivision of Thoracic Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanDepartment of Anesthesiology, Taipei Veterans General Hospital, Taipei 11217, TaiwanDepartment of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City 23561, TaiwanThe clinical efficacy of spectral entropy monitoring in improving postoperative recovery remains unclear. This trial aimed to investigate the impact of M-Entropy (GE Healthcare, Helsinki, Finland) guidance on emergence from anesthesia and postoperative delirium in thoracic surgery. Adult patients undergoing video-assisted thoracoscopic surgery for lung resection at a medical center were randomly allocated into the M-Entropy guidance group (<i>n</i> = 39) and the control group (<i>n</i> = 37). In the M-Entropy guidance group, sevoflurane anesthesia was titrated to maintain response and state entropy values between 40 and 60 intraoperatively. In the control group, the dosing of sevoflurane was adjusted based on clinical judgment and vital signs. The primary outcome was time to spontaneous eye opening. M-Entropy guidance significantly reduced the time proportion of deep anesthesia (entropy value <40) during surgery, mean difference: −21.5% (95% confidence interval (CI): −32.7 to −10.3) for response entropy and −24.2% (−36.3 to −12.2) for state entropy. M-Entropy guidance significantly shortened time to spontaneous eye opening compared to clinical signs, mean difference: −154 s (95% CI: −259 to −49). In addition, patients of the M-Entropy group had a lower rate of emergence agitation (absolute risk reduction: 0.166, 95% CI: 0.005–0.328) and delirium (0.245, 0.093–0.396) at the postanesthesia care unit. M-Entropy-guided anesthesia hastened awakening and potentially prevented emergence agitation and delirium after thoracic surgery. These results may provide an implication for facilitating postoperative recovery and reducing the complications associated with delayed emergence and delirium.https://www.mdpi.com/2077-0383/11/6/1631chest surgerydeliriumdepth of anesthesiaelectroencephalographyemergence agitation |
| spellingShingle | Jui-Tai Chen Yu-Ming Wu Tung-Yu Tiong Juan P. Cata Kuang-Tai Kuo Chun-Cheng Li Hsin-Yi Liu Yih-Giun Cherng Hsiang-Ling Wu Ying-Hsuan Tai Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial Journal of Clinical Medicine chest surgery delirium depth of anesthesia electroencephalography emergence agitation |
| title | Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial |
| title_full | Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial |
| title_fullStr | Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial |
| title_full_unstemmed | Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial |
| title_short | Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial |
| title_sort | spectral entropy monitoring accelerates the emergence from sevoflurane anesthesia in thoracic surgery a randomized controlled trial |
| topic | chest surgery delirium depth of anesthesia electroencephalography emergence agitation |
| url | https://www.mdpi.com/2077-0383/11/6/1631 |
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