Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study
Background and Objectives: Raw electroencephalographic (EEG) signals are rarely used to monitor the depth of volatile induction of general anaesthesia (VIGA) with sevoflurane, even though EEG-based indices may show aberrant values. We aimed to identify whether response (RE) and state entropy (SE) va...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-06-01
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| Series: | Brain Sciences |
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| Online Access: | https://www.mdpi.com/2076-3425/10/6/366 |
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| author | Michał Stasiowski Anna Duława Izabela Szumera Radosław Marciniak Ewa Niewiadomska Wojciech Kaspera Lech Krawczyk Piotr Ładziński Beniamin Oskar Grabarek Przemysław Jałowiecki |
| author_facet | Michał Stasiowski Anna Duława Izabela Szumera Radosław Marciniak Ewa Niewiadomska Wojciech Kaspera Lech Krawczyk Piotr Ładziński Beniamin Oskar Grabarek Przemysław Jałowiecki |
| author_sort | Michał Stasiowski |
| collection | DOAJ |
| description | Background and Objectives: Raw electroencephalographic (EEG) signals are rarely used to monitor the depth of volatile induction of general anaesthesia (VIGA) with sevoflurane, even though EEG-based indices may show aberrant values. We aimed to identify whether response (RE) and state entropy (SE) variations reliably reflect the actual depth of general anaesthesia in the presence of different types of epileptiform patterns (EPs) in EEGs during induction of general anaesthesia. Materials and Methods: A randomized, prospective clinical study was performed with 60 patients receiving VIGA using sevoflurane with the increasing concentrations (group VIMA) or the vital capacity (group VCRII) technique or an intravenous single dose of propofol (group PROP). Facial electromyography (fEMG), fraction of inspired sevoflurane (FiAA), fraction of expired sevoflurane (FeAA), minimal alveolar concentration (MAC) of sevoflurane, RE and SE, and standard electroencephalographic evaluations were performed in these patients. Results: In contrast to periodic epileptiform discharges, erroneous SE and RE values in the patients’ EEGs were associated with the presence of polyspikes (PS) and rhythmic polyspikes (PSR), which were more likely to indicate toxic depth rather than false emergence from anaesthesia with no changes in the FiAA, FeAA, and MAC of sevoflurane. Conclusion: Calculated RE and SE values may be misleading during VIGA when EPs are present in patients’ EEGs. During VIGA with sevoflurane, we recommend monitoring raw EEG data in scientific studies to correlate it with potentially erroneous RE and SE values and the end-tidal concentration of sevoflurane in everyday clinical practice, when monitoring raw EEG is not available, because they can mislead anaesthesiologists to reduce sevoflurane levels in the ventilation gas and result in unintentional true emergence from anaesthesia. Further studies are required to investigate the behaviour of EEG-based indices during rapid changes in sevoflurane concentrations at different stages of VIGA and the influence of polyspikes and rhythmic polyspikes on the transformation of EEG signals into a digital form. |
| first_indexed | 2024-03-10T19:13:31Z |
| format | Article |
| id | doaj.art-e2fdc89ab00a4153bda336a571f6795b |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-03-10T19:13:31Z |
| publishDate | 2020-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-e2fdc89ab00a4153bda336a571f6795b2023-11-20T03:39:03ZengMDPI AGBrain Sciences2076-34252020-06-0110636610.3390/brainsci10060366Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative StudyMichał Stasiowski0Anna Duława1Izabela Szumera2Radosław Marciniak3Ewa Niewiadomska4Wojciech Kaspera5Lech Krawczyk6Piotr Ładziński7Beniamin Oskar Grabarek8Przemysław Jałowiecki9Department of Anaesthesiology and Intensive Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Anaesthesiology and Intensive Care, Railway District Hospital Katowice, 40-055 Katowice, PolandDepartment of Anaesthesiology and Intensive Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Anaesthesiology and Intensive Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Epidemiology and Biostatistics, School of Public Health in Bytom, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Neurosurgery, Regional Hospital in Sosnowiec, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Anaesthesiology and Intensive Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Neurosurgery, Regional Hospital in Sosnowiec, Faculty of Medical Sciences in Katowice, Medical University of Silesia, 40-055 Katowice, PolandDepartment of Clinical Trials, Maria Sklodowska-Curie National Research Institute of Oncology Krakow Branch, 31-115 Katowice, PolandDepartment of Anaesthesiology and Intensive Therapy, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, 40-055 Katowice, PolandBackground and Objectives: Raw electroencephalographic (EEG) signals are rarely used to monitor the depth of volatile induction of general anaesthesia (VIGA) with sevoflurane, even though EEG-based indices may show aberrant values. We aimed to identify whether response (RE) and state entropy (SE) variations reliably reflect the actual depth of general anaesthesia in the presence of different types of epileptiform patterns (EPs) in EEGs during induction of general anaesthesia. Materials and Methods: A randomized, prospective clinical study was performed with 60 patients receiving VIGA using sevoflurane with the increasing concentrations (group VIMA) or the vital capacity (group VCRII) technique or an intravenous single dose of propofol (group PROP). Facial electromyography (fEMG), fraction of inspired sevoflurane (FiAA), fraction of expired sevoflurane (FeAA), minimal alveolar concentration (MAC) of sevoflurane, RE and SE, and standard electroencephalographic evaluations were performed in these patients. Results: In contrast to periodic epileptiform discharges, erroneous SE and RE values in the patients’ EEGs were associated with the presence of polyspikes (PS) and rhythmic polyspikes (PSR), which were more likely to indicate toxic depth rather than false emergence from anaesthesia with no changes in the FiAA, FeAA, and MAC of sevoflurane. Conclusion: Calculated RE and SE values may be misleading during VIGA when EPs are present in patients’ EEGs. During VIGA with sevoflurane, we recommend monitoring raw EEG data in scientific studies to correlate it with potentially erroneous RE and SE values and the end-tidal concentration of sevoflurane in everyday clinical practice, when monitoring raw EEG is not available, because they can mislead anaesthesiologists to reduce sevoflurane levels in the ventilation gas and result in unintentional true emergence from anaesthesia. Further studies are required to investigate the behaviour of EEG-based indices during rapid changes in sevoflurane concentrations at different stages of VIGA and the influence of polyspikes and rhythmic polyspikes on the transformation of EEG signals into a digital form.https://www.mdpi.com/2076-3425/10/6/366epileptiform EEG patternssevofluraneresponse entropystate entropyrhythmic polyspikespolyspikes |
| spellingShingle | Michał Stasiowski Anna Duława Izabela Szumera Radosław Marciniak Ewa Niewiadomska Wojciech Kaspera Lech Krawczyk Piotr Ładziński Beniamin Oskar Grabarek Przemysław Jałowiecki Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study Brain Sciences epileptiform EEG patterns sevoflurane response entropy state entropy rhythmic polyspikes polyspikes |
| title | Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study |
| title_full | Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study |
| title_fullStr | Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study |
| title_full_unstemmed | Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study |
| title_short | Variations in Values of State, Response Entropy and Haemodynamic Parameters Associated with Development of Different Epileptiform Patterns during Volatile Induction of General Anaesthesia with Two Different Anaesthetic Regimens Using Sevoflurane in Comparison with Intravenous Induct: A Comparative Study |
| title_sort | variations in values of state response entropy and haemodynamic parameters associated with development of different epileptiform patterns during volatile induction of general anaesthesia with two different anaesthetic regimens using sevoflurane in comparison with intravenous induct a comparative study |
| topic | epileptiform EEG patterns sevoflurane response entropy state entropy rhythmic polyspikes polyspikes |
| url | https://www.mdpi.com/2076-3425/10/6/366 |
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