Goyal Kush Ashokkumar, Nileshwar Anitha, Budania Lokvendra Singh, Gaude Yogesh, Mathew Shaji, Vaidya Shriram
Department of Anaesthesiology, Kasturba Medical College, Manipal, Karnataka, India.
J Anaesthesiol Clin Pharmacol. 2017 Oct-Dec;33(4):529-533. doi: 10.4103/0970-9185.222523.
Entropy monitoring entails measurement of the effect of anesthetic on its target organ rather than merely the concentration of anesthetic in the brain (indicated by alveolar concentration based on which minimum alveolar concentration [MAC] is displayed). We proposed this prospective randomised study to evaluate the effect of entropy monitoring on isoflurane consumption and anesthesia recovery period.
Sixty patients undergoing total abdominal hysterectomy under general anesthesia using an endotracheal tube were enrolled in either clinical practice (CP) or entropy (E) group. In group CP, isoflurane was titrated as per clinical parameters and MAC values, while in Group E, it was titrated to entropy values between 40 and 60. Data including demographics, vital parameters, alveolar isoflurane concentration, MAC values, entropy values, and recovery profile were recorded in both groups.
Demographic data and duration of surgery were comparable. Time to eye opening on command and time to extubation (mean ± standard deviation) were significantly shorter, in Group E (6.6 ± 3.66 and 7.27 ± 4.059 min) as compared to Group CP (9.77 ± 5.88 and 11.63 ± 6.90 min), respectively. Mean isoflurane consumption (ml/h) was 10.81 ± 2.08 in Group E and 11.45 ± 2.24 in Group CP and was not significantly different between the groups. Time to readiness to recovery room discharge and postanesthesia recovery scores were also same in both groups.
Use of entropy monitoring does not change the amount of isoflurane consumed during maintenance of anesthesia or result in clinically significant faster recovery.
熵监测涉及测量麻醉药对其靶器官的作用，而非仅仅是大脑中麻醉药的浓度（以肺泡浓度表示，基于此显示最低肺泡有效浓度[MAC]）。我们开展了这项前瞻性随机研究，以评估熵监测对异氟烷消耗量及麻醉恢复期的影响。
60例接受全身麻醉并使用气管内导管进行全腹子宫切除术的患者被纳入临床实践（CP）组或熵（E）组。在CP组，根据临床参数和MAC值滴定异氟烷，而在E组，将其滴定至熵值在40至60之间。两组均记录了包括人口统计学数据、生命体征参数、肺泡异氟烷浓度、MAC值、熵值及恢复情况等数据。
人口统计学数据和手术时长具有可比性。与CP组（分别为9.77±5.88和11.63±6.90分钟）相比，E组（分别为6.6±3.66和7.27±4.059分钟）的指令睁眼时间和拔管时间（均值±标准差）明显更短。E组的异氟烷平均消耗量（ml/h）为10.81±2.08，CP组为11.45±2.24，两组间无显著差异。两组的准备好出院至恢复室的时间和麻醉后恢复评分也相同。
使用熵监测不会改变麻醉维持期间异氟烷的消耗量，也不会导致临床上显著更快的恢复。
