Kim Young Sung, Won Young Ju, Jeong Hyerim, Lim Byung Gun, Kong Myoung Hoon, Lee Il Ok
Department of Anesthesiology and Pain Medicine, Korea University Guro Hospital, Seoul 08308, Korea.
Entropy (Basel). 2019 May 15;21(5):498. doi: 10.3390/e21050498.
This study compared the correlation of bispectral index (BIS) or entropy with different sevoflurane concentrations between children with and without cerebral palsy (CP) during induction.
For eighty-two children (40 CP and 42 non-CP children), anesthesia was induced with sevoflurane. BIS and entropy (response entropy and state entropy (RE and SE)) were recorded before and after the induction of anesthesia at end-tidal sevoflurane concentrations of 1-3 vol%. The sedation status was assessed using an Observer's Assessment of Alertness/Sedation scale. The ability to predict awareness was estimated using the area under the receiver-operator characteristic curve (AUC) analysis.
RE, SE and BIS values decreased continuously over the observed concentration range of sevoflurane in both groups. The SE values while awake and the RE, SE, BIS values at 3 vol% sevoflurane were lower in children with CP than in those without CP. The AUC of the BIS was significantly better than RE or SE in children without CP. The AUC of the BIS was not significantly higher than that of the RE or SE in children with CP.
BIS seems better correlated than entropy with the clinical state of loss of response in children without CP, but not in those with CP.
本研究比较了脑瘫（CP）患儿和非脑瘫患儿在麻醉诱导期间双谱指数（BIS）或熵与不同七氟醚浓度之间的相关性。
对82名儿童（40名CP患儿和42名非CP患儿）采用七氟醚进行麻醉诱导。在呼气末七氟醚浓度为1-3 vol%时，记录麻醉诱导前后的BIS和熵（反应熵和状态熵（RE和SE））。使用观察者警觉/镇静评估量表评估镇静状态。使用受试者操作特征曲线（AUC）分析评估预测意识的能力。
在两组观察到的七氟醚浓度范围内，RE、SE和BIS值均持续下降。CP患儿清醒时的SE值以及七氟醚浓度为3 vol%时的RE、SE、BIS值均低于非CP患儿。在非CP患儿中，BIS的AUC显著优于RE或SE。在CP患儿中，BIS的AUC并不显著高于RE或SE。
对于非CP患儿，BIS似乎比熵与反应丧失的临床状态相关性更好，但对于CP患儿并非如此。
