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Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report

The Entropy™ module and bispectral index (BIS) depth-of-anesthesia monitors have been shown to be influenced by electromyographic (EMG) activity. The increase in entropy and BIS values is most likely caused by increased EMG activity and a higher level of consciousness. A strong EMG activity can incr...

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Detalles Bibliográficos
Autores principales: Oh, Seok Kyeong, Lim, Byung Gun, Kim, Young Sung, Park, Sangwoo, Kim, Seong Shin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726784/
https://www.ncbi.nlm.nih.gov/pubmed/31342813
http://dx.doi.org/10.1177/0300060519863967
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author Oh, Seok Kyeong
Lim, Byung Gun
Kim, Young Sung
Park, Sangwoo
Kim, Seong Shin
author_facet Oh, Seok Kyeong
Lim, Byung Gun
Kim, Young Sung
Park, Sangwoo
Kim, Seong Shin
author_sort Oh, Seok Kyeong
collection PubMed
description The Entropy™ module and bispectral index (BIS) depth-of-anesthesia monitors have been shown to be influenced by electromyographic (EMG) activity. The increase in entropy and BIS values is most likely caused by increased EMG activity and a higher level of consciousness. A strong EMG activity can increase entropy and BIS values because it is impossible to separate electroencephalography (EEG) from EMG, and this results from their overlapping power spectra. Thus, the entropy module may be more affected by EMG compared with the BIS module because it has more overlap with the power spectra of EEG and EMG. Several studies have suggested that EMG activity is most likely to increase, especially as it relates to the level of total intravenous anesthesia without a muscle relaxant or an insufficient analgesic level, which results in falsely increased entropy values. We present the case of a patient whose entropy values were falsely elevated by increased EMG activity resulting from light neuromuscular block or nociceptive stimuli during surgery even when undergoing desflurane anesthesia. This was closely related to the change in the neuromuscular block level and it was influenced by the degree of analgesia and the remifentanil infusion rate.
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spelling pubmed-67267842019-09-13 Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report Oh, Seok Kyeong Lim, Byung Gun Kim, Young Sung Park, Sangwoo Kim, Seong Shin J Int Med Res Case Report and Case Series The Entropy™ module and bispectral index (BIS) depth-of-anesthesia monitors have been shown to be influenced by electromyographic (EMG) activity. The increase in entropy and BIS values is most likely caused by increased EMG activity and a higher level of consciousness. A strong EMG activity can increase entropy and BIS values because it is impossible to separate electroencephalography (EEG) from EMG, and this results from their overlapping power spectra. Thus, the entropy module may be more affected by EMG compared with the BIS module because it has more overlap with the power spectra of EEG and EMG. Several studies have suggested that EMG activity is most likely to increase, especially as it relates to the level of total intravenous anesthesia without a muscle relaxant or an insufficient analgesic level, which results in falsely increased entropy values. We present the case of a patient whose entropy values were falsely elevated by increased EMG activity resulting from light neuromuscular block or nociceptive stimuli during surgery even when undergoing desflurane anesthesia. This was closely related to the change in the neuromuscular block level and it was influenced by the degree of analgesia and the remifentanil infusion rate. SAGE Publications 2019-07-25 2019-08 /pmc/articles/PMC6726784/ /pubmed/31342813 http://dx.doi.org/10.1177/0300060519863967 Text en © The Author(s) 2019 http://creativecommons.org/licenses/by-nc/4.0/ Creative Commons Non Commercial CC BY-NC: This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Case Report and Case Series
Oh, Seok Kyeong
Lim, Byung Gun
Kim, Young Sung
Park, Sangwoo
Kim, Seong Shin
Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
title Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
title_full Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
title_fullStr Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
title_full_unstemmed Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
title_short Entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
title_sort entropy values are closely related to the degree of neuromuscular block during desflurane anesthesia: a case report
topic Case Report and Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6726784/
https://www.ncbi.nlm.nih.gov/pubmed/31342813
http://dx.doi.org/10.1177/0300060519863967
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