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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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Autores principales: Chen, Jui-Tai, Wu, Yu-Ming, Tiong, Tung-Yu, Cata, Juan P., Kuo, Kuang-Tai, Li, Chun-Cheng, Liu, Hsin-Yi, Cherng, Yih-Giun, Wu, Hsiang-Ling, Tai, Ying-Hsuan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948899/
https://www.ncbi.nlm.nih.gov/pubmed/35329957
http://dx.doi.org/10.3390/jcm11061631
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author Chen, Jui-Tai
Wu, Yu-Ming
Tiong, Tung-Yu
Cata, Juan P.
Kuo, Kuang-Tai
Li, Chun-Cheng
Liu, Hsin-Yi
Cherng, Yih-Giun
Wu, Hsiang-Ling
Tai, Ying-Hsuan
author_facet Chen, Jui-Tai
Wu, Yu-Ming
Tiong, Tung-Yu
Cata, Juan P.
Kuo, Kuang-Tai
Li, Chun-Cheng
Liu, Hsin-Yi
Cherng, Yih-Giun
Wu, Hsiang-Ling
Tai, Ying-Hsuan
author_sort Chen, Jui-Tai
collection PubMed
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 (n = 39) and the control group (n = 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.
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spelling pubmed-89488992022-03-26 Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial Chen, Jui-Tai Wu, Yu-Ming Tiong, Tung-Yu Cata, Juan P. Kuo, Kuang-Tai Li, Chun-Cheng Liu, Hsin-Yi Cherng, Yih-Giun Wu, Hsiang-Ling Tai, Ying-Hsuan J Clin Med Article 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 (n = 39) and the control group (n = 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. MDPI 2022-03-15 /pmc/articles/PMC8948899/ /pubmed/35329957 http://dx.doi.org/10.3390/jcm11061631 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Chen, Jui-Tai
Wu, Yu-Ming
Tiong, Tung-Yu
Cata, Juan P.
Kuo, Kuang-Tai
Li, Chun-Cheng
Liu, Hsin-Yi
Cherng, Yih-Giun
Wu, Hsiang-Ling
Tai, Ying-Hsuan
Spectral Entropy Monitoring Accelerates the Emergence from Sevoflurane Anesthesia in Thoracic Surgery: A Randomized Controlled Trial
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 Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8948899/
https://www.ncbi.nlm.nih.gov/pubmed/35329957
http://dx.doi.org/10.3390/jcm11061631
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