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Evaluation of Sample Entropy and Bispectral Index on Monitoring Sedation Depth during Target-controlled Infusion of Propofol Anesthesia

Author: HeXin
Tutor: GaoLuBo
School: Tianjin Medical University
Course: Anesthesiology
Keywords: EEG EEG sample entropy Bispectral Index Depth of sedation Propofol Target-controlled infusion
CLC: R614
Type: Master's thesis
Year: 2011
Downloads: 43
Quote: 1
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Abstract

Objective: The ideal depth of sedation is to ensure the safety of anesthesia and surgery successfully conducted one of the keys of this study improved approximate entropy (ApEn) algorithm - the calculation of the sample entropy (SampEn), evaluation of the anesthesia induction process, patients with brain electric sample entropy (SampEn) and bispectral index (BIS) and the controlled concentration of propofol and anesthesia sedation depth correlation, to explore the feasibility and accuracy of EEG the SampEn monitoring patients with changes in level of consciousness, as the EEG SampEn depth of sedation monitoring tools to guide patients with safe, effective, personalized medicine clinical theoretical basis. Method: Select contemplated in general anesthesia for elective cancer surgery 40 patients, ASA Ⅰ ~ Ⅱ, aged 18-65 years, limited to gender, body mass index (BMI) 20-28 kg/m2. All patients entering the operating room, the open vein stepped propofol target controlled infusion of intravenous anesthesia induction, propofol initial target concentration of 0.5μg/ml, and each subsequent increments of 1 min intervals 0.5μg / ml, induced during every 20 s improved sedation, alertness score (MOAA / S) score once, until MOAA / S score of 0. Routine monitoring of electrocardiogram (ECG), non-invasive blood pressure (NIBP) and finger pulse oximetry saturation degree (SpO2). The American the ASPECT company BIS A-1050 type EEG monitor, a one-time special electrode and of electroencephalogram (EEG) acquisition software written real-time collection of original EEG and BIS data (the computer sampling frequency for 128samples / s) and the end of the trial will be All recorded data is saved to a computer hard drive for the late line analysis calculated EEG SampEn changes (analysis of the sequence of 256 samples). Establish standard pharmacokinetic - pharmacodynamic (PK / PD) model to describe the relationship between the phenol concentration of target-controlled EEG SampEn and level of consciousness changes propofol MOAA / S Indicator Survey the EEG SarnpEn of sedation the predicted effect of the depth, and BIS in the same state at the same time the study of self-control. SPSS17.0 statistical software to analyze the data. The calculation of the coefficient of determination (R2) to analyze the correlation between SampEn.BIS with target-controlled propofol pharmacodynamics; calculate the predicted probability (PK) judge the EEG SampEn.BIS forecast conscious and the ability to disappear, Smith created ( PKMACRO) PK value calculation; applications paired t-test, comparing P2 the SampEn value under the PK and different MOAA / S score, BIS values. P lt; 0.05 as statistically significant. Results: With the concentration of propofol target controlled increments, EEG SampEn values ??with BIS values ??correlation decreasing coefficient of determination R2-SampEn = 0.91 ± 0.15.R2-BIS = 0.86 ± 0.08, between no significant difference (P gt; 0.05); With the depth of sedation deepened, MOAA / S score from 5 to 0, the EEG of SampEn with the BIS value gradually decreased, when compared to a MOAA / S score EEG SampEn with BIS effectively distinguish MOAA / S score of 5 to 2 points score change (P lt; 0.05) and SampEn 0 ratings change was statistically significant (P lt; 0.05); brain electric SampEn to distinguish between different MOAA / S score and BIS sedation depth prediction probability (PK) PK-SampEn = 0.94 ± 0.01, PKBIS = 0.92 ± 0.01, between PK was no significant sex difference (P gt; 0.05) . Conclusion: EEG SampEn complexity of a time series analysis methods, improved algorithms approximate entropy (ApEn), a simple algorithm, small errors, SampEn does not contain a comparison of the data segment, the calculation does not depend on the length of the data, with a more good consistency, strong anti-interference, for the loss of data is not sensitive. EEG SampEn reflect phenol vein target-controlled infusion of propofol pharmacodynamic changes showed a good correlation is equivalent to the BIS, can better distinguish between different MOAA / S score changes, and can effectively used for anesthesia predicted depth of sedation, indicating that the EEG the SampEn In sedation depth monitoring feasibility and value of the field.

Evaluation of Sample Entropy and Bispectral Index on Monitoring Sedation Depth during Target-controlled Infusion of Propofol Anesthesia

Abstract

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