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首页> 外文期刊>Open Journal of Anesthesiology >Comparison of Entropy vs. Bispectral Index Anesthetic Depth Monitoring during Isoflurane Anesthesia in Living Donor Liver Transplantation: Observational Study
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Comparison of Entropy vs. Bispectral Index Anesthetic Depth Monitoring during Isoflurane Anesthesia in Living Donor Liver Transplantation: Observational Study

机译：熵与双光谱指数麻醉深度监测在生活供体肝移植中异氟烷麻醉期间的比较：观察研究

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Liver transplantation (LT) recipients are known to require less anesthetic agents. Providing minimally required anesthetics while avoiding awareness is especially important in LT recipients because it would help manage perioperative hemodynamic instability with less vasopressor and fast track recovery. This study aims to compare state entropy (SE) against bispectral index (BIS) during isoflurane anesthesia in LT. We adjusted anesthesia to BIS values 40 - 60, and compared it with concomitant SE values. BIS, SE values, and anesthetic requirements according to liver failure severity, etiology and LT stages were analyzed. For BIS-SE differences, SE value that is different from the concomitant BIS by more than 15 was defined as a significant disagreement. Mann Whitney, Kruskal Wallis test and a Poisson exact test were used for analysis. The BIS-SE pair sets of 2895 from 38 patients were analyzed. BIS, SE values and anesthetic requirements were significantly lower in MELD ≥ 20 (p < 0.001 in all) and in alcoholic etiology (p < 0.001 in all). For BIS-SE differences, 320 disagreement data pairs were seen at a rate of 1.33 times/hr (95% CI = [1.19, 1.48], p < 0.001). A significant disagreement was delineated in MELD score ≥ 20 (3.04 times/hr, CI = [2.64, 3.49], p < 0.001), alcoholic etiology (3.19 times/hr, [2.67, 3.78], p < 0.001) and postreperfusion stage (1.63 times/hr, [1.43, 1.85], p < 0.001). In these significant BIS-SE differences, 95.9% (307/320 disagreement data pairs) showed higher BIS than SE. In conclusion, in high MELD and alcoholic etiology, anesthetic requirements were significantly less, and BIS and SE showed great discrepancy with lower SE values. Therefore, when SE monitoring is used during LT, anesthesiologists may need to consider that in high MELD and alcoholic etiology, SE tends to show lower values than the concomitant BIS values that are within optimal anesthetic depth ranges.
机译：已知肝移植（LT）接受者需要较少的麻醉剂。提供最小的所需麻醉剂，同时避免意识在LT接受者中尤为重要，因为它有助于通过较少的血管加压器和快速追踪来管理围手术期血液动力学不稳定。本研究旨在将状态熵（SE）与双光谱指数（BIS）进行比较，在异氟烷麻醉期间。我们调整麻醉到BIS值40-60，并将其与伴随的SE值进行比较。分析了根据肝功能衰竭严重程度，病因和LT阶段的单位，SE值和麻醉剂要求。对于BIS-SE差异，与伴随的BIS不同的SE值被定义为显着的分歧。 Mann Whitney，Kruskal Wallis测试和泊松精确测试用于分析。分析了38例患者的BIS-SE对2895组。在Meld≥20（全部P <0.001）和酒精病因中，BIS，SE值和麻醉剂要求显着降低（P <0.001）。对于BIS-SE差异，以1.33倍/小时/小时（95％CI = [1.19,111]，P <0.001），320个分歧数据对。在MELD评分≥20（3.04次/ HR，CI = [2.64,3.49]，P <0.001），酒精病因（3.19次/ HR，[2.67,3.78]，P <0.001）和POSTReperFusion阶段，将显着的分歧描述（1.63次/小时，[1.43,1.85]，P <0.001）。在这些显着的BIS-SE差异中，95.9％（307/320分歧数据对）显示比SE更高。总之，在高融合和酒精病因学中，麻醉剂需求显着较低，BIS和SE显示出具有较低的SE值的差异。因此，当在LT期间使用SE监测时，麻醉学家可能需要考虑在高融合和酒精的病因中，SE倾向于显示比在最佳麻醉深度范围内的伴随的BIS值较低的值。

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