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. 2010 Oct;59(4):238-43.
doi: 10.4097/kjae.2010.59.4.238. Epub 2010 Oct 21.

Effect of remifentanil on consumption of sevoflurane in entropy monitored general anesthesia

Hyung Tae Kim  1 , Hyeon Eon Heo, Young Eun Kwon, Myeong Jong Lee
Affiliations

Effect of remifentanil on consumption of sevoflurane in entropy monitored general anesthesia

Hyung Tae Kim et al. Korean J Anesthesiol. 2010 Oct.

Abstract

Background: Monitoring of anesthetic depth is important for successful general anesthesia. It is well known that entropy or BIS monitoring assisted titration of anesthetic drugs decreases their consumption. This study evaluated the effect of remifentanil on consumption of sevoflurane during entropy monitored general anesthesia.

Methods: Patients were randomly assigned to two groups. The R group was administered 0.1 µg/kg/min of remifentanil and inhaled sevoflurane, while the S group was administered only inhaled sevoflurane. Anesthesia was maintained using sevoflurane with nitrous oxide, and entropy was monitored. In both groups, the concentration of sevoflurane was adjusted to keep the state entropy (SE) value between 40 and 60. End-tidal sevoflurane concentration (ET), entropy value, systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were measured at 5 minute intervals, during a 25 minute period after intubation, skin suture and the end of surgery.

Results: ET was significantly lower in the R group than the S group. There were no significant differences in entropy value between R and S groups.

Conclusions: Entropy monitored titration of sevoflurane with remifentanil administration decreased ET with stable hemodynamics.

Keywords: Entropy; Remifentanil; Sevoflurane.

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Figures

Fig. 1
Fig. 1
Change of end-tidal sevoflurane concentration. Values are expressed as mean ± SD. Group S: group received normal saline. Group R: group received remifentanil (0.1 µg/kg/min). ET0-25: end-tidal sevoflurane concentration at 0-25 minute after intubation, ETss: end-tidal sevoflurane concentration at skin suture, ETend: end-tidal sevoflurane concentration at end of surgery. *P < 0.05 compared with ET0. †P < 0.05 compared with Group S.
Fig. 2
Fig. 2
Change of response entropy. Values are expressed as mean ± SD. Group S: group received normal saline. Group R: group received remifentanil (0.1 µg/kg/min). RE0-25: response entropy at 0-25 minute after intubation, REss: response entropy at skin suture, REend: response entropy at end of surgery.
Fig. 3
Fig. 3
Change of state entropy. Values are expressed as mean ± SD. Group S: group received normal saline. Group R: group received remifentanil (0.1 µg/kg/min). SE0-25: state entropy at 0-25 minute after intubation, SEss: state entropy at skin suture, SEend: state entropy at end of surgery.
Fig. 4
Fig. 4
Change of systolic blood pressure. Values are expressed as mean ± SD. Group S: group received normal saline. Group R: group received remifentanil (0.1 µg/kg/min). SBP0-25: systolic blood pressure at 0-25 minute after intubation, SBPss: systolic blood pressure at skin suture, SBPend: systolic blood pressure at end of surgery. *P < 0.05 compared with SBP0. †P < 0.05 compared with Group S.
Fig. 5
Fig. 5
Change of diastolic blood pressure. Values are expressed as mean ± SD. Group S: group received normal saline. Group R: group received remifentanil (0.1 µg/kg/min). DBP0-25: diastolic blood pressure at 0-25 minute after intubation, DBPss: diastolic blood pressure at skin suture, DBPend: diastolic blood pressure at end of surgery. *P < 0.05 compared with DBP0. †P < 0.05 compared with Group S.
Fig. 6
Fig. 6
Change of heart rate. Values are expressed as mean ± SD. Group S: group received normal saline. Group R: group received remifentanil (0.1 µg/kg/min). HR0-25: heart rate at 0-25 minute after intubation, HRss: heart rate at skin suture, HRend: heart rate at end of surgery. *P < 0.05 compared with HR0. †P < 0.05 compared with Group S.
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References

    1. Bruhn J, Bouillon TW, Radulescu L, Hoeft A, Bertaccini E, Shafer SL. Correlation of approximate entropy, bispectral index, and spectral edge frequency 95 (SEF95) with clinical signs of "anesthetic depth" during coadministration of propofol and remifentanil. Anesthesiology. 2003;98:621–627. - PubMed
    1. Vakkuri A, Yli-Hankala A, Talja P, Mustola S, Tolvanen-Laakso H, Sampson T, et al. Time-frequency balanced spectral entropy as a measure of anesthetic drug effect in central nervous system during sevoflurane, propofol, and thiopental anesthesia. Acta Anaesthesiol Scand. 2004;48:145–153. - PubMed
    1. Schmidt GN, Bischoff P, Standl T, Hellstern A, Teuber O, Schulte Esch J. Comparative evaluation of the Datex-Ohmeda S/5 Entropy Module and the Bispectral Index monitor during propofol-remifentanil anesthesia. Anesthesiology. 2004;101:1283–1290. - PubMed
    1. Vanluchene AL, Vereecke H, Thas O, Mortier EP, Shafer SL, Struys MM. Spectral entropy as an electroencephalographic measure of anesthetic drug effect: a comparison with bispectral index and processed midlatency auditory evoked response. Anesthesiology. 2004;101:34–42. - PubMed
    1. Glass PS, Hardman D, Kamiyama Y, Quill TJ, Marton G, Donn KH, et al. Preliminary pharmacokinetics and pharmacodynamics of an ultra-short-acting opioid: remifentanil (GI87084B) Anesth Analg. 1993;77:1031–1040. - PubMed

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