Recovery from paralysis with succinylcholine increased Response entropy and EMG but not State entropy.
OBJECTIVE
It is reported that the electromyogram is an indicator of patient arousal during pain stimulation if anesthesia is inadequate. This may not be true during recovery from succinylcholine induced paralysis. We evaluated State entropy of the electroencephalogram (EEG, 0.8-32 Hz) and Response entropy, a combined measure of the electromyogram (EMG) and EEG (0.8-47 Hz), during recovery from paralysis with succinylcholine.


METHODS
Twenty patients were randomized to receive either 0.8% (n = 10) or 1.4% isoflurane (n = 10), with 2 mg/kg succinylcholine administered for paralysis in all patients. State entropy and Response entropy were evaluated using a Datex-Ohmeda Entropy module. Frontal EMG was measured separately by an EEG module. State entropy, Response entropy, and EMG were measured in awake patients, during isoflurane anesthesia and paralysis, and after 100% recovery to train of four stimulation.


RESULTS
Response entropy and State entropy decreased from awake levels in a dose related manner during 0.8% or 1.4% isoflurane and succinylcholine. Recovery from succinylcholine significantly increased Response entropy and EMG in 5 of 10 patients with 0.8% isoflurane and 8 of 10 with 1.4% isoflurane without a change in State entropy.


CONCLUSIONS
Although RE and EMG increased during recovery from paralysis with succinylcholine, SE, an indicator of EEG, was not stimulated. EMG activity may not be an indicator of patient arousal after succinylcholine treatment.
Baughman
Verna L
VL
Anesthesiology Department, University of Illinois at Chicago, Chicago, IL 60612, USA.
Hoffman
William E
WE
Koenig
Heidi M
HM
Wheeler
Peggy L
PL
Ananda
Ranga C
RC
Wang
Mathew
M
D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D001143:Arousal; D004569:Electroencephalography; D004576:Electromyography; D006801:Humans; D007530:Isoflurane / Q000008:administration & dosage; D009467:Neuromuscular Depolarizing Agents / Q000008:administration & dosage*; D010243:Paralysis / Q000188:drug therapy*; D013390:Succinylcholine / Q000008:administration & dosage*
D018685:Anesthetics, Inhalation; D009467:Neuromuscular Depolarizing Agents; D007530:Isoflurane; D013390:Succinylcholine