Spectral entropy monitoring allowed lower sevoflurane concentration and faster recovery in children.
BACKGROUND
Anesthetic titration using spectral entropy monitoring reduces anesthetic requirements and shortens recovery in adult surgical patients. This study was performed to evaluate the effect of entropy monitoring on end-tidal sevoflurane concentration and recovery characteristics in pediatric patients undergoing sevoflurane anesthesia.


METHODS
Seventy-eight children (aged 3-12 years) scheduled for a tonsillectomy and/or an adenoidectomy were randomly divided into one of two groups: standard practice (Standard) or entropy-guided (Entropy). In the Standard group, sevoflurane was adjusted to maintain the heart rate and systolic blood pressure (BP) within 20% of the baseline values. In the Entropy group, sevoflurane was adjusted to achieve a state entropy of 40-50. We compared the entropy values, end-tidal sevoflurane concentration and recovery times between groups.


RESULTS
During maintenance of anesthesia, the entropy and BP values were higher in the Entropy group (P<0.05). The end-tidal sevoflurane concentration during maintenance was lower in the Entropy group (2.2 (0.3) vol%) compared with the Standard group (2.6 (0.4) vol%) (P<0.05). Recovery times were faster in the Entropy group (P<0.05).


CONCLUSIONS
Compared with standard practice, we found that entropy-guided anesthetic administration was associated with a reduced sevoflurane concentration and a slightly faster emergence and recovery in 3-12-year-old children.
Choi
S R
SR
Department of Anesthesiology and Pain Medicine, Dong-A University Hospital, Busan, South Korea.
Lim
Y H
YH
Lee
S C
SC
Lee
J H
JH
Chung
C J
CJ
D000233:Adenoidectomy; D000762:Anesthesia Recovery Period; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D001794:Blood Pressure / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D023381:Endpoint Determination; D019277:Entropy; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage*; D008991:Monitoring, Physiologic; D011229:Preanesthetic Medication; D000077149:Sevoflurane; D014068:Tonsillectomy
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane