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Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study

1
Faculty of Medicine, “Victor Babes” University of Medicine and Pharmacy, Timisoara 300041, Romania
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Clinic of Anaesthesia and Intensive Care, Emergency County Hospital “Pius Brinzeu”, Timisoara 325100, Romania
3
Department of Clinical Research and Medical Education, Romanian Society of Anaesthesia and Intensive Care (SRATI), Timisoara 325100, Romania
*
Authors to whom correspondence should be addressed.
Entropy 2020, 22(3), 356; https://doi.org/10.3390/e22030356
Received: 9 February 2020 / Revised: 17 March 2020 / Accepted: 18 March 2020 / Published: 19 March 2020
Laparoscopic cholecystectomy is one of the most frequently performed interventions in general surgery departments. Some of the most important aims in achieving perioperative stability in these patients is diminishing the impact of general anesthesia on the hemodynamic stability and the optimization of anesthetic drug doses based on the individual clinical profile of each patient. The objective of this study is the evaluation of the impact, as monitored through entropy (both state entropy (SE) and response entropy (RE)), that the depth of anesthesia has on the hemodynamic stability, as well as the doses of volatile anesthetic. A prospective, observational, randomized, and monocentric study was carried out between January and December 2019 in the Clinic of Anesthesia and Intensive Care of the “Pius Brînzeu” Emergency County Hospital in Timișoara, Romania. The patients included in the study were divided in two study groups: patients in Group A (target group) received multimodal monitoring, which included monitoring of standard parameters and of entropy (SE and RE); while the patients in Group B (control group) only received standard monitoring. The anesthetic dose in group A was optimized to achieve a target entropy of 40–60. A total of 68 patients met the inclusion criteria and were allocated to one of the two study groups: group A (N = 43) or group B (N = 25). There were no statistically significant differences identified between the two groups for both demographical and clinical characteristics (p > 0.05). Statistically significant differences were identified for the number of hypotensive episodes (p = 0.011, 95% CI: [0.1851, 0.7042]) and for the number of episodes of bradycardia (p < 0.0001, 95% CI: [0.3296, 0.7923]). Moreover, there was a significant difference in the Sevoflurane consumption between the two study groups (p = 0.0498, 95% CI: [−0.3942, 0.9047]). The implementation of the multimodal monitoring protocol, including the standard parameters and the measurement of entropy for determining the depth of anesthesia (SE and RE) led to a considerable improvement in perioperative hemodynamic stability. Furthermore, optimizing the doses of anesthetic drugs based on the individual clinical profile of each patient led to a considerable decrease in drug consumption, as well as to a lower incidence of hemodynamic side-effects. View Full-Text
Keywords: state entropy; response entropy; general anesthesia; patient safety; recovery state entropy; response entropy; general anesthesia; patient safety; recovery
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MDPI and ACS Style

Dinu, A.R.; Rogobete, A.F.; Popovici, S.E.; Bedreag, O.H.; Papurica, M.; Dumbuleu, C.M.; Velovan, R.R.; Toma, D.; Georgescu, C.M.; Trache, L.I.; Barsac, C.; Luca, L.; Buzzi, B.; Maghiar, A.; Sandesc, M.A.; Rimawi, S.; Vaduva, M.M.; Bratu, L.M.; Luminosu, P.M.; Sandesc, D. Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study. Entropy 2020, 22, 356. https://doi.org/10.3390/e22030356

AMA Style

Dinu AR, Rogobete AF, Popovici SE, Bedreag OH, Papurica M, Dumbuleu CM, Velovan RR, Toma D, Georgescu CM, Trache LI, Barsac C, Luca L, Buzzi B, Maghiar A, Sandesc MA, Rimawi S, Vaduva MM, Bratu LM, Luminosu PM, Sandesc D. Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study. Entropy. 2020; 22(3):356. https://doi.org/10.3390/e22030356

Chicago/Turabian Style

Dinu, Anca R., Alexandru F. Rogobete, Sonia E. Popovici, Ovidiu H. Bedreag, Marius Papurica, Corina M. Dumbuleu, Raluca R. Velovan, Daiana Toma, Corina M. Georgescu, Lavinia I. Trache, Claudiu Barsac, Loredana Luca, Bettina Buzzi, Andra Maghiar, Mihai A. Sandesc, Samir Rimawi, Madalin M. Vaduva, Lavinia M. Bratu, Paul M. Luminosu, and Dorel Sandesc. 2020. "Impact of General Anesthesia Guided by State Entropy (SE) and Response Entropy (RE) on Perioperative Stability in Elective Laparoscopic Cholecystectomy Patients—A Prospective Observational Randomized Monocentric Study" Entropy 22, no. 3: 356. https://doi.org/10.3390/e22030356

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