Year : 2020  |  Volume : 23  |  Issue : 3  |  Page : 272--276

The role of entropy monitoring in reducing propofol requirements during open heart surgeries. A prospective randomized study


Ahmed Said Elgebaly, Mona B El Mourad, Sameh Mohamad Fathy 
 Department of Anesthesia and PSICUD, Faculty of Medicine, Tanta University, Egypt

Correspondence Address:
Ahmed Said Elgebaly
Department of Anaesthesia and SICUD, 19 Elfaloga Street, Elgharbia, Tanta
Egypt

Background: Hypotension, which is commonly associated with propofol induction of general anesthesia in coronary artery bypass grafting (CABG) surgery, may cause adverse consequences in patients with coronary artery diseases undergoing this type of surgeries. The clinical absence of verbal response and eyelash reflex was used as an endpoint for hypnosis. Spectral entropy, as a novel monitoring method for the endpoint of hypnosis, affect the dose of required anesthetic agents for induction as well as the hemodynamic profile during general anesthesia in CABG surgery. Aims: We hypothesized that entropy monitoring might reduce the dose of propofol required for induction of anesthesia during CABG surgery and could maintain hemodynamic stability when compared with the conventional clinical monitoring. Materials and Methods: Sixty adult patients of both sexes, aged 30–60 years, ASA II and III, and scheduled for CABG surgery were enrolled in this prospective, controlled, randomized, double-blind study. These patients were randomly divided into two equal groups to receive intravenous propofol for induction of anesthesia guided by either the patients' clinical response (Group I) or by entropy monitoring (Group II). The total dose of propofol used for induction of anesthesia was recorded. Hemodynamic parameters and entropy values were also recorded. Results: Propofol consumption was significantly reduced in Group II than Group I (P = 0.000*). Heart rate showed no statistical significance between the two groups, whereas the mean arterial pressure significantly decreased at induction in group I compared to Group II (P = 0.000*). The entropy values were significantly lower in Group I than Group II at induction (P = 0.036* for state entropy; 0.002* for response entropy). However, during intubation, and after 1 and 5 min, entropy indices displayed a significant increase in Group I than Group II. Conclusions: Entropy monitoring significantly reduced the dose of propofol required for induction of anesthesia and maintained hemodynamic stability compared to the conventional clinical monitoring during CABG surgeries.


How to cite this article:
Elgebaly AS, El Mourad MB, Fathy SM. The role of entropy monitoring in reducing propofol requirements during open heart surgeries. A prospective randomized study.Ann Card Anaesth 2020;23:272-276


How to cite this URL:
Elgebaly AS, El Mourad MB, Fathy SM. The role of entropy monitoring in reducing propofol requirements during open heart surgeries. A prospective randomized study. Ann Card Anaesth [serial online] 2020 [cited 2020 Dec 1 ];23:272-276
Available from: https://www.annals.in/article.asp?issn=0971-9784;year=2020;volume=23;issue=3;spage=272;epage=276;aulast=Elgebaly;type=0