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M‐Entropy guidance vs standard practice during propofol‐remifentanil anaesthesia: a randomised controlled trial *
Author(s) -
Gruenewald M.,
Zhou J.,
Schloemerkemper N.,
Meybohm P.,
Weiler N.,
Tonner P. H.,
Scholz J.,
Bein B.
Publication year - 2007
Publication title -
anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.839
H-Index - 117
eISSN - 1365-2044
pISSN - 0003-2409
DOI - 10.1111/j.1365-2044.2007.05252.x
Subject(s) - remifentanil , medicine , propofol , anesthesia , vomiting , nausea , general anaesthesia , clinical practice , randomized controlled trial , surgery , physical therapy
Summary Seventy‐two patients undergoing routine surgical procedures under propofol‐remifentanil anaesthesia were randomly assigned to receive either standard clinical practice ( n = 35) or standard practice plus monitoring of depth of anaesthesia with M‐Entropy ( n = 37). Patients in the standard practice group received more propofol than the entropy group (mean (SD) 95 (14) vs 81 (22) μg.kg −1 .min −1 , respectively; p < 0.01), and less remifentanil (0.39 (0.08) vs 0.46 (0.08) μg.kg −1 .min −1 , respectively; p < 0.001). Loss of consciousness was best predicted by BIS (prediction probability (P K ) 0.96) and response entropy (P K 0.93), whereas emergence was best predicted by response entropy (P K 0.94). The frequency of unwanted patient responses was higher in the standard practice group than in the entropy group (47 vs 27 total events, respectively; p < 0.01). Both regimens resulted in fast recovery with no clinical advantage for either one. There were no significant differences in haemodynamic parameters, postoperative nausea and vomiting or satisfaction with the procedure.