TITLE:
Comparison of Entropy vs. Bispectral Index Anesthetic Depth Monitoring during Isoflurane Anesthesia in Living Donor Liver Transplantation: Observational Study
AUTHORS:
Sang Hyun Lee, Janie Jang, Kyunga Kim, Heejin Yoo, Yu Jeong Bang, Ji-Won Choi, Gaab Soo Kim
KEYWORDS:
Anesthetic Depth, Bispectral Index, Entropy, Liver Transplantation, Isoflurane
JOURNAL NAME:
Open Journal of Anesthesiology,
Vol.11 No.5,
May
12,
2021
ABSTRACT: Liver transplantation (LT) recipients are known to require less anesthetic agents. Providing minimally required anesthetics while avoiding awareness is especially important in LT recipients because it would help manage perioperative hemodynamic instability with less vasopressor and fast track recovery. This study aims to compare state entropy (SE) against bispectral index (BIS) during isoflurane anesthesia in LT. We adjusted anesthesia to BIS values 40 - 60, and compared it with concomitant SE values. BIS, SE values, and anesthetic requirements according to liver failure severity, etiology and LT stages were analyzed. For BIS-SE differences, SE value that is different from the concomitant BIS by more than 15 was defined as a significant disagreement. Mann Whitney, Kruskal Wallis test and a Poisson exact test were used for analysis. The BIS-SE pair sets of 2895 from 38 patients were analyzed. BIS, SE values and anesthetic requirements were significantly lower in MELD ≥ 20 (p