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Usefulness of permutation entropy as an anesthetic depth indicator in children

Pil-Jong Kim1, Hong-Gee Kim, Gyu-Jeong Noh

  • 1Biomedical Knowledge Engineering Laboratory, School of Dentistry, Seoul National University, 28 Yeongeon-dong Jongno-gu, Seoul, Republic of Korea.

Journal of Pharmacokinetics and Pharmacodynamics
|February 5, 2015
PubMed

Insights

Permutation entropy (PE) effectively monitors anesthetic depth in children, comparable to the standard Bispectral Index (BIS). This complexity measure shows significant correlation with anesthesia levels, validating its clinical use.

Area of Science:

  • Anesthesiology
  • Neuroscience
  • Biomedical Engineering

Background:

  • Permutation entropy (PE) is a complexity measure used to monitor anesthetic depth in adults.
  • The clinical applicability of PE as an indicator of anesthetic depth in children remains unevaluated.

Purpose of the Study:

  • To investigate the validity of Permutation entropy (PE) as an indicator of anesthetic depth in children.
  • To compare the performance of PE with the Bispectral Index (BIS) using pharmacodynamic (PD) modeling.

Main Methods:

  • Electroencephalogram (EEG) data were collected from pediatric patients undergoing sevoflurane anesthesia.
  • End-tidal sevoflurane concentration (Etsevo) and Bispectral Index (BIS) were measured concurrently.
  • Permutation entropy (PE) was calculated from processed EEG data, and pharmacodynamic (PD) relationships were analyzed using NONMEM software.

Main Results:

  • Adjusted PE (APE) values decreased with increasing anesthetic depth.
  • APE demonstrated a significant linear correlation with BIS (P < 0.001), indicating its utility in reflecting anesthesia depth.
  • Pharmacodynamic parameters estimated using a sigmoid Emax model showed comparable results for APE and BIS.

Conclusions:

  • Permutation entropy (PE) is a valid and useful indicator of anesthetic depth in children.
  • PE's performance is comparable to the established Bispectral Index (BIS) in pediatric anesthesia monitoring.

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