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Phase lag entropy as a hypnotic depth indicator during propofol sedation.

S Ki1, K M Kim2, Y H Lee3

  • 1Department of Anesthesiology and Pain Medicine, Busan Paik Hospital, Inje University, Busan, Korea.

Anaesthesia
|May 21, 2019
PubMed
Summary

Phase lag entropy, an EEG-based hypnotic depth indicator, showed similar performance to the bispectral index in predicting propofol sedation levels. This study validates phase lag entropy as a reliable tool for monitoring anesthetic depth.

Keywords:
EEGmonitoring: hypnotic depthpropofolsedation

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Area of Science:

  • Anesthesiology
  • Neuroscience
  • Signal Processing

Background:

  • Monitoring hypnotic depth during anesthesia is crucial for patient safety.
  • The bispectral index (BIS) is a widely used electroencephalography (EEG)-based measure.
  • Phase lag entropy (PLE) is a novel EEG complexity measure proposed as a hypnotic depth indicator.

Purpose of the Study:

  • To compare the performance of phase lag entropy (PLE) with the bispectral index (BIS) in assessing hypnotic depth during propofol sedation.
  • To evaluate the correlation and prediction probability of PLE and BIS with sedation levels and propofol effect-site concentration.
  • To analyze the pharmacodynamic relationships between propofol concentration, EEG measures, and sedation.

Main Methods:

  • 30 patients undergoing elective surgery received target-controlled propofol infusion using the Schnider model.
  • Sedation levels were assessed using the Modified Observer's Assessment of Alertness/Sedation (MOAAS) scale every 30 seconds.
  • Phase lag entropy and bispectral index values were recorded and analyzed for correlation and prediction probability against MOAAS and propofol concentration.

Main Results:

  • Both phase lag entropy and bispectral index decreased as sedation increased.
  • Prediction probability for sedation levels was comparable: 0.697 for PLE and 0.700 for BIS (p=0.261).
  • Prediction probability for propofol effect-site concentration was also similar: 0.646 for PLE and 0.630 for BIS (p=0.091).

Conclusions:

  • Phase lag entropy is a useful and reliable indicator of hypnotic depth during propofol sedation.
  • PLE demonstrates comparable performance to BIS in monitoring anesthetic depth.
  • The findings support the clinical utility of phase lag entropy in anesthesia monitoring.