• Jose L Guerrero, E Matute, E Alsina, B Del Blanco, and F Gilsanz.
• Department of Anesthesiology, Hospital Universitario Virgen de la Victoria, Campus Universitario Teatinos, C.P. 29010, Malaga, Spain. guerreroorriach@terra.es
• J Clin Monit Comput. 2012 Jun 1;26(3):171-5.

AbstractSmall changes in the frequency of the electromyography could reflect an inadequate anesthetic or analgesic level, and it could be more specific than the hemodynamic monitors. The Datex-Ohmeda S/5 Entropy Module includes information about the electromyographic activity of the face muscles (response entropy--RE). The aim of our study is compare entropy and BIS ability to detect a nociceptive stimulus during a sevoflurane anesthesia. We designed an observational, prospective and descriptive study that included 20 patients. We performed sevoflurane anaesthesia induction, the end-tidal was kept at 3 and 4 %, during 15 min at each concentration, with no analgesic drug and no neuromuscular blocking agent, and we applied a nociceptive stimulus: tetanus 100 Hz, during 5 s. We set the standard monitorization, BIS, RE, and state entropy (SE) along the study. There was a significant difference between RE and SE post-noxious stimulus values at 3 and 4 % end-tidal sevoflurane (p < 0.05). Only RE changed significantly at the moment of the noxious stimulation at both sevoflurane concentrations studied (p < 0.05). In patients under general anesthesia only carried out with sevoflurane at concentrations that inhibit the movement to painful stimuli, the RE is a single parameter able to detect variations after the nociceptive stimulation.

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