Pediatric anesthesia & critical care
Age-Dependent Entropic Features During Propofol Anesthesia in Developing Brain
Authors' conclusion
The frontal PeEn served as an excellent indicator for distinguishing propofol-induced unresponsiveness from recovery in children. Frontal complexity, represented by PeEn and SampEn, decreased with age during propofol maintenance, which was hypothesized to reflect sequential neurophysiological development in frontal cortex, particularly its maturation during adolescence.
Study context
- Population
- Children aged 1 to 18 years receiving propofol anaesthesiaincluded for analysis
- Participants
- 77 children
- Exposure
- EEG measures (permutation entropy (PeEn), sample entropy (SampEn), BIS) across wakefulness, maintenance and recovery of propofol anaesthesia, by age
- Outcome
- Accuracy of EEG measures to distinguish propofol-induced unresponsiveness from clinical recovery; age-related changes in entropic features
Main finding
As reported in the abstract
Wakefulness
0.75
median · IQR 0.71–0.78
Maintenance
0.61
median · IQR 0.57–0.63
Recovery
0.75
median · IQR 0.71–0.79
P < 0.001
- PeEn accuracy distinguishing unresponsiveness from clinical recovery (optimal threshold 0.67)
- 96.6%
Observational data: associations, not effects.
Further findings
Median
| Outcome | Wakefulness | Maintenance | P value |
|---|---|---|---|
| SampEnMaintenance vs Wakefulness · significant increase | 0.04 (IQR 0.04–0.06) | 0.25 (IQR 0.20–0.28) | P < 0.001 |
- SampEn — SampEn accuracy distinguishing unresponsiveness from recovery (optimal threshold 0.18)
- 81.1%
Distinguishing accuracy in toddlers (subgroup): PeEn vs BIS
- PeEn accuracy
- 94.7%
- BIS accuracy
- 88.9%
Age and frontal PeEn and SampEn during propofol maintenance
- PeEn decreased with age
- P = 0.017
- SampEn decreased with age
- P = 0.026
- Adolescents had significantly lower frontal power, PeEn and SampEn during propofol
Original publication
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