Unwanted spontaneous responsiveness and burst suppression in patients undergoing entropy-guided total intravenous anesthesia with target-controlled infusion: An observational prospective trial
Authors' conclusion
The SE-SPI-guided TIVA-TCI did not prevent unwanted spontaneous responsiveness and BSupp.
Study context
- Population
- Adult (<65 years) and elderly (≥65 years) women undergoing breast surgery under propofol-remifentanil TIVA-TCI guided by state entropy (target 40–60) and surgical pleth index (target 20–50), without NMB
- Participants
- 107 participants
- Outcome
- Incidence of unwanted spontaneous responsiveness and burst suppression (BSupp)
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
Unwanted spontaneous responsiveness
13.1%
Burst suppression (BSupp)
45.8%
Observational data: associations, not effects.
Further findings
Unwanted spontaneous responsiveness: associations
- Observed mainly in adults
- P < 0.05
- Higher CeP at return of responsiveness
- P < 0.05
BSupp: associations
- Lower median CeP during maintenance
- P < 0.01
- Lower CeP at return of responsiveness
- P < 0.05
Remifentanil effect-site concentrations
- Unwanted spontaneous responsiveness and BSupp not associated with significant differences in CeRs
Age-related hysteresis
- Higher CeP at loss than at return of responsiveness
- P < 0.001
Postoperative delirium (POD) (CAM-ICU)
- Incidence of POD
- 12.2%
- Only preoperative serum albumin associated with increased likelihood of POD
- P = 0.046
Original publication
Unwanted spontaneous responsiveness and burst suppression in patients undergoing entropy-guided total intravenous anesthesia with target-controlled infusion: An observational prospective trial. J Clin Anesth. Published 19 January 2023. doi:10.
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