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Entropy values of intellectually-disabled and normal children undergoing deep intravenous sedation for dental treatment.
MedLine Citation:
PMID:  22686103     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND: Intravenous sedation is an efficient method to facilitate dental treatment delivery to uncooperative children. Entropy is used for monitoring anesthetic depth. Nonetheless, scarce data is found on entropy monitoring in intellectually-disabled patients during sedation.
OBJECTIVE: This comparative study set out to evaluate entropy values of normal and intellectually-disabled patients during the steady state period of deep sedation and awakening. Additionally, the study aimed to establish whether normal and intellectually-disabled patients reached a comparable clinically assessed state of sedation and the doses of total anesthetic drugs administered. Materials and Methods: 30 patients were included in the study and divided into two groups: 16 normal and 14 intellectually-disabled children. Ages ranged between 2 to 16 years. All patients were assigned to receive dental treatment under intravenous sedation. Entropy tracings were recorded for all patients. Clinical sedation level was assessed every 5 minutes. Drug administration was guided clinically. The anesthesiologist was blinded to entropy tracing.
RESULTS: Although sedation levels assessed clinically were similar between groups, entropy values were significantly lower in the group of intellectually-disabled patients both during sedation steady state and waking. The total amount of anesthetic drugs administered to normal patients was higher compared to intellectually-disabled patients.
CONCLUSION: In this study, entropy monitoring was found to be a more sensitive modality for assessing intra-operative brain activity during steady state sedation compared to clinical assessment of sedation. Despite similar clinical assessment of sedation level, brain activity was lower in the intellectually-disabled group as were their anesthetic drug requirements. We conclude that intellectually-disabled patients may need less anesthetic drugs to reach a good level of sedation. Whether the lower level of brain activity during sedation, reflected by lower entropy tracings, is characteristic of the intellectually disabled warrants additional studies.
Authors:
Ruth Edry; Marshall Rovner; Dror Aizenbud
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Alpha omegan     Volume:  104     ISSN:  0002-6417     ISO Abbreviation:  Alpha Omegan     Publication Date:    2011 Fall-Winter
Date Detail:
Created Date:  2012-06-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  14730480R     Medline TA:  Alpha Omegan     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-84     Citation Subset:  D    
Affiliation:
Department of Anesthesiology, Rambam Health Care Campus, Haifa, Israel. ruedry@gmail.com
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