An unexpected increase of entropy in a sleepwalking disorder patient during propofol and remifentanil anesthesia: a case report
Korean Journal of Anesthesiology 2014³â 67±Ç 4È£ p.270 ~ p.274
ÃÖÀ±Áö(Choi Yoon-Ji) - Inje University Seoul Paik Hospital Department of Anesthesiology and Pain Medicine
(Kwon Koo) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
¹è°íÀº(Bae Go-Eun) - Korea University College of Medicine Department of Anesthesiology and Pain Medicine
À±½ÂÁÖ(Yoon Seung-Zhoo) - Korea University College of Medicine Department of Anesthesiology and Pain Medicine
ÀÌÇý¿ø(Lee Hye-Won) - Korea University College of Medicine Department of Anesthesiology and Pain Medicine
ÀÓÇýÀÚ(Lim Hae-Ja) - Korea University College of Medicine Department of Anesthesiology and Pain Medicine
Abstract
We report a case of increased values of entropy parameters Response Entropy (RE) and State Entropy (SE) during intravenous general anesthesia in a sleepwalking patient. An ASA class II, 64-year-old woman with stress incontinence underwent mid-urethral sling surgery. Prior to surgery, the patient had been administered paroxetine, valproic acid and clonazepam for the treatment of sleepwalking disorder. After 10 min of target-controlled infusion of propofol and remifentanil, entropy values increased up to 94 (RE) and 88 (SE) for 10 min. The target effect-site concentrations of anesthetics increased from 4 to 7 ¥ìg/ml propofol and 4 ng/ml remifentanil, at which point values fell back to adequate anesthesia levels. Episodes of recall or of explicit memories did not occur during the anesthesia. In conclusion, sleepwalking patients with long-term use medications may need increment of anesthetic dose caused by the anesthetic drug metabolism activation or impairment or immaturity of inhibitory circuits in brain.
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Anesthetics, Entropy, Somnambulism
KMID :
0356920140670040270
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