An unexpected increase of entropy in a sleepwalking disorder patient during propofol and remifentanil anesthesia: a case report.
10.4097/kjae.2014.67.4.270
- Author:
Yoon Ji CHOI
1
;
Koo KWON
;
Go Eun BAE
;
Seung Zhoo YOON
;
Hye Won LEE
;
Hae Ja LIM
Author Information
1. Department of Anesthesiology and Pain Medicine, Inje University Seoul Paik Hospital, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Anesthetics;
Entropy;
Somnambulism
- MeSH:
Anesthesia*;
Anesthesia, General;
Anesthetics;
Brain;
Clonazepam;
Entropy*;
Female;
Humans;
Metabolism;
Middle Aged;
Paroxetine;
Propofol*;
Somnambulism*;
Suburethral Slings;
Valproic Acid
- From:Korean Journal of Anesthesiology
2014;67(4):270-274
- CountryRepublic of Korea
- Language:English
-
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 microg/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.
