ENTROPY-GUIDED PROCEDURAL SEDATION. A PROSPECTIVE,
OBSERVATIONAL, MONO-CENTRIC STUDY
SILVIUS NEGOIȚĂ ¹, OANA TUDORACHE ², ROBERT IVAȘCU ², ALEXANDRU GRECU ², ANDRA MIRON ², DAN CORNECI ¹, MĂDĂLINA DUȚU ¹*
¹“Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
²“Elias” Emergency Hospital, Bucharest, Romania
*corresponding author: madalinadutu236@yahoo.com
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Abstract:
Procedural sedation outside the operating room is more and more common. The risk of adverse events increases in parallel
with the depth of sedation, therefore monitoring the level of consciousness through an objective method that accompanies
clinical evaluation increases the safety of the procedure. The aim of the study was to establish an objective method of
monitoring the level of consciousness in sedation and analgesia procedures. We performed a prospective, observational
study, conducted in the Anaesthesia and Intensive Care Clinic of the “Elias” Emergency University Hospital, Bucharest,
Romania, which included procedural sedation in the endoscopy laboratory. During the procedural sedation was registered:
the sedation level evaluated both clinically via the modified Wilson scale, as well as using response entropy (RE), state
entropy (SE), along with standard monitoring in procedural sedations. A statistically significant negative correlation was
obtained between the two parameters of entropy and the depth of sedation (r = -0.824, in the case of RE, and r = -0.804 in
case of SE). Response and state entropy values were statistically different between superficial (grades 1 and 2) and deep
sedation. Entropy correlates with the depth of sedation, allowing the differentiation between superficial sedation and deep
sedation. However, clear intervals of RE and SE could not be established for each degree of sedation.

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