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KMID : 0356920140670040270
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Korean Journal of Anesthesiology
2014 Volume.67 No. 4 p.270 ~ p.274
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An unexpected increase of entropy in a sleepwalking disorder patient during propofol and remifentanil anesthesia: a case report
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Choi Yoon-Ji
Kwon Koo
Bae Go-Eun
Yoon Seung-Zhoo
Lee Hye-Won
Lim Hae-Ja
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Abstract
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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 μg/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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KEYWORD
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Anesthetics, Entropy, Somnambulism
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