{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:06:42Z","timestamp":1779966402810,"version":"3.53.1"},"reference-count":24,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Conventional EEG-derived sedation targets for Entropy monitoring (State Entropy SE 40\u201360) were established in the context of general anaesthesia and may not be directly applicable to procedural sedation for endoscopic retrograde cholangiopancreatography (ERCP). This study aimed to characterize SE and Response Entropy (RE) trajectories during propofol-based sedation for ERCP and to evaluate their relationships with clinical sedation depth, patient characteristics, and procedural outcomes. Materials and Methods: In this prospective, single-center observational study, 50 consecutive adult patients undergoing elective ERCP under propofol-based sedation were enrolled. SE and RE were recorded at baseline and at serial intra-procedural timepoints. Time-in-zone analysis classified SE values into predefined ranges. Correlations between Entropy indices and MOAA\/S scores, patient factors, Aldrete recovery scores, and adverse events were assessed using Spearman\u2019s rank correlation. Results: The median patient age was 72.5 years (IQR 65.0\u201379.0), and the median ASA score was 3 (IQR 2\u20133). Following induction, SE declined from a baseline mean of 89.3 \u00b1 1.5 to a mean of 68.8 \u00b1 5.3 at 10 min, the lowest group-level value recorded; the mean individual SE nadir across patients was 67.2 \u00b1 5.3. No SE values below 40 were observed at any timepoint. Mean time spent within the conventional SE 40\u201360 target range was 3.7% \u00b1 10.6, while mean time within SE 60\u201385 was 80.7% \u00b1 8.3. SE at 3 min correlated moderately with MOAA\/S at 3 min (Spearman rho = 0.430, p = 0.002), with substantial within-category variability. Age showed a strong negative correlation with SE at 3 min (rho = \u22120.612, p &lt; 0.001), an effect that persisted at 5 min, consistent with deeper early EEG suppression in older patients, which may reflect increased pharmacodynamic sensitivity, age-related changes in spectral substrate, or both. ASA score was associated with SE at 15 min only (rho = \u22120.299, p = 0.035). Patients who experienced adverse events demonstrated higher SE instability, though differences did not reach statistical significance. Recovery was rapid, with a median Aldrete score of 10 at 15 min. Conclusions: During propofol sedation for ERCP, observed SE values operated predominantly between 60 and 85, well above the conventional general anaesthesia target of 40\u201360. Older age was the strongest predictor of early sedation depth. These findings suggest that in elderly, high-ASA patients receiving propofol-based multi-drug sedation for ERCP, numerical SE values differ systematically from conventional general anaesthesia-derived target ranges. Whether this reflects true procedure-specific sedation requirements or cohort-specific spectral substrate differences warrants prospective outcome-anchored investigation.<\/jats:p>","DOI":"10.3390\/medicina62061047","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:57:43Z","timestamp":1779962263000},"page":"1047","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["EEG-Derived Entropy Monitoring During Propofol Sedation for ERCP: Sedation Profiles, Age-Related Effects, and Implications for Procedure-Specific Target Ranges"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5195-3993","authenticated-orcid":false,"given":"Sonia Elena","family":"Popovici","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Doctoral School, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Anaesthesia and Intensive Care Research Center (CCATITM), Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8751-6813","authenticated-orcid":false,"given":"Stelian Adrian","family":"Ritiu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Doctoral School, Victor Babes University of Medicine and Pharmacy, Eftimie Murgu Square 2, 300041 Timisoara, Romania"},{"name":"Anaesthesia and Intensive Care Research Center (CCATITM), Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1510-9223","authenticated-orcid":false,"given":"Ioan","family":"Sporea","sequence":"additional","affiliation":[{"name":"Advanced Regional Research Center in Gastroenterology and Hepatology, Department VII: Internal Medicine II, Discipline of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorel","family":"Sandesc","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Anaesthesia and Intensive Care Research Center (CCATITM), Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care, Emergency County Hospital \u201cPius Br\u00eenzeu\u201d, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3432-9168","authenticated-orcid":false,"given":"Ovidiu Horea","family":"Bedreag","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Anaesthesia and Intensive Care Research Center (CCATITM), Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care, Emergency County Hospital \u201cPius Br\u00eenzeu\u201d, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marius","family":"P\u0103puric\u0103","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Anaesthesia and Intensive Care Research Center (CCATITM), Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Clinic of Anaesthesia and Intensive Care, Emergency County Hospital \u201cPius Br\u00eenzeu\u201d, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alina","family":"Popescu","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Advanced Regional Research Center in Gastroenterology and Hepatology, Department VII: Internal Medicine II, Discipline of Gastroenterology and Hepatology, Victor Babes University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1002\/phar.2712","article-title":"Systematic Review and Meta-analysis of the Correlation between Bispectral Index (BIS) and Clinical Sedation Scales: Toward Defining the Role of BIS in Critically Ill Patients","volume":"42","author":"Heavner","year":"2022","journal-title":"Pharmacother. 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