Case report: Large increases in entropy during general anesthesia to awake values antagonized with additional administration of rocuronium

We present the case of a 47-year-old female patient (ASA II) with acute cholecystitis, type 2 diabetes and grade 2 obesity (Body Mass Index 36 kg/m2) undergoing laparoscopic cholecystectomy under general anesthesia in our institution (SCJU Oradea). Depth of anesthesia was monitored with a General Electric Healthcare (GE) Entropy Module and muscle relaxation was monitored with a neuromuscular transmission module (NMT). During the procedure we noted a sudden large increase in RE and SE to awake values. An additional dose of rocuronium was administered and both RE and SE values decreased immediately. This exact scenario was repeated two times during the case. The patient reported no awareness postoperatively.