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MAC-awake of sevoflurane in children

Andrew J Davidson1, Aaron Wong, Graham Knottenbelt

  • 1Department of Anaesthesia & Pain Management, Royal Children's Hospital, Vic., Australia. andrew.davidson@rch.org.au

Paediatric Anaesthesia
|July 11, 2008
PubMed

Insights

Minimum alveolar concentration (MAC)-awake, a measure of anesthetic potency, is highest in young children and decreases with age. This suggests age-related MAC-awake changes are unlikely to cause awareness in children aged 5-12 years.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacodynamics

Background:

  • Anesthetic potency varies with age, but MAC-awake data in children is limited.
  • MAC-awake is crucial for preventing intraoperative awareness.
  • Understanding age-related MAC-awake is vital for pediatric anesthesia safety.

Purpose of the Study:

  • To determine the Minimum Alveolar Concentration (MAC)-awake across different pediatric age groups.
  • To investigate the influence of age on anesthetic potency relevant to awareness prevention.

Main Methods:

  • Sixty children were divided into three age groups (2 to <5, 5 to <8, and 8-12 years).
  • Sevoflurane anesthesia was administered, and MAC-awake was determined using the Dixon up-down method.
  • Probit analysis was employed to calculate the median effective dose (ED50) for MAC-awake in each group.

Main Results:

  • A statistically significant difference in ED50 for MAC-awake was observed between age groups (P = 0.008).
  • The youngest children (2 to <5 years) exhibited the highest MAC-awake (0.66%).
  • Older children (5 to <8 and 8-12 years) showed similar, lower MAC-awake values (0.45% and 0.43%, respectively).

Conclusions:

  • MAC-awake demonstrates age-dependent variability in children.
  • The relatively low MAC-awake in children aged 5-12 years makes it unlikely to be the primary cause of awareness in this group.
  • These findings contribute to optimizing anesthetic management for pediatric patients.
Abstract

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