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Minimum alveolar concentrations of sevoflurane for maintaining bispectral index below 50 in children

Shouhei Tsuruta1, Tsuyoshi Satsumae, Taro Mizutani

  • 1Department of Anesthesiology and Critical Care Medicine, University of Tsukuba, Tsukuba City, Ibaraki, Japan.

Paediatric Anaesthesia
|May 4, 2011
PubMed

Insights

The minimum alveolar concentration (MAC) of sevoflurane for maintaining bispectral index (BIS) below 50 in children was found to be 2.83%. This MAC(BIS50) is significantly higher than in adults, indicating a greater sevoflurane requirement in pediatric anesthesia.

Area of Science:

  • Anesthesiology
  • Pediatric Anesthesia
  • Pharmacology

Background:

  • The minimum alveolar concentration (MAC) of sevoflurane for maintaining bispectral index (BIS) below 50 (MAC(BIS50)) in adults is 0.97%.
  • This specific MAC value has not been previously determined in pediatric populations.

Purpose of the Study:

  • To determine the MAC(BIS50) of sevoflurane in children aged 1-8 years.
  • To compare pediatric MAC(BIS50) with established adult values.

Main Methods:

  • Twenty children (ASA physical status I or II, aged 1-8) received sevoflurane anesthesia.
  • End-tidal sevoflurane concentrations were adjusted using Dixon's up-down method with 0.2% increments.
  • BIS was measured after 10 minutes at each concentration to determine MAC(BIS50).

Main Results:

  • The determined MAC(BIS50) of sevoflurane in children was 2.83% (95% CI: 2.70-3.14).
  • This value is approximately three times higher than the reported MAC(BIS50) in adults.

Conclusions:

  • Children require significantly higher end-tidal sevoflurane concentrations to suppress electroencephalogram activity compared to adults.
  • These findings highlight the need for adjusted sevoflurane dosing in pediatric anesthesia to achieve adequate depth of anesthesia.
Abstract

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