MAC(EI) and MAC(awake) of sevoflurane in infants with obstructive jaundice

The aim of this study was to determine whether the MACEI and MACawake of sevoflurane in infants with obstructive jaundice are different from that observed in nonjaundiced infants.

Infants scheduled for abdominal surgery were recruited into the study. General anesthesia was induced with 8% sevoflurane inhaled with 8 l·min(-1) of oxygen via mask, followed by adjustment of inspired sevoflurane to the target concentration based on the result in previous patient at which laryngoscopy and tracheal intubation were attempted and maintained for 15 min. All responses to tracheal intubation were assessed. At the end of the procedure, sevoflurane was titrated to the target concentration, which was kept constant for 15 min before a standard stimulus was applied to determine whether the infant was awake. The Dixon's 'up and down' method was used to determine progression of subsequent concentrations.

There was no significant difference between the MACEI of sevoflurane in infants with obstructive jaundice (3.40 ± 0.21%) and that observed in the control group (3.43 ± 0.18%). But the MACawake of sevoflurane in jaundiced infants (1.00 ± 0.15%) was significantly lower than that of nonjaundiced controls (1.40 ± 0.21%; P = 0.004); to complement these findings, we reported a negative correlation between serum total bilirubin and the probability of awakening (OR = 0.984, 95% CI is 0.970-0.998, P = 0.028).

The MACawake of sevoflurane was reduced in obstructive jaundiced infants compared with nonjaundiced controls, whereas there was no significant difference between the MACEI of sevoflurane in infants with obstructive jaundice and that observed in nonjaundiced infants.