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Related Experiment Videos

Isoflurane minimum alveolar concentration reduction by fentanyl

A I McEwan1, C Smith, O Dyar

  • 1Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina 27710.

Anesthesiology
|May 1, 1993
PubMed
Summary

Fentanyl significantly reduces the minimum alveolar concentration (MAC) of isoflurane, with a 50% MAC reduction achieved at 1.67 ng/ml. A ceiling effect limits further reduction at higher fentanyl concentrations.

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Area of Science:

  • Anesthesiology
  • Pharmacology
  • Pharmacokinetics

Background:

  • Isoflurane and fentanyl are common anesthetic agents.
  • Drug hysteresis necessitates studying steady-state concentrations for accurate interaction assessment.

Purpose of the Study:

  • To quantify the minimum alveolar concentration (MAC) reduction of isoflurane induced by fentanyl at steady-state biophase concentrations.
  • To establish a dose-response relationship between fentanyl and isoflurane MAC reduction.

Main Methods:

  • Seventy-seven patients received continuous infusion fentanyl at various plasma concentrations or no fentanyl.
  • Patients also received a steady-state end-tidal isoflurane concentration.
  • Fentanyl concentrations were measured, and MAC reduction was calculated using logistic regression.

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Main Results:

  • A fentanyl concentration of 1.67 ng/ml produced a 50% reduction in isoflurane MAC.
  • An initial steep MAC reduction was observed, with 3 ng/ml yielding a 63% reduction.
  • A ceiling effect limited further MAC reduction beyond 10 ng/ml.

Conclusions:

  • Quantifying opioid-induced MAC reduction enables rational co-administration with inhalational anesthetics.
  • This study provides comparative anesthetic potencies of opioids and inhalational agents.