Document Detail


Minimum alveolar concentration of sevoflurane that blocks the adrenergic response to surgical incision in women: MACBAR.
MedLine Citation:
PMID:  10225167     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We have investigated the cardiovascular and plasma noradrenaline response to surgical incision under sevoflurane anaesthesia and determined the end-tidal concentration of sevoflurane that blocks the adrenergic response or responses to surgical incision (MACBAR) and changes in mean arterial pressure (MAP) in response to surgical incision (MACBCR) in 50% of women. We randomly assigned 64 female patients, aged 20-49 years, to eight groups according to end-tidal sevoflurane concentration: 5.0%, 5.5%, 6.0%, 6.5%, 7.0%, 7.5%, 8.0% and 8.5%. All patients received only sevoflurane anaesthesia. An increase of 10% or more from prestress (incision) values of MAP or plasma noradrenaline concentration was considered a positive response. The probability of no response to stress was analysed using logistic regression to obtain the probability of no response vs. end-tidal sevoflurane concentration and the best-fit curve from the maximum likelihood estimators of the model parametes. MACBAR (mean +/- SE) was 8.0 +/- 0.2%, MACBCR was 7.9 +/- 0.2%. However, such high doses of sevoflurane cannot be used clinically because of their high toxicity. It may be preferable to combine sevoflurane with other anaesthetics to reduce haemodynamic responses to strong stimulation.
Authors:
T Ura; H Higuchi; M Taoda; T Sato
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  16     ISSN:  0265-0215     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-27     Completed Date:  1999-07-27     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  176-81     Citation Subset:  IM    
Affiliation:
Department of Anaesthesia, Self Defense Force Central Hospital, Tokyo, Japan.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthetics, Inhalation / administration & dosage,  pharmacokinetics,  pharmacology*
Blood Pressure / drug effects
Dose-Response Relationship, Drug
Female
Humans
Intubation, Intratracheal
Laryngoscopy
Methyl Ethers / administration & dosage,  pharmacokinetics,  pharmacology*
Middle Aged
Norepinephrine / blood*
Pulmonary Alveoli / metabolism*
Surgical Procedures, Operative / adverse effects*
Chemical
Reg. No./Substance:
0/Anesthetics, Inhalation; 0/Methyl Ethers; 28523-86-6/sevoflurane; 51-41-2/Norepinephrine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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