Minimal alveolar concentration of sevoflurane for induction of isoelectric electroencephalogram in middle-aged adults.
Minimal alveolar concentration of sevoflurane for induction of isoelectric electroencephalogram in middle-aged adults.
复制标题
中年成人等电脑电图诱导七氟醚最低肺泡浓度。
DOI：
10.1093/bja/aet280
复制
发表时间：
2014
影响因子：
9.8
通讯作者：
Yu
中科院分区：
文献类型：
--
作者：
B. Niu;Y. Fang;J. Miao;Y. Yu;F. Cao;F. Cao;H. X. Chen;Z. Zhang;Wei Mei;Yu
背景
BACKGROUND
We determined the minimal alveolar concentration (MAC) of sevoflurane inducing an isoelectric EEG in 50% of adult subjects (MACie).
METHODS
We included 31 middle-aged subjects; 30 subjects finished the study protocol and received sevoflurane at preselected concentrations according to a modified Dixon 'up-and-down' design starting at 1.7 vol% with 0.2 vol% steps size. General anaesthesia was induced and maintained with sevoflurane; tracheal intubation was facilitated with cisatracurium. After a period of 30 min before skin incision, the state of isoelectric EEG was considered as significant when a burst suppression ratio of 100% lasted for >1 min. The haemodynamic responses to skin incision and the vasopressor requirement to maintain stable haemodynamic status were also analysed according to the EEG state.
RESULTS
MACie was 3.5% (95% confidence interval, 3.4-3.7%) in middle-aged subjects. When compared with subjects not in isoelectric EEG state, subjects in isoelectric EEG state received more phenylephrine to maintain stable haemodynamics (10 of 10 compared with 7 of 20 subjects, P=0.001) and experienced less sympathetic responses to skin incision (1 of 10 compared with 11 of 20 subjects, P=0.024).
CONCLUSIONS
MACie for sevoflurane was ∼2.1 times MAC for immobilization in phenobarbital premedicated middle-aged adults. Sevoflurane-induced isoelectric EEG state is associated with significant cardiovascular depression but reduced haemodynamic responses to skin incision.
DOI：
10.1056/nejmra0808281
发表时间：
2010-12-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Brown EN;Lydic R;Schiff ND
通讯作者：
Schiff ND