Advance of age decreases the minimum alveolar concentrations of isoflurane and sevoflurane for maintaining bispectral index below 50
Advance of age decreases the minimum alveolar concentrations of isoflurane and sevoflurane for maintaining bispectral index below 50
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DOI：
10.1093/bja/aen382
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发表时间：
2009-03-01
影响因子：
9.8
通讯作者：
Asada, A.
中科院分区：
文献类型：
--
作者：
Matsuura, T.;Oda, Y.;Asada, A.
我们研究了维持脑电双频指数 (BIS) 低于 50 (MAC(BIS50)) 的异氟醚和七氟醚最低肺泡浓度 (MAC) 与年龄相关的差异。120 名年轻 (= 70 岁) 患者被随机分配到六组之一。在氧气中用异氟烷或七氟烷诱导麻醉。气管插管后，我们任意开始各组维持麻醉，呼气末异氟醚和七氟醚浓度分别为0.8和1.2vol%。在预定的潮气末异氟烷或七氟烷浓度下 10 分钟后，测量 BIS 1 分钟。采用自上而下法测定各组异氟醚或七氟醚的 MAC(BIS50)。青年、中年和老年患者的异氟醚 MAC(BIS50) 分别为 0.82% 呼气末（95% 置信区间 0.76-0.88）、0.67%（0.61-0.73）和 0.56%七氟醚在青年、中年和老年患者中的使用率分别为1.28%（1.24-1.32）、0.97%（0.89-1.05）和0.87%（0.84-0.90）。对于异氟醚和七氟醚，年轻患者的 MAC(BIS50) 显着高于中年患者（分别为 P=0.002 和 0.001），而老年患者显着低于中年患者（P=0.02）。年龄的增长显着降低了维持 BIS 低于 50 所需的异氟醚和七氟醚浓度。BIS 正确反映了与年龄相关的潮气末浓度的降低。在静息状态下维持足够的麻醉深度所需的异氟醚和七氟醚。
We investigated age-related differences in the minimum alveolar concentration (MAC) of isoflurane and sevoflurane for maintaining bispectral index (BIS) below 50 (MAC(BIS50)).One hundred and twenty young (= 70 yr) patients were randomly allocated to one of the six groups. Anaesthesia was induced with isoflurane or sevoflurane in oxygen. After tracheal intubation, we arbitrarily started maintenance of anaesthesia in each group with end-tidal isoflurane and sevoflurane concentrations of 0.8 and 1.2 vol%, respectively. After 10 min at predetermined end-tidal isoflurane or sevoflurane concentrations, BIS was measured for 1 min. MAC(BIS50) of isoflurane or sevoflurane for each group was determined by up-down methodology.MAC(BIS50) of isoflurane in young, middle-aged, and elderly patients was 0.82% end-tidal (95% confidence intervals 0.76-0.88), 0.67% (0.61-0.73), and 0.56% (0.51-0.61), respectively, and that of sevoflurane in young, middle-aged, and elderly patients was 1.28% (1.24-1.32), 0.97% (0.89-1.05), and 0.87% (0.84-0.90), respectively. For both isoflurane and sevoflurane, the MAC(BIS50) was significantly higher (P=0.002 and 0.001, respectively) in young patients and significantly lower (P=0.02 for both) in elderly patients than those in middle-aged patients.Advance in age significantly decreased the concentrations of isoflurane and sevoflurane required to maintain BIS below 50. BIS correctly reflected age-associated decrease of end-tidal concentrations of isoflurane and sevoflurane required for maintaining adequate depth of anaesthesia during resting state.