MAC‐awake of sevoflurane in children

Davidson, Andrew; Wong, Aaron; Knottenbelt, Graham; Sheppard, Suzette; Donath, Susan; Frawley, Geoff

doi:10.1111/j.1460-9592.2008.02664.x

Cited by 49 publications

(23 citation statements)

References 13 publications

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“…We maintained the predetermined sevo ET for more than 10 min, and data collection was completed before commencing surgery. We continued data sampling until we had obtained six mid‐points of pairs of concentration and approximately 10 changes in direction, which are required to obtain a reliable MAC value using Dixon's up‐and‐down method .…”

Section: Methodsmentioning

confidence: 99%

The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50 in children

et al. 2014

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SummaryWe evaluated the minimum alveolar concentration of sevoflurane required to maintain the bispectral index below 50 in children. We studied 55 children, divided into 1-year-old, 2-to 4-year-old and 5-to 9-year-old groups and used Dixon's up-and-down method and probit analysis. In the 1-year-old group, the bispectral index values remained above 50, with the end-tidal sevoflurane concentration reaching 4.0% or higher. The minimum alveolar concentration of sevoflurane for maintaining the bispectral index below 50 was significantly higher in the 2-to 4-year-old group (2.33%, 95% CI 2.25-2.57) than in the 5-to 9-year-old group (2.10%, 95% CI 1.94-2.25; p = 0.005). We conclude that assessing the depth of anaesthesia using bispectral index is unreliable in children aged < 2 years anaesthetised with sevoflurane.

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Section: Methodsmentioning

confidence: 99%

The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50 in children

et al. 2014

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“…Probit analysis was performed using sas version 9.2 (SAS Institute Inc, Cary, NC, USA). To obtain reliable MAC value using the up‐down method, six midpoints of pair and approximately 10 changes in direction are required (11,12). We assumed that 20 children would be enough to satisfy these concerns.…”

Section: Methodsmentioning

confidence: 99%

Minimum alveolar concentrations of sevoflurane for maintaining bispectral index below 50 in children

Tsuruta

Satsumae

Mizutani

et al. 2011

Pediatric Anesthesia

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“…Under sevoflurane, several studies describe a steady decrease in BIS for increasing sevoflurane concentrations between 1% and 3% . As for propofol, no dose‐related raw EEG pediatric analyses are available to explain this relationship, except for some data describing a decrease in spectral edge frequency for increasing doses of sevoflurane . For higher concentrations, some authors report cases of increase in BIS value .…”

Section: Introductionmentioning

confidence: 99%

“…7,8 As for propofol, no dose-related raw EEG pediatric analyses are available to explain this relationship, except for some data describing a decrease in spectral edge frequency for increasing doses of sevoflurane. 9,10 For higher concentrations, some authors report cases of increase in BIS value. 8,11 There is no clear explanation to this phenomenon, often qualified as "paradoxical.…”

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confidence: 99%

EEG profiles during general anesthesia in children: A comparative study between sevoflurane and propofol

Rigouzzo

Khoy-Ear

Laude

et al. 2019

Pediatric Anesthesia

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Background In this prospective study, we describe the electroencephalographic (EEG) profiles in children anesthetized with sevoflurane or propofol. Methods Seventy‐three subjects (11 years, range 5‐18) were included and randomly assigned to two groups according to the anesthetic agent. Anesthesia was performed by target‐controlled infusion of propofol (group P) or by sevoflurane inhalation (group S). Steady‐state periods were performed at a fixed randomized concentration between 2, 3, 4, 5, and 6 μg.ml−1 of propofol in group P and between 1, 2, 3, 4, and 5% of sevoflurane in group S. Remifentanil was continuously administered throughout the study. Clinical data, Bispectral Index (BIS), and raw EEG were continuously recorded. The relationship between BIS and anesthetic concentrations was studied using nonlinear regression. For all steady‐state periods, EEG traces were reviewed to assess the presence of epileptoid signs, and spectral analysis of raw EEG was performed. Results Under propofol, BIS decreased monotonically and EEG slowed down as concentrations increased from 2 to 6 μg.ml−1. Under sevoflurane, BIS decreased from 0% to 4% and paradoxically rose from 4% to 5% of expired concentration: this increase in BIS was associated with the occurrence of fast oscillations and epileptoid signs on the EEG trace. Propofol was associated with more delta waves and burst suppression periods compared to sevoflurane. Conclusion Under deep anesthesia, the BIS and electroencephalographic profiles differ between propofol and sevoflurane. For high concentrations of sevoflurane, an elevated BIS value may be interpreted as a sign of epileptoid patterns or EEG fast oscillations rather than an insufficient depth of hypnosis.

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MAC‐awake of sevoflurane in children

Abstract: Although MAC-awake changes with age, in the ages where awareness has been reported, MAC-awake was found to be relatively low, and therefore it seems unlikely that age-specific changes to MAC-awake are a cause for awareness in children aged 5-12 years.

Cited by 49 publications

References 13 publications

The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50 in children

The relationship between age and minimum alveolar concentration of sevoflurane for maintaining bispectral index below 50 in children

Minimum alveolar concentrations of sevoflurane for maintaining bispectral index below 50 in children

EEG profiles during general anesthesia in children: A comparative study between sevoflurane and propofol

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