title: Minimum alveolar concentration of desflurane and hemodynamic responses in neonates, infants, and children.
abstract: We sought to determine the minimum alveolar concentration (MAC) and hemodynamic responses to desflurane in 72 fasting and unpremedicated full-term neonates, infants, and children up to 12 yr of age. The patients were divided into six groups (n = 12) according to age. After awake tracheal intubation, neonates were anesthetized with desflurane in oxygen and air. Infants greater than 1 month of age and all older children were anesthetized with desflurane in 100% oxygen, and their tracheas were intubated without muscle relaxation. MAC was determined using the "up-and-down technique" and logistic regression. Heart rate and systolic arterial pressure were recorded awake, at approximately 1 MAC desflurane before skin incision and at approximately 1 MAC during the peak hemodynamic responses to skin incision. We found that the relationship between MAC (mean +/- standard deviation) as determined by the up-and-down technique and age was quadratic, reaching a maximum value in infants 6-12 months of age: in neonates 0-1 month MAC was 9.16 +/- 0.02%, in infants 1-6 months 9.42 +/- 0.06%, in infants 6-12 months 9.92 +/- 0.44%, in children 1-3 yr 8.72 +/- 0.59%, in children 3-5 yr 8.62 +/- 0.45%, and in children 5-12 yr 7.98 +/- 0.43%. MAC values obtained using logistic regression were similar. Heart rate decreased an average of 16% before skin incision in infants 6-12 months of age and children 1-3 and 3-5 yr of age when compared to awake values (P less than 0.025) but did not change significantly in the remaining three groups.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Anaesthesia, Hospital for Sick Children, University of Toronto, Ontario, Canada.
authors.forename: R H
authors.initials: RH
authors.lastname: Taylor
authors.forename: J
authors.initials: J
authors.lastname: Lerman
mesh_terms: D000367:Age Factors; D000777:Anesthetics / Q000378:metabolism*; D001794:Blood Pressure; D002648:Child; D002675:Child, Preschool; D000077335:Desflurane; D006339:Heart Rate; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007530:Isoflurane / Q000031:analogs & derivatives* / Q000378:metabolism; D011650:Pulmonary Alveoli / Q000378:metabolism*; D013599:Systole
chemical_list: D000777:Anesthetics; D000077335:Desflurane; D007530:Isoflurane