Association of ethnicity with the minimum alveolar concentration of sevoflurane.
BACKGROUND
Selective breeding produces animal strains with varying anesthetic sensitivity. It thus seems unlikely that various human ethnicities have identical anesthetic requirements. Therefore, the authors tested the hypothesis that the minimum alveolar concentration of sevoflurane differs significantly as a function of ethnicity.


METHODS
The authors recruited 90 American Society of Anesthesiologists physical status I and II adult patients belonging to three Jewish ethnic groups: European, Oriental, and Caucasian (from the Caucasus Mountain region). All were scheduled to undergo surgery requiring a skin incision exceeding 3 cm. Without premedication, anesthesia was induced with 6-8% sevoflurane in 100% oxygen, and tracheal intubation was facilitated with succinylcholine. The skin incision was made after a predetermined end-tidal concentration of sevoflurane of 2.0% was maintained for at least 10 min in the first patient in each group. Blinded investigators observed the patient for movement during the subsequent minute. The concentration in the next patient was increased by 0.2% when patients moved, or decreased by the same amount when they did not. Results are presented as means [95% confidence intervals].


RESULTS
Morphometric and demographic characteristics were similar among the groups; however, mean arterial pressure was slightly greater in European Jews. Minimum alveolar concentration for sevoflurane was greatest in Caucasian Jews (2.32% [2.27-2.41%]), less in Oriental Jews (2.14% [2.06-2.22%]), and still less in European Jews (1.9% [1.82-1.99%]) (P < 0.001).


CONCLUSIONS
The results suggest that minimum alveolar concentration varies as a function of ethnicity. However, the extent to which confounding characteristics contribute, including lifestyle choices and environmental factors, remains unknown.
Ezri
Tiberiu
T
Department of Anesthesia, the Edith Wolfson Medical Center, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Isreal. tezri@netvision.net.il
Sessler
Daniel
D
Weisenberg
Marian
M
Muzikant
Gleb
G
Protianov
Michael
M
Mascha
Edward
E
Evron
Shmuel
S
D000328:Adult; D018685:Anesthetics, Inhalation / Q000493:pharmacokinetics*; D001208:Asia; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D003627:Data Interpretation, Statistical; D004311:Double-Blind Method; D005006:Ethnicity; D005060:Europe; D005061:Europe, Eastern; D005260:Female; D006801:Humans; D007585:Jews; D008297:Male; D008738:Methyl Ethers / Q000493:pharmacokinetics*; D008875:Middle Aged; D011229:Preanesthetic Medication; D011650:Pulmonary Alveoli / Q000378:metabolism*; D000077149:Sevoflurane
D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D003577:Cytochrome P-450 Enzyme System