title: MAC(EI) and MAC(awake) of sevoflurane in infants with obstructive jaundice.
abstract: BACKGROUND
  The aim of this study was to determine whether the MACEI and MACawake of sevoflurane in infants with obstructive jaundice are different from that observed in nonjaundiced infants.
  
  
  METHODS
  Infants scheduled for abdominal surgery were recruited into the study. General anesthesia was induced with 8% sevoflurane inhaled with 8 l·min(-1) of oxygen via mask, followed by adjustment of inspired sevoflurane to the target concentration based on the result in previous patient at which laryngoscopy and tracheal intubation were attempted and maintained for 15 min. All responses to tracheal intubation were assessed. At the end of the procedure, sevoflurane was titrated to the target concentration, which was kept constant for 15 min before a standard stimulus was applied to determine whether the infant was awake. The Dixon's 'up and down' method was used to determine progression of subsequent concentrations.
  
  
  RESULTS
  There was no significant difference between the MACEI of sevoflurane in infants with obstructive jaundice (3.40 ± 0.21%) and that observed in the control group (3.43 ± 0.18%). But the MACawake of sevoflurane in jaundiced infants (1.00 ± 0.15%) was significantly lower than that of nonjaundiced controls (1.40 ± 0.21%; P = 0.004); to complement these findings, we reported a negative correlation between serum total bilirubin and the probability of awakening (OR = 0.984, 95% CI is 0.970-0.998, P = 0.028).
  
  
  CONCLUSIONS
  The MACawake of sevoflurane was reduced in obstructive jaundiced infants compared with nonjaundiced controls, whereas there was no significant difference between the MACEI of sevoflurane in infants with obstructive jaundice and that observed in nonjaundiced infants.
authors: Department of Anesthesiology and Critical Care Medicine, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China.
authors: Si-Qin
authors: SQ
authors: Chen
authors: Hai-Rong
authors: HR
authors: Ye
authors: Yi-Jun
authors: YJ
authors: Chen
authors: Ying-Wei
authors: YW
authors: Wang
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D000769:Anesthesia, Inhalation; D018685:Anesthetics, Inhalation / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D018686:Anesthetics, Intravenous; D001279:Atracurium / Q000031:analogs & derivatives; D001656:Biliary Atresia / Q000150:complications; D001663:Bilirubin / Q000097:blood; D005260:Female; D006801:Humans; D007223:Infant; D041781:Jaundice, Obstructive / Q000378:metabolism*; D008297:Male; D008738:Methyl Ethers / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D011171:Portoenterostomy, Hepatic; D011650:Pulmonary Alveoli / Q000378:metabolism*; D012018:Reflex / Q000187:drug effects; D000077208:Remifentanil; D000077149:Sevoflurane
chemical_list: D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D008738:Methyl Ethers; D003473:Neuromuscular Nondepolarizing Agents; D010880:Piperidines; D001279:Atracurium; D000077149:Sevoflurane; D000410:Alanine Transaminase; D000077208:Remifentanil; C101584:cisatracurium; D001663:Bilirubin
keywords: MAC
  EI; MAC
  awake; infants; obstructive jaundice; sevoflurane