refreshingred
09-25-2005, 11:08 AM
So is this right?
0 - 0.3 MAC pt is awake
0.3 - 0.7 - pt asleep
0.7 - 1.0 - anesthesia
1.0 - 1.3 surgical anesthesia
1.3 - 1.6 intubating MAC
An attending quoted the above to me, but I can't find a similar chart in baby Miller or my Clinical Anesthesia textbook.
Does anybody know where I can find the original lit that supports this, or in other words does anybody know where the above came from?
coccygodynia
09-25-2005, 12:14 PM
That info might be found in Eger's 'The Pharmacology of Inhaled Anesthetics'. I've been told by different attendings that MACawake is 0.5 and MAC-BAR is 1.3-1.5 (depending on the agent).
toofache32
09-26-2005, 05:02 PM
Its in baby Barash.
pages 185-186
VolatileAgent
09-26-2005, 05:38 PM
oh yeah? i had a patient wake-up on me today at 0.6 MAC. no kidding. ortho case. i was running sevo and nitrous and had just turned the vapors off. was letting the guy rebreathe. he was at about 30% nitrous and about 0.5% ET sevo and "BING!" his eyes popped open and he was ready for the tube to be yanked. i pulled it out and the first thing he did was scream in pain. (guess my epidural didn't work.)
funny. i guess patients don't read the textbooks.
Disse
09-26-2005, 08:45 PM
oh yeah? i had a patient wake-up on me today at 0.6 MAC. no kidding. ortho case. i was running sevo and nitrous and had just turned the vapors off. was letting the guy rebreathe. he was at about 30% nitrous and about 0.5% ET sevo and "BING!" his eyes popped open and he was ready for the tube to be yanked. i pulled it out and the first thing he did was scream in pain. (guess my epidural didn't work.)
funny. i guess patients don't read the textbooks.
Outlier on the bell curve of MAC levels....
jetproppilot
09-26-2005, 09:08 PM
oh yeah? i had a patient wake-up on me today at 0.6 MAC. no kidding. ortho case. i was running sevo and nitrous and had just turned the vapors off. was letting the guy rebreathe. he was at about 30% nitrous and about 0.5% ET sevo and "BING!" his eyes popped open and he was ready for the tube to be yanked. i pulled it out and the first thing he did was scream in pain. (guess my epidural didn't work.)
funny. i guess patients don't read the textbooks.
Reminds me of an ACL I did as a resident under epidural on a Tulane football player who had obviously done his share of partying...propofol 150ug/kg/min finally stopped him from talking. Sats stayed fine with a nasal cannula.
funny. i guess patients don't read the textbooks.
Yep, no concept of MAC whatsoever.
Remember - 50% of rats will respond when you pinch their tail with a hemostat at 1 MAC of anything, and 50% don't. MAC is a concept, not a rule.
New2Midwest
09-27-2005, 06:14 PM
True-mac is only a guideline-remember the machine calculates the mac-you can get burned just by following mac levels