MAC levels

[refreshingred]

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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]

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).

 

[MAC10]

Its in baby Barash.

 

[toofache32]

Its in baby Barash.

pages 185-186

 

[VolatileAgent]

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]

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]

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.

 

[jwk]

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]

True-mac is only a guideline-remember the machine calculates the mac-you can get burned just by following mac levels