The Minimum Alveolar Concentration of Xenon in the Elderly Is Sex-dependent

2002 ◽  
Vol 97 (5) ◽  
pp. 1129-1132 ◽  
Author(s):  
Takahisa Goto ◽  
Yoshinori Nakata ◽  
Shigeho Morita
Keyword(s):  
Regression Analysis ◽  
Minimum Alveolar Concentration ◽  
The Elderly ◽  
Skin Incision ◽  
Men And Women ◽  
Mk 801 ◽  
Bodily Movement ◽  
Aspartate Receptor ◽  
Significant Difference ◽  
End Tidal

Background The minimum alveolar concentration (MAC) of xenon in the elderly has not been determined. Moreover, because xenon inhibits the activity of the N-methyl-D-aspartate receptors, and because N-methyl-D-aspartate receptor antagonists such as ketamine and MK-801 exert sex-dependent actions, we hypothesized that the MAC of xenon would also be sex-dependent. Methods Forty-eight patients of both sexes (24 patients of each sex), who were aged 65 yr or older and were undergoing elective laparotomy, were anesthetized with inhalational induction of xenon. Those who demonstrated marked agitation received supplemental propofol intravenously. After tracheal intubation, the end-tidal concentration of xenon was maintained at 45 (women only), 50, 55, 60, 65, 70, or 75% (men only) for at least 15 min before skin incision. These concentrations were randomly allocated to four patients of each sex. Each patient was monitored for the presence or absence of any purposeful bodily movement for 1 min following skin incision. The MAC of xenon was calculated separately for men and women using logistic regression analysis. Results The MAC of xenon was 69.3% (95% CI, 63.0-75.6%) for men and 51.1% (44.6-57.6%) for women. The two 95% confidence intervals did not overlap, indicating a statistically significant difference (P < 0.05). Conclusions The MAC of xenon in the elderly is higher in men than in women.

Reduction of the Minimum Alveolar Concentration of Isoflurane by Dexmedetomidine 

1997 ◽  
Vol 86 (5) ◽  
pp. 1055-1060 ◽  
Author(s):  
Riku Aantaa ◽  
Marja-Leena Jaakola ◽  
Antero Kallio ◽  
Jussi Kanto
Keyword(s):  
Minimum Alveolar Concentration ◽  
Study Drug ◽  
Abdominal Hysterectomy ◽  
Skin Incision ◽  
Control Group ◽  
High Dose ◽  
Anesthesia Induction ◽  
Drug Infusion ◽  
Target Plasma Concentration ◽  
End Tidal

Background alpha 2-Adrenergic agonists have been shown to reduce anesthetic requirements of other anesthetics, and they may even act as complete anesthetics by themselves at high doses in animal models. The present study was designed to define the interaction of intravenous infusion of dexmedetomidine, an alpha 2-adrenergic agonist, and isoflurane in patients having surgery by using the minimum alveolar concentration (MAC) of isoflurane as the measure of anesthetic potency. Methods Forty-nine women scheduled for abdominal hysterectomy were randomly allocated to receive either a placebo infusion (n = 16) or a two-stage infusion of dexmedetomidine with target plasma concentration of 0.3 ng/ml (n = 17) or 0.6 ng/ml (n = 16). The study drug infusion was commenced 15 min before induction of anesthesia with thiopental and alfentanil and was continued until skin incision. The end-tidal concentration of isoflurane for each patient was predetermined according to the "up-down" method of Dixon, and it was maintained for at least 15 min before the patient's response to skin incision was assessed. Results The MAC of isoflurane was 0.85% end-tidal in the control group, 0.55% end-tidal with the low dose of dexmedetomidine, and 0.45% end-tidal with the high dose of dexmedetomidine. Conclusions The MAC of isoflurane in the control group was lower than that reported previously in similar patients having surgery, probably due to anesthesia induction with thiopental and alfentanil. Nevertheless, with the high dose of dexmedetomidine, the MAC of isoflurane was still 47% less than that without dexmedetomidine.

scholarly journals Estimating Lifetime Dental Care Expenditure in South Korea: An Abridged Life Table Approach

2020 ◽  
Vol 17 (9) ◽  
pp. 3308
Author(s):  
Minsung Sohn ◽  
Xianhua Che ◽  
Sungwon Lim ◽  
Hee-Jung Park
Keyword(s):  
Life Expectancy ◽  
Life Table ◽  
Dental Care ◽  
Age Groups ◽  
Information Service ◽  
The Elderly ◽  
Average Lifetime ◽  
Men And Women ◽  
Significant Difference ◽  
Per Capita

The aim of this study was to measure the magnitude and distribution of a Korean’s lifetime dental expenses depending on age and sex, by constructing a hypothetical lifetime and life table of survival. Additionally, we estimated the difference in life expectancy between men and women and its impact on dental expenses. We used the 2015 Korea Health Panel Survey to calculate the total dental expenditure, including expenses paid directly by patients and those paid by insurers. We generated survival profiles to simulate dental expenses during a typical lifetime (from birth to age 95) using the abridged life table (five-year intervals for age groups) in 2015 from the South Korean Statistical Information Service. We independently calculated the remaining dental expenses for survivors of all ages. The results showed that an estimate of average lifetime dental expenditure was $31,851 per capita: $31,587 for men and $32,318 for women. Nearly 33% of the average per capita lifetime dental expenditure was attributable to the longer life expectancy of women, with no statistically significant difference in lifetime dental expenditure between men and women. Many survivors incurred 70% of their lifetime dental expenses before age 65. The results highlighted the need for policymakers to address spending on age-specific dental care owing to extended life expectancy, given the disproportionate share of healthcare resources supporting the elderly.

Minimum Alveolar Concentration (MAC) of Xenon with Sevoflurane in Humans

2001 ◽  
Vol 94 (4) ◽  
pp. 611-614 ◽  
Author(s):  
Yoshinori Nakata ◽  
Takahisa Goto ◽  
Yoshiki Ishiguro ◽  
Katsuo Terui ◽  
Hiromasa Kawakami ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Minimum Alveolar Concentration ◽  
Interaction Coefficient ◽  
Bodily Movement ◽  
Xenon Concentration ◽  
Multiple Variable ◽  
End Tidal ◽  
Somatic Response ◽  
Technological Limitations ◽  
Group Target

Background Although more than 30 yr ago the minimum alveolar concentration (MAC) of xenon was determined to be 71%, that previous study had technological limitations, and no other studies have confirmed the MAC value of xenon since. The current study was designed to confirm the MAC value of xenon in adult surgical patients using more modern techniques. Methods Sixty patients were anesthetized with sevoflurane with or without xenon. They were randomly allocated to one of four groups; patients in group 1 received no xenon, whereas those in groups 2, 3, and 4 received end-tidal concentrations of 20, 40, and 60%, respectively (n = 15 each group). Target end-tidal sevoflurane concentrations were chosen using the "up-and-down" method in each group. After steady state sevoflurane and xenon concentrations were maintained for at least 15 min, each patient was monitored for a somatic response at surgical incision. Somatic response was defined as any purposeful bodily movement. The MAC of sevoflurane and its reduction by xenon was evaluated using the multiple independent variable logistic regression model. Results The interaction coefficient of the multiple variable logistic regression was not significantly different from zero (P = 0.143). The MAC of xenon calculated as xenon concentration that would reduce MAC of sevoflurane to 0% was 63.1%. Conclusions The authors could not determine whether interaction in blocking somatic responses in 50% of patients is additive. The MAC of xenon is in the range of the values that were predicted in a previous study.

The Effect of Hypothermia on Isoflurane MAC in Children

2001 ◽  
Vol 94 (3) ◽  
pp. 429-432 ◽  
Author(s):  
Mingzheng Liu ◽  
Xiaoqin Hu ◽  
Jin Liu
Keyword(s):  
Minimum Alveolar Concentration ◽  
Heart Diseases ◽  
Skin Incision ◽  
Open Heart ◽  
Isoflurane Concentration ◽  
Inhaled Anesthetics ◽  
End Tidal

Background Hypothermia has been shown to decrease the requirement for inhaled anesthetics in animals, but information in humans is limited. Methods Thirty-three unpremedicated children with congenital left-to-right shunt heart diseases undergoing open heart surgeries were assigned to one of three groups, with nasopharyngeal temperatures at the time of skin incision of 37, 34, or 31 degrees C. Anesthesia was induced and maintained with isoflurane in oxygen. End-tidal isoflurane concentration and nasopharyngeal temperature were kept at stable levels for at least 15 min before the skin incision. Isoflurane minimum alveolar concentration was determined by using the Dixon up-and-down approach. Results Isoflurane minimum alveolar concentration values were 1.69 +/- 0.14%, 1.47 +/- 0.10%, and 1.22 +/- 0.15% (mean +/- SD) at 37, 34, and 31 degrees C, respectively. Conclusions Hypothermia decreases the isoflurane requirement in children by 5.1 degrees C.

scholarly journals The Effects of Dizocilpine Maleate (MK-801), an Antagonist of the N-Methyl-D-Aspartate Receptor, on Neurologic Recovery and Histopathology following Complete Cerebral Ischemia in Primates

1990 ◽  
Vol 10 (2) ◽  
pp. 252-261 ◽  
Author(s):  
William L. Lanier ◽  
William J. Perkins ◽  
Bente R. Karlsson ◽  
James H. Milde ◽  
Bernd W. Scheithauer ◽  
...  
Keyword(s):  
Cerebral Ischemia ◽  
Excitatory Amino Acid ◽  
Neurologic Injury ◽  
Primate Model ◽  
Mk 801 ◽  
Neurologic Recovery ◽  
Aspartate Receptor ◽  
Significant Difference ◽  
Neurologic Function ◽  
Complete Cerebral Ischemia

The present study was designed to determine if the noncompetitive excitatory amino acid antagonist, dizocilpine maleate, when administered after a 17 min period of complete cerebral ischemia in primates, would improve postischemic neurologic function and hippocampal histopathologic outcome when compared to placebo-treated animals. Ten pigtail monkeys were anesthetized and subjected to complete cerebral ischemia using an established neck tourniquet model. Five minutes postischemia, five monkeys received dizocilpine 300 μg/kg i.v. over 5 min, followed by an infusion of 150 μg/kg/h for 10 h. This produced plasma levels of the drug in excess of 30 ng/ml for the duration of the infusion. An additional five monkeys were treated with an identical volume of saline placebo. All monkeys received intensive care for the initial 24 to 48 h postischemia. At 96 h postischemia, there was no significant difference in neurologic function between the two groups ( p = 0.53, with the placebo group having the numerically better outcome). There also was no significant difference between hippocampal histopathology scores between dizocilpine and placebo-treated monkeys. The authors conclude that dizocilpine is not an efficacious therapy in the treatment of neurologic injury that occurs following complete cerebral ischemia in this primate model.

Anesthetic Doses of Sevoflurane To Block Cardiovascular Responses to Incision when Administered with Xenon or Nitrous Oxide 

1999 ◽  
Vol 91 (2) ◽  
pp. 369-373 ◽  
Author(s):  
Yoshinori Nakata ◽  
Takahisa Goto ◽  
Yoshiki Ishiguro ◽  
Katsuo Terui ◽  
Yoshinari Niimi ◽  
...  
Keyword(s):  
Heart Rate ◽  
Nitrous Oxide ◽  
Mean Arterial Pressure ◽  
Minimum Alveolar Concentration ◽  
Cardiovascular Response ◽  
Cardiovascular Responses ◽  
Suppressive Effect ◽  
Skin Incision ◽  
The Mean ◽  
End Tidal

Background The authors' previous study demonstrated that xenon (Xe) and nitrous oxide (N2O) in combination with sevoflurane can attenuate cardiovascular responses to skin incision. To quantitatively evaluate their suppressive effects on cardiovascular responses, the authors compared the MAC-BAR (minimum alveolar concentration that blocks adrenergic or cardiovascular response to incision) values of sevoflurane when administered with Xe or N2O. Methods Forty-three patients received sevoflurane with one of three anesthetics; 1 MAC Xe, 0.7 MAC Xe and 0.7 MAC N2O. The MAC-BAR of sevoflurane was determined in each anesthetic using the "up and down" method. The response was considered positive if the heart rate or mean arterial pressure increased 15% or more. The end-tidal sevoflurane concentration given to the next patient was increased or decreased by 0.3 MAC if the response was positive or negative in the previous patient, respectively. The MAC-BAR was calculated as the mean of four independent cross-over responses. Results The MAC-BAR of sevoflurane, including the contribution of Xe or N2O, was 2.1+/-0.2 MAC and 2.7+/-0.2 MAC when administered with 1 MAC and 0.7 MAC Xe, respectively, and 2.6+/-0.4 MAC when administered with 0.7 MAC N2O (mean +/- SD). Conclusions Although 1 MAC Xe has a more potent suppressive effect on cardiovascular responses to incision than 0.7 MAC Xe or N2O, Xe and N2O have a similar suppressive effect at 0.7 MAC.

scholarly journals A study of correlations between metabolic syndrome factors and osteosarcopenic adiposity

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yu-Hsiang Su ◽  
Yu-Ming Chang ◽  
Chih-Ying Kung ◽  
Chiu-Kuei Sung ◽  
Wei-Shin Foo ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Health Management ◽  
Multinomial Logistic Regression ◽  
The Elderly ◽  
Simultaneous Occurrence ◽  
Multinomial Logistic Regression Analysis ◽  
Significant Difference

Abstract Background Aging reduces the quality and strength of bones and muscles and increases body fat, which can lead to the simultaneous occurrence of sarcopenia, osteopenia, and adiposity, a condition referred to as OsteoSarcopenic Adiposity (OSA). While previous studies have demonstrated that metabolic syndrome is associated with sarcopenia, osteopenia, and adiposity, the relationship between metabolic syndrome and OSA remains largely unknown. Methods We analyzed data for a sample of middle-aged individuals from a Health Management Center database, which was collected in 2016–2018. There are 2991 cases of people over 50 years from a physical examination center in a hospital in Taiwan during 2016–2018. In addition to descriptive statistics, chi-squared test, analysis of variance, and multinomial logistic regression analysis were conducted to examine OSA risk and associated factors. Results Based on multinomial logistic regression analysis, in different OSA severity level (1–3 more serious), those who are with metabolic syndrome has increased the 2.49–2.57 times risk of OSA (p < 0.001) in OSA = 2 and 3 groups while there is no significant difference in OSA =1 group. Conclusion The prevalence of OSA may impair the health and quality of life in the elderly group, especially those diagnosed with metabolic syndrome, increasing the risk of OSA. These results can help promote early diagnosis and treatment of OSA in clinical settings, particularly among aging individuals with abnormal physical function, the group with the highest OSA incidence.

scholarly journals PERBEDAAN KEJADIAN DEPRESI PADA PRIA DAN WANITA PADA LANSIA YANG MENDERITA DIABETES MELLITUS

2021 ◽  
Vol 7 (1) ◽  
pp. 36-40
Author(s):  
Nur Ainiyah ◽  
Iis Noventi ◽  
Chilyatiz Zahroh
Keyword(s):  
Diabetes Mellitus ◽  
Standard Deviation ◽  
Data Collection ◽  
Elderly Women ◽  
The Elderly ◽  
Depression Score ◽  
Elderly Men ◽  
Men And Women ◽  
Significant Difference ◽  
The Mean

Elderly is the final stage of the human life cycle. The process of aging is a process that shows a decline in human physical function, emotional changes, as well as social interactions that will  change gradually. Diabetes Mellitus (DM) is a metabolic disease that occurs chronically due to interference with insulin and has various complications for sufferers, both acute and chronic. Decreased physical, unstable emotional, interaction of social abilities decrease, anda also  metabolic disorders and its complications make the elderly had depression which is manifested in the quality of sleep of the elderly. The purpose of this study was to determine the differences in the incidence of depression in men and women in the elderly who suffer from diabetes mellitus. The method in this research was comparative. The population of this study were all elderly in Region X as many as 60 elderly consisting of 27 elderly men and 33 elderly women. The sample in this study was a research of 60 members, using total sampling / depression data collection was done by giving a questionnaire based on the Beck depression scale. Data analysis used elderly depression scores in men and elderly women collected from the results of data collection will be measured the difference with a two-mean difference test (T-test). The results showed the mean depression score for men = 1.59 and the standard deviation = 1.575 and the mean depression score for women = 3.54 the standard deviation was 1.96, the level of significance (p = 0.001; p <0.05). Its shows a significant difference between depression in elderly men and women who suffer from DM. Therefore, it is expected that all members of the elderly family as one of the support systems for the elderly can provide support so that the elderly do not experience depression.

Association of Ethnicity with the Minimum Alveolar Concentration of Sevoflurane

2007 ◽  
Vol 107 (1) ◽  
pp. 9-14 ◽  
Author(s):  
Tiberiu Ezri ◽  
Daniel Sessler ◽  
Marian Weisenberg ◽  
Gleb Muzikant ◽  
Michael Protianov ◽  
...  
Keyword(s):  
Selective Breeding ◽  
Minimum Alveolar Concentration ◽  
Skin Incision ◽  
Physical Status ◽  
The Caucasus ◽  
Lifestyle Choices ◽  
American Society ◽  
End Tidal ◽  
American Society Of Anesthesiologists ◽  
Animal Strains

Abstract 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 &lt; 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.

scholarly journals Effect of epidural administration of lidocaine, fentanyl and their combination on the minimum alveolar concentration of halothane in dogs

2012 ◽  
Vol 49 (No. 11) ◽  
pp. 421-426
Author(s):  
P. Rauser ◽  
L. Lexmaulova ◽  
M. Vlasin ◽  
T. Fichtel ◽  
J. Lorenzova
Keyword(s):  
Minimum Alveolar Concentration ◽  
Control Group ◽  
Epidural Administration ◽  
General Anesthetics ◽  
Mutual Relationship ◽  
Significant Difference ◽  
Basic Parameters ◽  
Healthy Dogs ◽  
End Tidal ◽  
Vital Parameters

The efficacy of lidocaine, fentanyl, combination of both (2 mg/kg of lidocaine, along with fentanyl in the dose of 0.005 mg/kg) and saline (as a control) administered epidurally to 40 healthy dogs was under investigation, regarding their influence on minimum alveolar concentration (MAC) of halothane. Basic vital parameters, such as heart rate, respiratory rate, saturation of hemoglobin with oxygen and end-tidal partial pressure of CO<sub>2</sub> were recorded. Minimum alveolar concentration of halothane after administration of lidocaine (0.75 ± 0.24%), or the lidocaine/fentanyl combination (0.43 ± 0.08%) was found to be significantly lower (p &lt; 0.05) compare to control group (1.15 ± 0.20%). However, we have not found significant difference in the group given fentanyl alone (0.95 ± 0.35%) compare to control group. Mutual relationship between epidurally given lidocaine and fentanyl (same route of administration) can be called as simply additive. There were no significant deviations in basic parameters within groups. We conclude that epidural administration of combination of these drugs we are able to reduce the dose of general anesthetics, which is important in management of critically ill patients.

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