Clinical Application and Interpretation of MAC

MAC is a valuable index for clinical anesthesia, but it is seldom employed without taking other factors into consideration. For example, inhibiting movement in only 50% of patients is not acceptable. Consequently, if an inhalational agent were being used alone—that is, without the administration of other anesthetics or analgesic drugs—the anesthesiologist would employ a multiple of its MAC value to ensure immobility. MAC is frequently multiplied by a factor of 1.3 to achieve nearly 100% clinical efficacy. On the other hand, useful clinical results may be achieved with doses of anesthetics below MAC levels. For example, mild analgesia and amnesia often occur with doses of inhalational agents that are near 0.5 MAC. In this state, it may even be possible to communicate with patients intraoperatively, while their recall is limited.

Anesthetics are infrequently used without the administration of other drugs. Many of these drug combinations can interact to alter MAC requirements. For example, inhalational anesthetics used in combination

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