Effect of age on MAC in humans: a meta-analysis

Abstract

It is well known that MAC, the minimum alveolar concentration required to prevent movement in response to surgical incision in 50% of patients, decreases with age. Regression analysis showed that data for humans derived from a comprehensive literature survey were consistent, for age > 1 yr, with log10 MAC decreasing with increasing age at the same rate for all inhaled anaesthetics; approximately equivalent to 6% change per decade of age. With some slight reservation on differences between data from different institutions, the present data for humans are consistent (for age > 1 yr), with the equation MAC = a x 10bx where x = difference in age (in years) from 40, b = -0.00269 (95% confidence limits (CL) -0.0030, -0.0024) and a = MAC at age 40 yr, which, for anaesthetics currently in use clinically, is given by: halothane, 0.75%; isoflurane, 1.17%; enflurane, 1.63%; sevoflurane, 1.80%; desflurane 6.6%; nitrous oxide, 104%; with 95% CL of approximately +/- 7% (+/- 10% for desflurane, +/- 17% for enflurane).