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Minimum alveolar concentration or MAC is the concentration of a vapour in the alveoli of the that is needed to prevent movement (motor response) in 50% of subjects in response to surgical (pain) stimulus. MAC is used to compare the strengths, or, of anaesthetic. The concept of MAC was first introduced in 1965.MAC actually is a median value, not a minimum as term implies. The original paper proposed MAC as the minimal alveolar concentration, which was shortly thereafter revised to minimum alveolar concentration. A lower MAC value represents a more potent volatile anesthetic.Other uses of MAC include MAC-BAR (1.7-2.0 MAC), which is the concentration required to block reflexes to, and MAC-awake (0.3-0.5 MAC), the concentration required to block voluntary reflexes and control perceptive awareness. Contents.Formal definition The MAC is the concentration of the vapour (measured as a percentage at 1 atmosphere, i.e. The ) that prevents patient movement in response to a supramaximal stimulus (traditionally a set depth and width of skin incisions) in 50% of subjects.

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This measurement is done at steady state (assuming a constant alveolar concentration for 15 minutes), under the assumption that this allows for an equilibration between the gasses in the, the and the. MAC is accepted as a valid measure of potency of inhalational general anaesthetics because it remains fairly constant for a given species even under varying conditions.Meyer-Overton hypothesis.

See also:The MAC of a volatile substance is inversely proportional to its solubility (oil:gas coefficient), in most cases. This is the Meyer-Overton hypothesis put forward in 1899–1901.

MAC is inversely related to potency, i.e. High MAC equals low potency.The hypothesis correlates lipid solubility of an anaesthetic agent with potency (1/MAC) and suggests that onset of anaesthesia occurs when sufficient molecules of the anaesthetic agent have dissolved in the cell's lipid membranes, resulting in anaesthesia. Exceptions to the Meyer-Overton hypothesis can result from:.

convulsant property of an agent. specific receptor (various agents may exhibit an additional effect through specific receptors). co-administration of Alpha 2 agonists (dexmedetomidine) and/or opioid receptor agonists (morphine/fentanyl) can decrease the MAC. Mullin's critical volume hypothesis. Positive modulation of at GABA A receptors by barbiturates or benzodiazepinesFactors affecting MAC Certain physiological and pathological states may alter MAC. For example, MAC increases with hyperthermia and hypernatremia. Interestingly, human subjects with red hair have also been found to have increased MAC.

Conversely, anemia, hypercarbia, hypoxia, hypothermia, hypotension (MAP. Laboratory Animal Science Center. Archived from on 2008-06-09. Retrieved 2008-11-10. Eger EI, Saidman LJ, Brandstater B (1965). 'Minimum alveolar anesthetic concentration: a standard of anesthetic potency'.

26 (6): 756–63. Merkel, Giles; Eger, Edmond I. The Journal of the American Society of Anesthesiologists.

24 (3): 346–357. ^ Eger, Edmond I.; Saidman, Lawrence J.; Brandstater, Bernard (1965-11-01). The Journal of the American Society of Anesthesiologists. 26 (6): 756–763. Miller ANESTHESIOLOGY. Daniel M, Weiskopf RB, Noorani M, Eger EI (January 1998).

'Fentanyl augments the blockade of the sympathetic response to incision (MAC-BAR) produced by desflurane and isoflurane: desflurane and isoflurane MAC-BAR without and with fentanyl'. 88 (1): 43–9.

Katoh T, Kobayashi S, Suzuki A, Iwamoto T, Bito H, Ikeda K (February 1999). 'The effect of fentanyl on sevoflurane requirements for somatic and sympathetic responses to surgical incision'. 90 (2): 398–405. ^. Nickalls, R. D., & Mapleson, W.

(August 2003). British Journal of Anaesthesia. 91 (2): 170–4.:. CS1 maint: multiple names: authors list.

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