The concept of the so-called “minimum”—but actually median—alveolar concentration (MAC) required to prevent movement to a surgical stimulus was the original yardstick that advanced mechanistic anesthesia research by allowing comparisons between agents and species.1 Understanding the processes underlying MAC was the original “holy grail” of research into anesthetic drug actions, but it appeared to be uncrackable. Funding for laboratories to systematically look into mechanisms of immobility dried up as interest moved toward mechanisms of memory suppression and hypnosis, commonly referred to with the trendy but poorly defined term “unconsciousness.” This pitiful paucity of basic science investigation into mechanisms of MAC is unfortunate because of its biologic complexity and obvious clinical relevance. All clinicians will at some time have experienced the frustration of having a patient who is apparently overanesthetized, requires vasoconstrictors for blood pressure support, and...
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Editorial| June 2021
A Crack at MAC
From the Department of Anesthesiology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin (M.P.); and the Department of Anaesthesiology, Waikato Clinical Campus, Faculty of Medical and Health Sciences, University of Auckland, Hamilton, New Zealand (J.W.S.).
This editorial accompanies the article on p. 901.
Accepted for publication February 26, 2021.
Address correspondence to Dr. Perouansky: firstname.lastname@example.org
Anesthesiology June 2021, Vol. 134, 835–837.
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Misha Perouansky, Jamie W. Sleigh; A Crack at MAC. Anesthesiology 2021; 134:835–837 doi: https://doi.org/10.1097/ALN.0000000000003761
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Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology