Minimum Alveolar Concentration-Awake of Sevoflurane is Decreased in Patients with Parkinson’s Disease: An Up-and-Down Sequential Allocation Trial

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Main idea: Sevoflurane is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used as an inhalational anesthetic. A recent study demonstrated that patients with Parkinson’s disease require a smaller concentration of sevoflurane compared to patients without Parkinson’s disease.  Clinicians should avoid an overdose of sevoflurane in patients with Parkinson’s disease.

Abstract 

An increasing number of patients with Parkinson’s disease (PD) will have surgery under general anesthesia. The requirement of inhaled anesthetics in PD patients has not been clarified. The aim of this study was to investigate the minimum alveolar concentration-awake of sevoflurane in patients with PD. The current study is an up-and-down sequential allocation trial. The initial end-tidal concentration of sevoflurane (CETsevo) was estimated by the response of the previous patient to verbal command. Forty-one patients including 20 PD patients and 21 NPD patients were enrolled. Patients’ characteristics and arterial blood gas parameters (except blood sodium) were comparable between the two groups. The MACawake of sevoflurane in PD patients was significantly lower than that in NDP patients. The relative median potency was 0.73 in both groups. Patients with PD exhibit a significantly lower MACawake of sevoflurane compared with NPD patients. Clinicians should avoid an overdose of sevoflurane in patients with PD.

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