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Minimum alveolar concentration or MAC is the concentration of the vapour in the lungs 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 potency, of anaesthetic vapours. MAC was introduced in 1965. MAC actually is a ''median'' value, not a minimum as term implies. The use of ''minimum'' is from the original paper, where the term was ''minimal'' 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 autonomic reflexes to nociceptive stimuli, and MAC-awake (0.3-0.5 MAC), the concentration required to block voluntary reflexes and control perceptive awareness. ==Formal definition== The MAC is the concentration of the vapour (measured as a percentage at 1 atmosphere, i.e. the partial pressure) that prevents patient ''movement'' in response to a supramaximal 〔Miller ANESTHESIOLOGY〕stimulus (traditionally a set depth and width of skin incisions) in 50% of subjects. 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 alveoli, the blood and the brain. 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== The MAC of a volatile substance is inversely proportional to its lipid solubility (oil:gas coefficient), in most cases. This is the Meyer-Overton hypothesis put forward in 1899–1901 by Hans Horst Meyer and Charles Ernest Overton. 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 Alpha2 agonists (dexmedetomidine) and/or opioid receptor agonists (morphine/fentanyl) can decrease the MAC〔 * 〕 * Mullin's critical volume hypothesis * Positive modulation of GABA at GABAA receptors by barbiturates or benzodiazepines 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「minimum alveolar concentration」の詳細全文を読む スポンサード リンク
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