ArticleCureus2026
Impact of Patient Age on Age-Adjusted Minimum Alveolar Concentration Fractions and Prolonged Tracheal Extubations Where Anesthesia Machines Display the Fractions.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Introduction Prolonged time to tracheal extubation after general anesthesia is defined as an interval of 15 minutes or longer from the recorded end of surgery to the actual removal of the tracheal tube. Thereafter, the operating room team is idle, so prolonged extubations reduce workflow and the productivity of anesthesia clinicians. During inhalational anesthesia, the overwhelming majority of prolonged times to tracheal extubation are caused by substantial residual doses at the completion of the surgical procedure. The minimum alveolar concentration (MAC) fraction is the end-tidal inhalational agent concentration divided by the agent's altitude- and age-adjusted minimum alveolar concentration for a 40-year-old. Age adjustment is essential because volatile anesthetic requirements decline markedly with increasing age, meaning that a fixed percentage concentration represents a much higher effective dose in an elderly patient than in a young adult. Previously, the authors showed a substantial positive correlation between the MAC fraction at the end of surgery and prolonged extubations. In the current study, we tested three hypotheses on the associations between MAC fraction for maintenance of anesthesia and patient age, MAC fraction at the end of surgery and patient age, and prolonged extubations and patient age. Methods Our retrospective cohort study used a subset of the same dataset from the University of Iowa that was used in an earlier investigation of inhalational agent dosing behaviors. The anesthesia machines displayed MAC fractions. The cohort of
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