Sevoflurane : A review of its pharmacodynamic and pharmacokinetic properties and its clinical use in general anaesthesia

摘要: Sevoflurane is an ether inhalation general anaesthetic agent with lower solubility in blood than isoflurane or halothane but not desflurane. The low and the absence of pungency facilitate rapid mask induction ; also expedites 'wash-out' therefore recovery from anaesthesia. produces dose-dependent CNS, cardiovascular respiratory depressant effects that generally, parallel those isoflurane. degraded by carbon dioxide absorbents to nephrotoxic (in rats) haloalkenes, although renal toxicity has been observed humans. Compared other anaesthetics, negligible quantities monoxide are generated degradation sevoflurane absorbents. airway irritant effects, which facilitates a 'smooth' induction, even comparison paediatric patients, makes especially amenable anaesthesia adults children. Emergence, orientation postoperative cognitive psychomotor function outpatients significantly more In adult inpatients outpatients, emergence faster after desflurane Other parameters (e.g. times sitting, ambulation) occur at similar either Recovery occurs generally sevoflurane, propofol, predictable extubation better modified Aldrete scores for both agents. As supplement opioid during coronary bypass graft surgery risk myocardial ischaemia, comparable Limited data suggest it as useful maintenance neurosurgical obstetric procedures. well tolerated patients anaesthesia, incidence mild complications (breath-holding, coughing, excitement laryngospasm). During particularly halothane. potential hepatic injury Unlike methoxyflurane, undergoes minimal intrarenal defluorination, may account lack fluoride ion-induced nephrotoxicity humans, despite elevated plasma levels its use. summary, provides smooth of, from, These features combined favourable profile should make gent choice Although further clinical evaluation will define role this relative propofol desflurane, prove be valuable alternative outpatient inpatient surgery.