Sevoflurane

What is Sevoflurane

Sevoflurane is a halogenated general anesthetic, which was first synthesized and tested in the early 1970s. Clinical studies of the drug were halted because of questionable phase I study results.

Experience in Japan has lead to wide spread clinical use of sevoflurane. In comparison, adjustment of depth of anesthesia is easier with sevoflurane than with either enflurane, halothane, or isoflurane.

Induction and recovery from anesthesia is rapid and cardiorespiratory depression is minimal which makes it generally safe in patients with coronary artery disease. Also, due to its low tissue solubility and non-irritating odor, sevoflurane is an appropriate agent for pediatric patients.

Sevoflurane was FDA-approved in June 1995 for induction and maintenance of general anesthesia.

Brand Name

Ultane

Indications & Dosage

• general anesthesia induction
• general anesthesia maintenance

Side Effects

1. agitation
2. amblyopia
3. anaphylactoid reactions
4. angioedema
5. apnea
6. arrhythmia exacerbation
7. asthenia
8. atrial fibrillation
9. AV block
10. bradycardia
11. bronchospasm
12. cardiac arrest
13. confusion
14. conjunctivitis
15. contact dermatitis
16. cough
17. delirium
18. dizziness
19. drowsiness
20. dysgeusia
21. dyspnea
22. elevated hepatic enzymes
23. fever
24. glycosuria
25. headache
26. hepatic failure
27. hepatic necrosis
28. hepatitis
29. hiccups
30. hyperbilirubinemia
31. hyperglycemia
32. hyperkalemia
33. hypersalivation
34. hypertension
35. hypertonia
36. hyperventilation
37. hypophosphatemia
38. hypotension
39. hypothermia
40. hypoventilation
41. hypoxia
42. insomnia
43. jaundice
44. laryngospasm
45. leukocytosis
46. malignant hyperthermia
47. myoglobinuria
48. nausea
49. oliguria
50. pharyngitis
51. proteinuria
52. pruritus
53. QT prolongation
54. rash
55. respiratory depression
56. restlessness
57. seizures
58. shivering
59. sinus tachycardia
60. ST-T wave changes
61. syncope
62. thrombocytopenia
63. torsade de pointes
64. urinary retention
65. urticaria
66. ventricular tachycardia
67. vomiting
68. wheezing
69. xerostomia

Monitoring Parameters

• arterial blood gases (ABGs)

Contraindications

• accidental exposure
• alcoholism
• bradycardia
• breast-feeding
• cardiac arrhythmias
• cardiac disease
• children
• coronary artery disease
• diabetes mellitus
• females
• geriatric
• halogenated anesthetics hypersensitivity
• head trauma
• heart failure
• hepatic disease
• hypertension
• hypocalcemia
• hypokalemia
• hypomagnesemia
• hypotension
• increased intracranial pressure
• infants
• intracranial mass
• labor
• long QT syndrome
• malignant hyperthermia
• malnutrition
• myasthenia gravis
• myocardial infarction
• neonates
• neuromuscular disease
• obstetric delivery
• pregnancy
• QT prolongation
• renal failure
• renal impairment
• seizure disorder
• seizures
• thyroid disease

Interactions

• Abarelix
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• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine; Dihydrocodeine
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• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
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• Acetaminophen; Codeine
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• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
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