Sevoflurane

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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
  • Acetaminophen; Butalbital
  • Acetaminophen; Butalbital; Caffeine
  • Acetaminophen; Butalbital; Caffeine; Codeine
  • Acetaminophen; Caffeine; Dihydrocodeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
  • Acetaminophen; Codeine
  • Acetaminophen; Dextromethorphan; Doxylamine
  • Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
  • Acetaminophen; Dextromethorphan; Phenylephrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Diphenhydramine
  • Acetaminophen; Guaifenesin; Phenylephrine
  • Acetaminophen; Hydrocodone
  • Acetaminophen; Oxycodone
  • Acetaminophen; Propoxyphene
  • Acetaminophen; Pseudoephedrine
  • Acetaminophen; Tramadol
  • Aclidinium; Formoterol
  • Acrivastine; Pseudoephedrine
  • Alfentanil
  • Alfuzosin
  • Aliskiren
  • Aliskiren; Amlodipine
  • Aliskiren; Amlodipine; Hydrochlorothiazide, HCTZ
  • Aliskiren; Hydrochlorothiazide, HCTZ
  • Aliskiren; Valsartan
  • Ambenonium Chloride
  • Ambrisentan
  • Amikacin
  • Amiodarone
  • Amobarbital
  • Amoxapine
  • Amoxicillin; Clarithromycin; Lansoprazole
  • Amoxicillin; Clarithromycin; Omeprazole
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  • Anagrelide
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  • Apomorphine
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  • Asenapine
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  • Aspirin, ASA; Butalbital; Caffeine; Codeine
  • Aspirin, ASA; Caffeine; Dihydrocodeine
  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Oxycodone
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  • Atropine; Edrophonium
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  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
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  • Chlorpheniramine; Dihydrocodeine; Phenylephrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone
  • Chlorpheniramine; Hydrocodone; Phenylephrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Phenylephrine
  • Chlorpheniramine; Pseudoephedrine
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  • Dextromethorphan; Diphenhydramine; Phenylephrine
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  • Dextromethorphan; Promethazine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
  • Dimenhydrinate
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