Understanding Anesthesiology - The Global Regional Anesthesia ...

ISOFLURANE
Class
Volatile inhaled agent. Used for maintenance of anesthesia.
Mechanism of Action
Uncertain
Dose
Titrated to effect; MAC (age 40)=1.15
Onset
Higher solubility than sevoflurane and desflurane therefore
uptake is slower than the modern agents. Onset of
effect is hastened by using higher flows of carrier gases
and by using higher concentrations of volatile agent.
Duration
Clinical recovery in less than 15 minutes (usually).
Theoretically a slower wake-up than the modern
agents due to higher solubility.
CVS
Dose-related hypotension (vasodilation).
Respiratory
Respiratory depression with rapid, shallow respiratory
pattern. Loss of intercostal muscle function creates a
rocking boat appearance. Isoflurane is irritating to the
airways and can cause breath-holding, cough, laryngospasm
or bronchospasm. Its pungent quality makes it
unsuitable for use with a mask induction.
GI
Nausea, vomiting.
MSK
Potentiates neuromuscular blockade. Malignant hyperthermia
trigger.
Contraindications
Malignant hyperthermia susceptibility
Elimination
Pulmonary
Effects
CNS
Isoflurane produces an additive central nervous system
(CNS)-depressant effect along with other sedative/
hypnotics and analgesics. Has the potential to increase
intracranial pressure which can be mitigated with hyperventilation.
Delirium.
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