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Understanding Anesthesiology - The Global Regional Anesthesia ...

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Isoflurane<br />

Class<br />

Volatile inhaled agent. Used for maintenance of anesthesia.<br />

Mechanism of Action<br />

Uncertain<br />

Dose<br />

Titrated to effect; MAC (age 40)=1.15<br />

Onset<br />

Higher solubility than sevoflurane and desflurane therefore uptake is slower than the modern<br />

agents. Onset of effect is hastened by using higher flows of carrier gases and by using<br />

higher concentrations of volatile agent.<br />

Duration<br />

Clinical recovery in less than 15 minutes (usually). <strong>The</strong>oretically a slower wake-up than the<br />

modern agents due to higher solubility.<br />

Elimination<br />

Pulmonary<br />

Effects<br />

CNS<br />

Isoflurane produces an additive central nervous system (CNS)-depressant effect along with<br />

other sedative/hypnotics and analgesics. Has the potential to increase intracranial pressure<br />

which can be mitigated with hyperventilation. Delirium.<br />

CVS<br />

Dose-related hypotension (vasodilation).<br />

Respiratory<br />

Respiratory depression with rapid, shallow respiratory pattern. Loss of intercostal muscle<br />

function creates a rocking boat appearance. Isoflurane is irritating to the airways and can<br />

cause breath-holding, cough, laryngospasm or bronchospasm. Its pungent quality makes it<br />

unsuitable for use with a mask induction.<br />

GI<br />

Nausea, vomiting.<br />

MSK<br />

Potentiates neuromuscular blockade. Malignant hyperthermia trigger.<br />

Contraindications<br />

Malignant hyperthermia susceptibility.<br />

Related Glossary Terms<br />

Balanced anesthesia, Desflurane, Four A’s of anesthesia, Inhaled agents, MAC, Malignant<br />

hyperthermia, Sevoflurane, Vapourizer, Volatile<br />

Index<br />

Find Term<br />

Chapter 3 - General <strong>Anesthesia</strong><br />

Chapter 6 - Drug Finder<br />

Chapter 6 - Inhaled Agents

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