Understanding Anesthesiology - The Global Regional Anesthesia ...

Sevoflurane
Class
Volatile inhaled anesthetic. Used for maintenance of anesthesia. Can be used for induction of
anesthesia particularly in children. Rarely may be used as a treatment for status asthmaticus.
Mechanism of Action
Uncertain
Dose
Titrated to effect; MAC (age 40) = 2.1%.
Onset
Low solubility allows rapid uptake and equilibration. 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 10 minutes (usually). If given for prolonged periods, wake-up
will be slower as adipose stores have been saturated and are slow to off-load.
Elimination
Pulmonary (major); hepatic (2-5%); renal (metabolites excretion only)
Effects
CNS
Sevoflurane 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.
CVS
Dose-related hypotension (vasodilation).
Respiratory
Respiratory depression with a rapid, shallow respiratory pattern. Loss of intercostal muscle
function creates a rocking boat appearance. Causes bronchodilation. Sevoflurane is sweetsmelling
and not as irritating to the respiratory tract as desflurane.
GI
Nausea, vomiting.
MSK
Potentiates neuromuscular blockade. Malignant hyperthermia trigger.
Misc.
Potential nephrotoxicity due to Compound A which is produced through contact with sodalime.
Compound A can be produced if sevoflurane is used with very low fresh gas flows
or for long MAC-hours. Therefore, sevoflurane must be used with a minimum of 2 litres/
minute of fresh gas flow.
Related Glossary Terms
Balanced anesthesia, Desflurane, Four A’s of anesthesia, Inhaled agents, Isoflurane, MAC,
Malignant hyperthermia, Vapourizer, Volatile
Index
Find Term
Chapter 2 - Anesthetic Equipment and Monitoring
Chapter 3 - General Anesthesia
Chapter 6 - Drug Finder
Chapter 6 - Inhaled Agents