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Sevoflurane
| Sevoflurane |
|  Sevoflurane is a potent inhalational agent that is taken up and eliminated nearly as rapidly as desfiurane and nitrous oxide. Because its vapor pressure is similar to that of conventional inhalational agents, it can be administered through a conventional vaporizer. Pleasant to inhale, sevoflurane is quite suitable for mask induction, especially of children. Because the vapor is insoluble, emergence is rapid. Other situations for which sevoflurane appears to be particularly well suited are outpatient surgery and mask induction of patients with potentially difficult airways. Although in many respects sevoflurane resembles an ideal anesthetic, it has several problems First, the compound is extremely expensive Second, sevoflurane is metabolized to both fluoride and "compound A.'1 Fluoride appears to be only a theoretical complication, probably because the drug is rapidly eliminated and fluoride levels remain elevated for only a brief interval. Compound A is released by the reaction between sevoflurane and C02 absorbers (soda lime and Baralyme). Again, the toxicity of compound A appears to be theoretical and not clinically important. The drug has been administered to millions of people in Japan, the country in which it was first released for use, without evidence of renal toxicity. |
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