Inhalational Anesthetic Agents

Desflurane, CF3-CFH-O-CF2H

desflurane

Introduced in 1992.

Physical Properties

  • vapor pressure = 681 mmHg at 20 degrees C so
  • boils at room temperature at high altitudes (eg, Denver, Colorado), and
  • requires special vaporizer
  • low solubility permits rapid changes in pA and thus pBrain
  • pungent and irritating to the airway

Organ System Effects

Cardiovascular
  • similar to isoflurane (but does NOT increase coronary artery blood flow)
  • cardiac output no more than slightly depressed at 1-2 MAC
  • rapid increases in pa may -> pronounced tachycardia and hypertension
Respiratory
  • fast, shallow breathing with incresased paCO2
  • airway irritation
    • salivation
    • breath-holding
    • coughing
    • laryngospasm
CNS
  • general anesthesia, MAC = 6.0
  • cerebral vasodilator, increases CBF and ICP
  • marked decrease in CMRO2 tends to cause compensatory vasoconstriction
  • EEG effects similar to isoflurane

Biotransformation and Toxicity

  • minimal metabolism in vivo
  • degraded (more than other agents) to potentially harmful levels of carbon monoxide by desiccated carbon dioxide absorbent
    • especially by barium hydroxide lime, but also by sodium and potassium hydroxide
    • use of calcium hydroxide minimizes this degradation problem

Contraindications





Send Comments to Greg Gordon MD, gjg@po.cwru.edu
Department of Anesthesiology
The MetroHealth System
2500 MetroHealth Drive
Cleveland, Ohio 44109-1998
Phone: (216) 778-4801
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