Inhalational Anesthetic Agents

Sevoflurane, (CF3)2-CH-O-CFH2

Relatively low solubility and nonpungency make it an excellent choice for inhalational induction.

Physical Properties

  • vapor pressure = 160 mmHg at 20 deg C
  • low solubility (lambdablood:gas = 0.65)
  • moderate vapor pressure (160 mmHg at 20 degrees C)

Organ System Effects

  • mild negative inotrope
  • little or no tachycardia
  • so cardiac output not as well maintained as with isoflurane or desflurane
  • may prolong the QT interval
  • depresses respiration
  • bronchodilator
  • general anesthesia, MAC = 2.0
  • slightly increases CBF and ICP
  • decreases CMRO2

Biotransformation and Toxicity

  • rate of metabolism = 5% (ten times that of isoflurane)
  • inorganic fluoride is a metabolic product soda lime (NOT calcium hydroxide) degrades sevoflurane to compound A
    • nephrotoxic in rats
    • accumulation of compound A increases with
      • increased respiratory gas temperature
      • low-flow anesthesia
      • dry barium hydroxide absorbent
      • high sevoflurane concentrations
      • time
  • some recommend minimum total fresh gas flows of 2 L/min and
  • avoid if preexisting renal dysfunction
  • metal and environmental impurities can degrade sevoflurane to hydrogen fluoride
    • can produce acid burn of respiratory mucosa
    • degradation minimized by adding water during manufacture and packaging in special plastic containers


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