Sevoflurane

An inhalational anesthetic used in surgery

Chemical structure of Sevoflurane

Sevoflurane is a volatile inhalational anesthetic used for the induction and maintenance of general anesthesia. It is one of the most commonly used anesthetics in modern medicine due to its rapid onset and low blood-gas partition coefficient, which allows for quick adjustments in anesthetic depth.

Chemical Properties

Sevoflurane is a fluorinated ether with the chemical formula C₄H₃F₇O. Its structure includes a fully fluorinated carbon chain, which contributes to its stability and low reactivity. The presence of fluorine atoms also reduces the solubility of sevoflurane in blood, enhancing its pharmacokinetic properties.

3D molecular model of Sevoflurane

Pharmacokinetics

Sevoflurane is characterized by a low blood-gas partition coefficient of approximately 0.65, which means it equilibrates quickly between the blood and alveolar gas. This property allows for rapid induction and emergence from anesthesia. Sevoflurane is minimally metabolized in the body, with the majority being exhaled unchanged. A small percentage is metabolized by the liver to produce inorganic fluoride ions and hexafluoroisopropanol, but these metabolites are generally not considered clinically significant.

Clinical Use

Sevoflurane is widely used in both adult and pediatric anesthesia. It is particularly favored for pediatric anesthesia due to its non-irritating properties, making it suitable for inhalational induction. The agent is delivered via a vaporizer in a controlled manner, allowing anesthesiologists to maintain the desired depth of anesthesia throughout surgical procedures.

Advantages

Sevoflurane offers several advantages over other inhalational anesthetics, including:

• Rapid induction and recovery: Due to its low solubility in blood, patients can be quickly anesthetized and recover rapidly post-surgery.
• Minimal airway irritation: Unlike some other anesthetics, sevoflurane is non-pungent and does not irritate the airways, making it ideal for inhalational induction.
• Hemodynamic stability: It maintains cardiovascular stability, which is crucial during surgical procedures.

Side Effects

Common side effects of sevoflurane include nausea, vomiting, and dizziness. Rarely, it can cause malignant hyperthermia, a life-threatening condition that requires immediate treatment. Sevoflurane can also lead to a decrease in blood pressure and respiratory depression, which are typical of inhalational anesthetics.

Environmental Impact

Sevoflurane, like other volatile anesthetics, is a greenhouse gas. However, its global warming potential is lower than that of some other anesthetics, such as desflurane. Efforts are ongoing to minimize the environmental impact of anesthetic gases through improved scavenging systems and the development of more sustainable practices.

Related Pages

• Inhalational anesthetic
• General anesthesia
• Pediatric anesthesia
• Malignant hyperthermia