Desflurane - revisited

Mukul Chandra Kapoor, Mahesh Vakamudi, Mukul Chandra Kapoor, Mahesh Vakamudi

Abstract

The search for an ideal inhalational general anesthetic agent continues. Desflurane, which was recently introduced in the Indian market, possesses favorable pharmacokinetic and pharmacodynamic properties and is closer to the definition of an ideal agent. It offers the advantage of precise control over depth of anesthesia along with a rapid, predictable, and clear-headed recovery with minimal postoperative sequelae, making it a valuable anesthetic agent for maintenance in adults and pediatric patients in surgeries of all durations. The agent has advantages when used in extremes of age and in the obese. Its use may increase the direct costs of providing anesthetic care. Methods or techniques, such as low-flow anesthesia, to reduce the overall cost and along with minimal environmental implications must be followed.

Keywords: Anesthetics; desflurane; inhalational; low-flow anesthesia.

Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Desflurane degradation in dessicated sodalime
Figure 2
Figure 2
Faster 90% terminal decrement times with desflurane (adapted from Bailey JM. Anesth Analg 1997;85:681-6.)
Figure 3
Figure 3
Return of protective airway reflexes after sevoflurane and desflurane-based anesthesia (measured as ability to swallow 20 ml of water without coughing or drooling) (adapted from McKay et al. Br J Anaesth 2010;104:175-82.)

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