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Inhalational anesthetics: desflurane and sevoflurane
1Department of Anesthesia and Critical Care, University of Chicago, IL 60637, USA.
Journal of Clinical Anesthesia
|November 1, 1995
Summary
Desflurane and sevoflurane offer faster anesthetic recovery due to lower solubility. Desflurane resists breakdown but irritates airways, while sevoflurane is non-irritating but has potential toxic byproducts.
Area of Science:
- Anesthesiology
- Pharmacology
- Clinical Medicine
Background:
- Review of two potent inhaled anesthetics: desflurane and sevoflurane.
- Comparison of their physico-chemical properties and performance characteristics.
- Focus on advancements in anesthetic depth control and recovery speed.
Purpose of the Study:
- To review and compare desflurane and sevoflurane.
- To evaluate their clinical utility, advantages, and disadvantages.
- To discuss safety profiles and potential toxicities.
Main Methods:
- Comparative review of existing literature on desflurane and sevoflurane.
- Analysis of physico-chemical properties, clinical performance, and safety data.
- Discussion of economic and patient-specific factors.
Main Results:
- Both agents offer improved anesthetic control and faster recovery compared to older agents.
- Desflurane: rapid, resistant to degradation, but pungent and may cause CO production.
- Sevoflurane: non-irritating, rapid induction, but potential toxic byproducts (Compound A, fluoride).
Conclusions:
- Desflurane and sevoflurane represent significant advancements in inhaled anesthesia.
- Choice depends on clinical scenario; desflurane for maintenance, sevoflurane for induction.
- Further studies needed for sevoflurane safety in specific patient groups and low fresh gas flows.
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