Abstract
Kinetic profiles of many new anesthetic drugs permit a more rapid and precise adjustment of effect, including a more rapid recovery of normal function. Desflurane and, to a lesser extent, sevoflurane fit this mold. These newest inhaled anesthetics differ kinetically from isoflurane and halothane because of their lower solubility in blood (Table), a feature produced by halogenation solely with fluorine [CHF2-O-CHF-CF3 (desflurane); CH2F-O-CH-(CF3)2 (sevoflurane)]. Tissue/gas partition coefficients approximately double from desflurane to sevoflurane to isoflurane to halothane (Table).
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References
Eger EI, II: Partition coefficients of I-653 in human blood, saline, and olive oil. Anesth Analg 1987; 66:971–3
Strum DP, Eger EI, II: Partition coefficients for sevoflurane in human blood, saline, and olive oil. Anesth Analg 1987; 66:654–6
Eger RR, Eger EI, II: Effect of temperature and age on the solubility of enflurane, halothane, isoflurane and methoxyflurane in human blood. Anesth Analg 1985; 64:640–2
Yasuda N, Targ AG, Eger EI, II: Solubility of I-653, sevoflurane, isoflurane, and halothane in human tissues. Anesth Analg 1989; 69:370–3
Jones RM, Cashman JN, Eger EI, II, Damask MC, Johnson BH: Kinetics and potency of desflurane (1–653) in volunteers. Anesth Analg 1990; 70:3–7
Katoh T, Suguro Y, Nakajima R, Kazama T, Ikeda K: Blood concentration of sevoflurane and isoflurane on recovery from anaesthesia. Br J Anaesth 1992; 69:259–62
Dwyer R, Bennett HL, Eger EI, II, Heilbron D: Effects of isoflurane and nitrous oxide in subanesthetic concentrations on memory and responsiveness in volunteers. Anesthesiology 1992; 77:888–98
Yasuda N, Lockhart SH, Eger EI, II, Weiskopf RB, Liu J, Laster M, Taheri S, Peterson NA: Comparison of kinetics of sevoflurane and isoflurane in humans. Anesth Analg 1991; 72:316–24
Holaday DA, Smith FR: Clinical characteristics and biotransformation of sevoflurane in healthy human volunteers. Anesthesiology 1981; 54:100–6
Bacher A, Burton AW, Uchida T, Zornow MH: Sevoflurane or halothane anesthesia: Can we tell the difference? Anesth Analg 1997; 85:1203–6
O’Brien K, Kumar R, Morton NS: Sevoflurane compared with halthane for tracheal intubation in children. Br J Anaesth 1998; 80:452–5
Eger EI, II: Desflurane (Suprane). A Compendium and Reference. Healthpress Publishing Group. Rutherford, NJ. 1993; pp 1–119
Eger EI, II, Johnson BH: Rates of awakening from anesthesia with I-653, halothane, isoflurane, and sevoflurane: A test of the effect of anesthetic concentration and duration in rats. Anesth Analg 1987; 66:977–82
Ghouri AF, Bodner M, White PF: Recovery profile after desflurane-nitrous oxide versus isoflurane-nitrous oxide in outpatients. Anesthesiology 1991; 74:419–24
Frink EJ, Jr, Malan TP, Atlas M, Dominguez LM, DiNardo JA, Brown BR, Jr: Clinical comparison of sevoflurane and isoflurane in healthy patients. Anesth Analg 1992; 74:241–5
Eger EI, II, Bowland T, Ionescu P, Laster MJ, Fang ZX, Gong D, Sonner J, Weiskopf RB: Recovery and kinetic characteristics of desflurane and sevoflurane in volunteers after 8-hour exposure, including kinetics of degradation products. Anesthesiology 1997; 87:517–26
O’Brien K, Robinson DN, Morton NS: Induction and emergence in infants less than 60 weeks post-conceptual age: comparison of thiopental, halothane, sevoflurane and desflurane. Br J Anaesth 1998; 80:456–9
Gupta A, Kullander M, Ekberg K, Lennmarken C: Anaesthesia for day-care arthroscopy. A comparison between desflurane and isoflurane. Anaesthesia 1996; 51:56–62
Natonson RA, Anpel LL, Gilbert HC, Ragin A: Comparisons of cost and recovery following desflurane or isoflurane anesthesia. Anesthesiology 1995; 83:A50
Bennett JA, Lingaraju N, Horrow JC, McElrath T, Keykhah MM: Elderly patients recover more rapidly from desflurane than from isoflurane anesthesia. J Clin Anesth 1992; 4:378–81
Tsai SK, Lee C, Kwan W-F, Chen B-J: Recovery of cognitive functions after anaesthesia with desflurane or isoflurane and nitrous oxide. Br J Anaesth 1992; 69:255–8
Philip BK, Kallar SK, Bogetz MS, Scheller MS, Wetchler BV, SMAG: A multicenter comparison of maintenance and recovery with sevoflurane or isoflurane for adult ambulatory anesthesia. Anesth Analg 1996; 83:314–9
Eger EI, II, Gong D, Koblin DD, Bowland T, Ionescu P, Laster MJ, Weiskopf RB: Effect of anesthetic duration on kinetic and recovery characteristics of desflurane vs. sevoflurane (plus compound A) in volunteers. Anesth Analg 1998; 86:414–21
Neumann MA, Weiskopf RB, Gong DH, Eger EI, II, Ionescu P: Changing from isoflurane to desflurane towards the end of anesthesia does not accelerate recovery in humans. Anesthesiology 1998; 88:(In press)
Aono J, Ueda W, Mamiya K, Takimoto E, Manabe M: Greater incidence of delirium during recovery from sevoflurane anesthesia in preschool boys. Anesthesiology 1997; 87:1298–300
Ebert TJ, Muzi M: Sympathetic hyperactivity during desflurane anesthesia in healthy volunteers. A comparison with isoflurane. Anesthesiology 1993; 79:444–53
Weiskopf RB, Moore M, Eger EI, II, M Mn, McKay L, Chortkoff BS, Hart PS, Damask M: Rapid increase in desflurane concentration is associated with greater transient cardiovascular stimulation than with rapid increase in isoflurane concentration in humans. Anesthesiology 1994; 80:1035–45
Weiskopf RB, Eger EI, II, Noorani M, Daniel M: Fentanyl, esmolol, and Clonidine blunt the transient cardiovascular stimulation induced by desflurane in humans. Anesthesiology 1994; 81:1350–5
Weiskopf RB, Eger EI, II, Noorani M, Daniel M: Repetitive rapid increases in desflurane concentration blunt transient cardiovascular stimulation in humans. Anesthesiology 1994; 81:843–9
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© 1999 Springer Science+Business Media Dordrecht
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Eger, E.I. (1999). Kinetic Considerations in the Selection of an Inhaled Anesthetic. In: Stanley, T.H., Egan, T.D. (eds) Anesthesia for the New Millennium. Developments in Critical Care Medicine and Anesthesiology, vol 34. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4566-4_21
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DOI: https://doi.org/10.1007/978-94-011-4566-4_21
Publisher Name: Springer, Dordrecht
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