Induction and / or maintenance of general anesthesia in adults and maintenance of anesthesia in children (as monoanesthetics or under combined anesthesia).
Composition:
1 bottle contains 240 ml desflurane.
Action:
An inhaled anesthetic from the group of halogenated methyl ethyl ethers (it is exclusively fluorinated). It is characterized by a low boiling point (22.8 degrees Celsius) and an irritating odor. The evaporating pressure at 20 ° C is 664 mm Hg. The blood / gas division coefficient is 0.42, oil / gas - 18.7. Due to the low solubility in tissues, both the introduction of anesthesia and the awakening after desflurane proceed quickly. Causes tachypnoe, decreased tidal volume, respiratory depression and apnea (at 2 MAC); reduces the tension of the bronchi and skeletal muscles. It causes depression of the circulatory system (reduction of blood pressure) in proportion to the dose. It weakens reflexes on hypovolaemia. It minimally modifies the sensitivity of the myocardium to catecholamines. It widens the cerebral vessels, reduces the resistance of the cerebral vessels and increases the cerebral blood flow and intracranial pressure in proportion to the dose. During desflurane anesthesia no reduction of seizure threshold or other undesirable changes in EEG was observed. It slightly reduces renal blood flow. It is eliminated by the lungs unchanged (only 0.02% of the dose is metabolized in the body).
Contraindications:
Hypersensitivity to halogen derivatives. Known or genetically determined threat of malignant hyperthermia. Metabolic disorders (hyperthermia, liver dysfunction, leukocytosis) after previous administration of anesthetics from the group of halogen derivatives. Do not use for the induction of anesthesia in patients with an increased risk of ischemic heart disease and in situations where the acceleration of heart rate and increase in blood pressure is not recommended.
Precautions:
The use of desflurane for anesthesia in neurosurgical and obstetrical procedures is not recommended, as well as in patients with elevated intracranial pressure in patients with a tendency to bronchospasm. Desflurane is not recommended for the induction of anesthesia in children under 12 years of age due to frequent cough, respiratory arrest, apnea, laryngospasm and increased salivation. Carefully use in patients with hypovolaemia, low blood pressure and generally weakened (lower drug concentrations should be used). The experience with desflurane for repeated anesthesia is still insufficient - similarly to other anesthetics from the group of halogen derivatives, re-anesthesia of the same patient within a short interval of the previous anesthesia should be considered with caution.
Pregnancy and lactation:
It is not recommended to use the drug during pregnancy and lactation (no tests).
Side effects:
May cause: low blood pressure, respiratory depression, increased cerebral blood flow and increased intracranial pressure, tachycardia and arrhythmias, myocardial ischemia. May cause salivation (especially in children), cough, larynx and bronchospasm, nausea and / or vomiting, transient leukocytosis. Used to induce anesthesia causes: cough (34%), respiratory arrest (30%), apnea (15%), salivation, laryngeal spasm, decreased oxyhemoglobin saturation (3-10%). It is a potential inducer of malignant hyperthermia. Hepatitis may occur in patients who are allergic to previous use of anesthetics from the group of halogens.
Dosage:
Desfluran should only be used with evaporators specially designed and intended for use with this medicine. Minimal anesthetic concentrations (MAC) in 100% O2 is: 8.95-10.65% in children in one year; 7.2-9.4% in children aged 1-12; 6.35-7.25% in people aged 18-30; 5.75-6.25% in people aged 30-65. MAC using 60% N2O with oxygen is: 5.75-7.75% in children in 3-12 months; 5.75-7.0% in children aged 1-5 years; 3.75-4.25% in people aged 18-30; 1.75-3.25% in people aged 30-65.Usually used in the induction of anesthesia in concentrations of 4-11%, to maintain anesthesia in concentrations of 2-6%.
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