A clinical review of inhalation anesthesia with sevoflurane: from early research to emerging topics

Abstract

A large number of studies during the past two decades have demonstrated the efficacy and safety of sevoflurane across patient populations. Clinical researchers have also investigated the effects of sevoflurane, its hemodynamic characteristics, its potential protective effects on several organ systems, and the incidence of delirium and cognitive deficiency. This review examines the clinical profiles of sevoflurane and other anesthetic agents, and focuses upon emerging topics such as organ protection, postoperative cognitive deficiency and delirium, and novel ways to improve postanesthesia outcomes.

Incidence and risk factors of postoperative delirium in elderly patients undergoing urological surgery: A multi‐institutional prospective study

“…26 In contrast, procedures associated with longer operation times and more invasiveness, such as Cx and open radical nephrectomy, had high incidences of postoperative delirium. These operations are associated with multiple factors that could induce delirium, such as general anesthesia, 27 mechanical ventilation, 4 severe pain 28 and intense inflammatory responses. 5 The results suggest that the risk of postoperative delirium in urological surgery is clearly correlated to the invasiveness of the operation.…”

Sevoflurane anesthesia impairs metabotropic glutamate receptor‐dependent long‐term depression and cognitive functions in senile mice

“…Sevoflurane is a routinely used anesthetic in many types of surgeries, and POCD is mostly seen in aged patients. It is well tolerated by young and old patients alike, and elicits less airway irritation; however, as other volatile anesthetics, sevoflurane has been suggested to affect a wide range of organs or tissues, including the cardiovascular system, respiratory system and central nervous system . Prior investigations, both clinical and pre‐clinical, have implicated the involvement of sevoflurane anesthesia in POCD.…”

Supporting paediatric patients: Parental presence in the anaesthetic journey

“…During an inhalational induction the child may resist, try to flee, protest and cause themselves harm 13 . Sevoflurane can also produce this type of stimulation stimulus 14 .…”