Desflurane and Sevoflurane: Inhalation Anaesthetics for This Decade?

Abstract

It was not until the 1930s that anaesthetic agents were developed in the light of some understanding of structure-activity relationships. Probably the first to be investigated with this principle in mind was divinyl ether when, in 1930, Leake and Chen thought the compound might combine some of the advantages of diethyl ether and ethylene [4]. Previously, it had been chance observation, as much as any other factor, which brought a new compound to the attention of chemists and physicians. For instance, Arno Luckhardt first suspected that the gas ethylene might have anaesthetic properties when learning that the botanists, Crocker and Knight, had shown that it prevented carnation buds from opening [36]. The anaesthetic potential of halogens had long been known, but the particular advantages of fluorine compounds were perceived much earlier than is often appreciated. In a prophetic introduction to their studies on fluorine derivatives of chloroform, published in 1932, Harold Booth and E. May Bixby of Western Reserve University, Cleveland stated [1]: "A survey of the properties of 166 known gases suggested that the best possibility of finding a new noncombustible anesthetic gas lay in the field of organic fluoride compounds. Fluorine substitution for other halogens lowers the boiling point, increases stability, and generally decreases toxicity". Fluorine, the halogen with the lowest atomic weight (18.998; chlorine = 35.453, bromine = 79.904 and iodine = 126.904) was first identified in 1771 by the Swedish chemist, Karl Scheele, but it was not isolated until 1886, when Henri Moissan used platinum electrodes at low temperatures to separate fluorine from hydrogen fluoride. Fluorine is very active chemically and although it KEY WORDS Anaesthetics, volatile: desflurane, sevoflurane.

Comparison of Isoflurane and Sevoflurane for Anesthesia in Beaver

“…In dogs, sevoflurane is characterized by more rapid induction and recovery and more rapid change in depth than isoflurane anesthesia because of its lower blood-gas solubility coefficient (0.6) (Jones, 1990). Theoretically, rapid adjustment to the anesthetic plane, should allow more rapid recovery, which would decrease the time a wild animal is kept in captivity.…”

Sevoflurane and its use in veterinary practice

“…Στα ζωικά πρότυπα, που βρίσκονται σε κατάσταση εγκυμοσύνης, η έκθεση στο σεβοφλουράνιο δεν έχει συν δεθεί με συγκεκριμένη οργανική ή εμβρυογενετική τοξι κότητα (Jones 1990, Smith et al 1996, Grounds and Newman 1997.…”

“…Το σΰμπλοκο Α είναι νεφροτοξικό στους επιμυς και η τοξικότητα του οφείλεται στη νέκρωση της μυελώ δους ουσίας των νεφρών. Η παραγωγή του συ μπλόκου Α είναι μεγαλύτερη όταν χρησιμοποιείται το Baralyme ως μέσο εξουδετέρωσης του C0 2 σε σχέση με τη νατράσβε-στο, είναι δοσοεξαρτώμενη, αντιστρόφως ανάλογη της ροής των αέριων και είναι μεγαλύτερη σε υψηλές θερμο κρασίες (Kandel et al 1995, Keller et al 1995.Στην κτηνιατρική κλινική πράξη, παρά το γεγονός ότι η παραγωγή του συ μπλόκου Α στο αναισθητικό κύκλωμα δε φαίνεται να επηρεάζει την ασφάλεια, το σεβοφλουράνιο συ νιστάται να χορηγείται με προσοχή και με ροή 0 2 μεγαλύ τερη από 2 λίτρα/λεπτό, ιδιαίτερα σε νεφροπαθή ζώα (Morio et al 1992, Frink et al 1994, Bito and Ikeda 1995.Στα ζωικά πρότυπα, που βρίσκονται σε κατάσταση εγκυμοσύνης, η έκθεση στο σεβοφλουράνιο δεν έχει συν δεθεί με συγκεκριμένη οργανική ή εμβρυογενετική τοξι κότητα (Jones 1990, Smith et al 1996, Grounds and Newman 1997.Σε ό,τι αφορά την περιβαλλοντική συμπεριφορά του σεβοφλουρανιου, αξίζει να αναφερθεί ότι δεν επηρεάζει το όζον της ατμόσφαιρας (Jones 1990, Grounds andNewman 1997). …”

Desflurane Inhalation Provide Cardiovascular Stability During Intubation but Prevention of Rocuronium Injection Pain

“…However, these adverse airway responses seem to be related to acute administration at high concentrations [4] and inadequate doses or drugs as adjunctive medication [2,5]. Many anesthesiologists feel that its pungent odor and tendency to irritate the upper airway make it improper for maintenance, and more specifically, for induction of anesthesia.…”

“…In fact, upper airway irritation is one of the major drawbacks when desflurane is used as the sole induction agent. Various methods have been used to reduce adverse airway responses (coughing, breathholding, or laryngospasm), including increasing airway humidity using an artificial nose [10], applying a low [4,6] or gradual increase of inspired concentration [6], or premedication with fentanyl [7,11]. Therefore, we used an appropriate dose of fentanyl to prevent adverse airway events.…”