Methodological aspects of desflurane application in modern anesthesiology. Review

Abstract

Introduction. Desflurane is the last inhalational anesthetic approved for use in the Russian Federation. The experience of its use in the country in comparison with sevoflurane is still not great for a number of reasons, including the insufficient volume of methodological literature in Russian. Objectives. To highlight the methodological aspects of the use of desflurane in modern anesthesiology. Materials and methods. The search for sources was carried out using the resources of the Russian scientific electronic library (eLIBRARY.ru), the bibliographic database of articles from the US National Library of Medicine (NCBI), the ClinicalKey electronic library, and the Scopus abstract and citation database. The search depth is 7 years. Results. A review of publications in 2014-2020, devoted to the methodology of using modern vapor-generating anesthetics, has been performed. The methodological techniques of anesthesia with desflurane are described in detail: inhalation induction, maintenance of anesthesia using a low and minimal flow of fresh gas, the peculiarities of the period of awakening and post-anesthetic rehabilitation are given. Conclusion. Desflurane is not the drug of choice for inhalation induction of anesthesia, but has a number of distinctive feature: advantages for using with low or minimal fresh gas flow; superiority in speed and predictability of the period of early post-anesthetic rehabilitation; safety of use, both in elderly patients and in children; relevance for Outpatient anesthesiology, Bariatric surgery, and programs for Enhanced Recovery After Surgery.