Sevoflurane-a long-awaited volatile anaesthetic

Abstract

History of sevoflurane Research to develop a safe, non-inflammable inhaled anaesthetic agent began in the 1930s when chemists discovered that the substitution of fluorine for other halogens "lowers the boiling point, increases stability, and generally decreases toxicity" [5]. This work was continued by McBee, who used his knowledge of fluorine chemistry gained from working on the "Manhattan" atomic bomb project, to investigate a number of fluorine-containing compounds, none of which was eventually suitable for clinical use. In 1951, Suckling synthesized halothane, and soon the search for other clinically useful fluorine-containing anaesthetics began in earnest.

Le sévoflurane et l’isoflurane, mais pas le propofol, diminuent les besoins en mivacurium avec le temps

“…Sevoflurane is less lipid-soluble than isoflurane, 22 but pharmacokinetic studies have failed to identify a faster time constant for access to muscle (approximately 60 min for both agents). 23 Nevertheless, the time constant is of the same magnitude as the time course of blockade in our study, suggesting that the site of action of potentiation is in muscle. The kinetic study 23 provided a huge variability on the estimation of the time constants, the standard deviation being approximately half the mean value.…”

“…23 Nevertheless, the time constant is of the same magnitude as the time course of blockade in our study, suggesting that the site of action of potentiation is in muscle. The kinetic study 23 provided a huge variability on the estimation of the time constants, the standard deviation being approximately half the mean value. Thus, time constant of sevoflurane in muscle could be faster than that of isoflurane.…”

Conditions for laryngeal mask insertionA comparison of propofol versus sevoflurane with or without alfentanil

“…However, our study showed a synergistic cardiac depressant effect of sevoflurane with alfentanil. Sevoflurane decreases mean arterial pressure predominantly through decreased peripheral resistance, with cardiac output being well maintained in the normal anaesthetic maintenance range [14]. The myocardial depression occurs with high concentrations of sevoflurane, as a result of an effect on calcium channels [15].…”

L’inhalation de sévoflurane à capacité vitale et l’inhalation autocontrôlée induisent l’anesthésie de façon similaire

“…Sevoflurane is a relatively recently released volatile anesthetic agent which has already proven itself as an agent of choice for inhalational induction of anesthesia. 2 It has important properties (low blood: gas solubility coefficient of 0.69 and minimal airway irritation), which make it close to the ideal anesthetic gas. 3 Inhalational induction techniques using sevoflurane include vital capacity induction (VCI) in which the patient is asked to take a deep breath and hold it for as long as possible then breathe out to residual volume.…”