The Effect of Anesthetic Duration on Kinetic and Recovery Characteristics of Desflurane Versus Sevoflurane, and on the Kinetic Characteristics of Compound A, in Volunteers

Eger, Edmond I.; Gong, Diane; Koblin, Donald D.; Bowland, Terri; Ionescu, Pompiliu; Laster, Michael J.; Weiskopf, Richard B.

doi:10.1097/00000539-199802000-00037

Cited by 57 publications

(40 citation statements)

References 26 publications

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“…The use of volunteers also avoids the confounding effects of surgery and other medications. Volunteers given desflurane awaken sooner than those given sevoflurane (27).…”

Section: Discussionmentioning

confidence: 91%

Tutorial: Context-Sensitive Decrement Times for Inhaled Anesthetics

Eger

Shafer

2005

Anesthesia & Analgesia

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Context-sensitive decrement times for inhaled anesthetics connect two values: a) the duration of anesthesia (nominally at a constant alveolar concentration)-the "context" and b) the time to decrease the alveolar or vital tissue (e.g., brain, heart, kidney, and liver, collectively called the vessel-rich group of tissues) concentration by some fractional "decrement" of the starting concentration. Increasing duration of anesthesia increases the time to a given decrement in a nonlinear manner that may considerably delay recovery. In the present report we use a commercially available simulation program (Gas Man) to confirm and enlarge on these concepts. In this simulation, increasing duration of anesthesia can markedly delay complete awakening for isoflurane. Increasing anesthesia duration imposes considerably less delay in awakening from sevoflurane compared with isoflurane. For desflurane, only prolonged anesthesia or decrements of 95% and more should delay awakening from anesthesia. These changes are shown to be the result of the relative solubility of each anesthetic in blood and tissue. An increase in cardiac output is also shown to delay awakening.

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“…The use of volunteers also avoids the confounding effects of surgery and other medications. Volunteers given desflurane awaken sooner than those given sevoflurane (27).…”

Section: Discussionmentioning

confidence: 91%

Tutorial: Context-Sensitive Decrement Times for Inhaled Anesthetics

Eger

Shafer

2005

Anesthesia & Analgesia

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“…In the later follow-up study, an average inspired compound A concentration of 40 ppm was measured during sevoflurane anesthesia, and the ratio of end-tidal to inspired compound A concentration was approximately 0.8 (67). Therefore, average inspired compound A concentrations were similar between the three studies.…”

Section: Renal Effectsmentioning

confidence: 84%

Sevoflurane: Approaching the Ideal Inhalational Anesthetic A Pharmacologic, Pharmacoeconomic, and Clinical Review

2001

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Sevoflurane is a safe and versatile inhalational anesthetic compared with currently available agents. Sevoflurane is useful in adults and children for both induction and maintenance of anesthesia in inpatient and outpatient surgery. Of all currently used anesthetics, the physical, pharmacodynamic, and pharmacokinetic properties of sevoflurane come closest to that of the ideal anesthetic (200). These characteristics include inherent stability, low flammability, non-pungent odor, lack of irritation to airway passages, low blood:gas solubility allowing rapid induction of and emergence from anesthesia, minimal cardiovascular and respiratory side effects, minimal end-organ effects, minimal effect on cerebral blood flow, low reactivity with other drugs, and a vapor pressure and boiling point that enables delivery using standard vaporization techniques. As a result, sevoflurane has become one of the most widely used agents in its class.

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“…The rats were randomly divided into four groups of ten each with three groups receiving desflurane inhalation (Baxter Healthcare Co., Guayana, USA) via tight fitting mask with end-tidal concentrations of 5.7%, 7.1%, and 8.6% in air for two hours, which corresponded to 1.0, 1.25 and 1.5 minimum alveolar concentration (MAC) (Eger et al, 1998). The fourth group received intraperitoneal injection of chloral hydrate 400 mg/kg (n = 10) plus incremental doses of 100 mg/kg ip., when necessary, during the two hour procedure.…”

Section: Drug Administrationmentioning

confidence: 99%

“…Desflurane is a new inhalation anesthetic with rapid induction and fast recovery due to its low blood/ gas solubility ratio (Yasuda et al, 1990;Tsai et al, 1992;Eger et al, 1998). Studies have shown that desflurane decreased cerebral vascular resistance (Matta et al, 1995;Lutz et al, 1990) in humans and animals.…”

Section: Introductionmentioning

confidence: 99%

The effect of desflurane on ameliorating cerebral infarction in rats subjected to focal cerebral ischemia-reperfusion injury

et al. 2004

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The Effect of Anesthetic Duration on Kinetic and Recovery Characteristics of Desflurane Versus Sevoflurane, and on the Kinetic Characteristics of Compound A, in Volunteers

Abstract: Regardless of the duration of anesthesia, elimination is faster and recovery is quicker for the inhaled anesthetic desflurane than for the inhaled anesthetic sevoflurane. The toxic degradation product of sevoflurane, Compound A, seems to bind irreversibly to proteins in the body.

Cited by 57 publications

References 26 publications

Tutorial: Context-Sensitive Decrement Times for Inhaled Anesthetics

Tutorial: Context-Sensitive Decrement Times for Inhaled Anesthetics

Sevoflurane: Approaching the Ideal Inhalational Anesthetic A Pharmacologic, Pharmacoeconomic, and Clinical Review

The effect of desflurane on ameliorating cerebral infarction in rats subjected to focal cerebral ischemia-reperfusion injury

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