Overview
Desflurane is a volatile halogenated ether general anesthetic used for induction and maintenance of anesthesia during surgery. It has low blood-gas solubility, allowing rapid induction and emergence from anesthesia.
Mechanism of Action
Potentiates GABA-A receptor activity and inhibits excitatory neurotransmission via NMDA receptor antagonism, producing dose-dependent CNS depression and anesthesia.
Indications
- Induction and maintenance of general anesthesia in adults
- Maintenance of general anesthesia in pediatric patients after induction with other agents
Dosage
Inhalation: Induction: 4-11% with oxygen or oxygen/nitrous oxide mixture; Maintenance: 2-6% with oxygen or oxygen/nitrous oxide mixture. Adjust based on patient response and vital signs.
Contraindications
- Known or suspected genetic susceptibility to malignant hyperthermia
- Patients with known sensitivity to desflurane or other halogenated agents
- Induction of anesthesia in pediatric patients due to risk of respiratory adverse events
Side Effects
- Hypotension
- Nausea
- Vomiting
- Cough
- Laryngospasm
- Bronchospasm
- Bradycardia
- Hypertension
- Arrhythmias
- Malignant hyperthermia
- Increased intracranial pressure
- Hepatitis (rare)
Interactions
- Non-depolarizing muscle relaxants: Potentiates neuromuscular blockade
- Opioids: Enhances respiratory depression
- Benzodiazepines: Enhances CNS depression
- MAO inhibitors: May cause hypertensive crisis
- Epinephrine: May increase risk of ventricular arrhythmias