M & H Sevoflurane USP

Induction & maintenance of general anesth in adult & ped patients for in-patient & out-patient surgery.

Adult & childn Induction Individualized dose. May administer short-acting barbiturate or other IV induction followed by inhalation of treatment. May be achieved in O₂ or in combination w/ O₂-nitrous oxide mixtures. Inspired conc of up to 8% usually produces surgical anesth in <2 min. Maintenance: May be sustained w/ 0.5-3% conc w/ or w/o nitrous oxide.

Known or suspected sensitivity to sevoflurane or other halogenated inhalational anesth (eg, history of hepatotoxicity, usually including elevated liver enzymes, fever, leukocytosis &/or eosinophilia temporally related to anesth w/ 1 of these agents); genetic susceptibility to malignant hyperthermia.

Hypersensitivity reactions, manifesting as asthma, angioedema, or dermatitis, associated w/ occupational exposure to isoflurane & sevoflurane. Increased hypotension & resp depression as anesth is deepened; serum K levels resulting in cardiac arrhythmias & death in ped during post-op period. May cause resp depression; increase potential for hepatic injury if patient is previously exposed to halogenated hydrocarbon anesth, especially if interval is <3 mth; persist small changes in moods for several days following administration. QT prolongation, associated w/ Torsades de Pointes; malignant hyperthermia; seizures; dose-dependent decrease in BP. Mild, moderate & severe post-op hepatic dysfunction or hepatitis w/ or w/o jaundice. Patients at risk for ICP elevations; w/ mitochondrial disorders; latent overt neuromuscular disease particularly Duchene muscular dystrophy. Extreme heat, smoke, &/or spontaneous fire in anesth machine during use in conjunction w/ dessicated O₂ absorbent, specifically those containing K hydroxide. Monitor, & sustain if possible urine flow. Consider maintenance of hemodynamic stability in patients w/ CAD. Carefully assess recovery from general anesth prior to discharge of patient from post-anesth care unit. Routinely replace CO₂ absorbents regardless of color indicator state. Concomitant use of succinylcholine. May impair ability to operate motor vehicles or hazardous machinery. Patients w/ underlying hepatic conditions or under treatment w/ drugs causing hepatic dysfunction. Renal insufficiency (baseline serum creatinine >1.5 mg/dL). Labor & delivery. Pregnancy. Skip breastfeeding for 48 hr after treatment administration & discard milk produced during this period. Ventricular arrhythmia in ped patient w/ Pompe's disease. Young adults & childn ≥2 mth.

Agitation; bradycardia; hypotension; cough; nausea, vomiting. Somnolence, dizziness, headache; tachycardia; HTN; resp disorder, laryngospasm; salivary hypersecretion; chills, pyrexia; abnormal blood glucose, LFT, & WBC, increased fluoride; hypothermia.

Concomitant use w/ β-sympathomimetics eg, isoprenaline & α- & β-sympathomimetics eg, adrenaline & noradrenaline. Risk of additive -ve inotropic effect w/ Ca antagonists. Increased serum K levels w/ succinylcholine. Decreased min alveolar conc w/ benzodiazepines & opioid; nitrous oxide. Increased metabolism w/ INH & alcohol. Enhanced effects of competitive neuromuscular blockers eg, atracurium. Affected both intensity & duration of neuromuscular blockade by non-depolarizing muscle relaxants. Potentiated neuromuscular block induced w/ pancuronium, vecuronium or atracurium.

Anaesthetics - Local & General

N01AB08 - sevoflurane ; Belongs to the class of halogenated hydrocarbons. Used as general anesthetics.

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