M & H Sevoflurane USP Dosage/Direction for Use

Sevoflurane is volatile halogenated anesthetic given by inhalation. It has a minimum alveolar concentration (MAC) value ranging from 1.4% in the elderly to 3.3% in neonates. It is used for the induction and maintenance of general anesthesia. It is non-flammable. Sevoflurane has a nonpungent odour and does not cause respiratory irritation.
Premedication: Premedication should be selected according to the need of the individual patient, and at the discretion of the anesthesiologist.
Surgical Anesthesia: The concentration of sevoflurane being delivered from a vaporizer during anesthesia should be known. This may be accomplished by using a vaporizer calibrated specifically for sevoflurane.
Induction: Dosage should be individualized and titrated to the desired effect according to the patient's age and clinical status. A short acting barbiturate or other intravenous induction agent may be administered followed by inhalation of sevoflurane. Induction with sevoflurane may be achieved in oxygen or in combination with oxygen-nitrous oxide mixtures. For induction of anesthesia, inspired concentrations of up to 8% sevoflurane usually produces surgical anesthesia in less than two minutes in both adults and children.
Maintenance: Surgical levels of anesthesia may be sustained with concentrations of 0.5-3% sevoflurane with or without the concomitant use of nitrous oxide (see Nitrous Oxide under Interactions). (See Table 1.)

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Emergence: Emergence times are generally short following sevoflurane anesthesia. Therefore, patients may require postoperative pain relief earlier.
Geriatric: MAC (Minimum Alveolar Concentration) decreases with increasing age. The average concentration of sevoflurane to achieve MAC in an 80 year old is approximately 50% of that required in a 20 year old.