Sevorane Warnings

Sevoflurane should be administered only by persons trained in the administration of general anesthesia. Facilities for maintenance of a patent airway, artificial ventilation and oxygen enrichment, and circulatory resuscitation must be immediately available.
Since levels of anesthesia may be altered easily and rapidly, only vaporizers specifically calibrated for sevoflurane should be used. Hypotension and respiratory depression increase as anesthesia is deepened.
Malignant Hyperthermia: In susceptible individuals, potent inhalation anesthetic agents, including sevoflurane, may trigger a skeletal muscle hypermetabolic state leading to high oxygen demand and the clinical syndrome known as malignant hyperthermia. In clinical trials, 1 case of malignant hyperthermia was reported. In genetically susceptible pigs, sevoflurane induced malignant hyperthermia. The clinical syndrome is signaled by hypercapnia and may include muscle rigidity, tachycardia, tachypnea, cyanosis, arrhythmias and/or unstable blood pressure. Some of these nonspecific signs may also appear during light anesthesia, acute hypoxia, hypercapnia and hypovolemia. Treatment of malignant hyperthermia includes discontinuation of triggering agents, administration of dantrolene sodium IV and application of supportive therapy. (Consult prescribing information for dantrolene sodium IV for additional information on patient management.) Renal failure may appear later, and urine flow should be monitored and sustained if possible.