||This article may require cleanup to meet Wikipedia's quality standards. The specific problem is: the content/scope are not encyclopedic for an important anesthetic, and sources are often primary/lacking. (August 2014)|
|Systematic (IUPAC) name|
|Trade names||Sojourn, Ultane, Sevorane|
|Mol. mass||200.055 g/mol|
|(what is this?)|
Sevoflurane (1,1,1,3,3,3-hexafluoro-2-(fluoromethoxy)propane; synonym, fluoromethyl hexafluoroisopropyl ether), is a sweet-smelling, nonflammable, highly fluorinated methyl isopropyl ether used for induction and maintenance of general anesthesia. The anesthetic is a gas at room temperature and is therefore an inhalational anaesthetic. Sevoflurane's name derives from having its from having seven fluorine atoms in its substituents, alongside a standard suffix for such agents.
It is one of the most commonly used volatile anesthetic agents, particularly for outpatient anesthesia, and including in anesthesia of children and infants, and in veterinary medicine. Together with desflurane, sevoflurane is replacing isoflurane and halothane in modern anesthesiology. It is often administered in a mixture of nitrous oxide and oxygen.
After desflurane, it is the volatile anesthetic with the fastest onset and offset. Though desflurane has the lowest blood–gas partition coefficient of the currently used volatile anesthetics, sevoflurane is the preferred agent for mask induction due to its lesser irritation to mucous membranes.
Sevoflurane "has an excellent safety record", but is under review for potential neurotoxicity, especially relevant to administration in infants and children, and rare case reports akin to halothane hepatotoxicity, have made clear that low frequency liver injury may occur.
Sevoflurane was discovered by Ross Terrell. First reports on the use of sevoflurane appeared in the literature in 1971; it was introduced into clinical practice initially in Japan in 1990. The rights for sevoflurane in the US and other countries were held by Abbott Laboratories; it is now available as a generic drug.[when?]
Sevoflurane is an inhaled anaesthetic that is often used to put children asleep for surgery. During the process of waking up from the medication, it has been known to cause agitation and delirium. It is not clear if this can be prevented.
Studies examining a current significant health concern, anesthetic-induced neurotoxicity (including with sevoflurane, and especially with children and infants) are "fraught with confounders, and many are underpowered statistically", and so are argued to need "further data... to either support or refute the potential connection".
Concern regarding the safety of anaesthesia is especially acute with regard to children and infants, where preclinical evidence from relevant animal models suggest that common clinically important agents, including sevoflurane, may be neurotoxic to the developing brain, and so cause neurobehavioural abnormalities in the long term; two large-scale clinical studies (PANDA and GAS) were ongoing as of 2010, in hope of supplying "significant [further] information" on neurodevelopmental effects of general anaesthesia in infants and young children, including where sevoflurane is used.
|Boiling point:||58.6 °C||(at 101.325 kPa)|
|Density:||1.517–1.522 g/cm³||(at 20 °C)|
|MAC :||2.1 vol %|
|Molecular weight:||200 u|
|Vapor pressure:||157 mmHg (22.9 kPa)||(at 20 °C)|
|197 mmHg (26.3 kPa)||(at 25 °C)|
|317 mmHg (42.3 kPa)||(at 36 °C)|
|Blood:Gas partition coefficient:||0.68|
|Oil:Gas partition coefficient:||47|
- Livertox: Clinical and Research Information on Drug-Induced Liver Injury (2014) "Drug Record: Sevoflurane", U.S. National Library of Medicine, 2 July 2014 update, see , accessed 15 August 2014.
- Sakai EM, Connolly LA, Klauck JA (December 2005). "Inhalation anesthesiology and volatile liquid anesthetics: focus on isoflurane, desflurane, and sevoflurane". Pharmacotherapy 25 (12): 1773–88. doi:10.1592/phco.2005.25.12.1773. PMID 16305297.
- Burns, William; Edmond I Eger II (August 2011). "Ross C. Terrell, PhD, an Anesthetic Pioneer". Anesth. Analg. 2 113 (113): 387–9. doi:10.1213/ane.0b013e3182222b8a.
- Costi, D; Cyna, AM; Ahmed, S; Stephens, K; Strickland, P; Ellwood, J; Larsson, JN; Chooi, C; Burgoyne, LL; Middleton, P (Sep 12, 2014). "Effects of sevoflurane versus other general anaesthesia on emergence agitation in children.". The Cochrane database of systematic reviews 9: CD007084. PMID 25212274.
- P. Vlisides P & Z. Xie (2012) Neurotoxicity of general anesthetics: an update., Curr Pharm Design, 18(38):6232-40, see , accessed 15 August 2015.
- L. Sun (2010) Early childhood general anaesthesia exposure and neurocognitive development, Br J Anaesth. 105 Suppl 1:i61-8, DOI 10.1093/bja/aeq302, see , accessed 15 August 2015.
- Kim JK (Feb 2014). "Relationship of bispectral index to minimum alveolar concentration during isoflurane, sevoflurane or desflurane anaesthesia.". J Int Med Res 42 (1): 130–7. doi:10.1177/0300060513505525. PMID 24366495.
- Kreuer S (Oct 2009). "Comparative pharmacodynamic modeling of desflurane, sevoflurane and isoflurane.". J Clin Monit Comput. 23 (8). doi:10.1007/s10877-009-9196-6. PMID 19711188.
- Patel SS, Goa KL (April 1996). "Sevoflurane. A review of its pharmacodynamic and pharmacokinetic properties and its clinical use in general anaesthesia". Drugs 51 (4): 658–700. doi:10.2165/00003495-199651040-00009. PMID 8706599.
"Erratum". Drugs 52 (2): 253. August 1996.
- Wallin, Richard F., Regan, Bernard M., Napoli, Martha D., Stern, Ivan j. (Nov–Dec 1975). "Sevoflurane: A New Inhalational Anesthetic Agent". Anesthesia and Analgesia 54 (6): 758–766. doi:10.1213/00000539-197511000-00021.