Drug reference

Desflurane

General Anesthetic · Anaesthesia

Also known as Desflurane volatile liquid

General AnestheticAnaesthesia

CDSCO approved

EXCRETION

—

not curated

INTERACTIONS

9 major

SEVERE in our sources

PREGNANCY

May depress neonatal respiration if used during delivery.

FDA category + note

Top interactionssee all 10 →

Desiccated Co2 AbsorbentSevereTextbookG&G 14e · p479
DroperidolSevereDatabaseDDInter
EpinephrineSevereDatabaseDDInter
IsocarboxazidSevereDatabaseDDInter

Mechanism

Desflurane is a fluorinated methyl ethyl ether volatile anesthetic that potentiates GABA-A receptor-mediated inhibitory neurotransmission and inhibits NMDA receptor-mediated excitatory transmission. Its very low blood:gas partition coefficient (0.42) — the lowest of the volatile anesthetics — enables the most rapid induction and emergence from anesthesia. However, its pungency and airway irritation preclude use for inhalational induction, and it requires a heated pressurized vaporizer due to its near-room-temperature boiling point (22.8°C).

Indications

Induction of anaesthesia (but not recommended)Maintenance of anaesthesia (in nitrous oxide–oxygen)Maintenance of anaesthesia in caesarean section (in nitrous oxide–oxygen)maintenance of anesthesia (after intravenous induction)

Dosing

Adult: Induction: Initially 0.5 %, increased to 3 %, adjusted according to response, administered using speciﬁcally calibrated vaporiser. Maintenance (in nitrous oxide–oxygen): 1–2.5 %, administered using speciﬁcally calibrated vaporiser; an additional 0.5–1% may be required when given with oxygen alone.…

Pharmacokinetics

Excretion

minimally metabolized; more than 99% eliminated unchanged through the lungs

Contraindications

Hepatotoxicity in those sensitised to halogenated anaesthetics
primary anesthetic for induction (due to irritant properties)
use with desiccated CO2 absorbents (risk of carbon monoxide production)

Side effects

Common

carboxyhaemoglobinaemiachest discomfortcognitive impairmentdeliriumdyspnoeaileusmood altered (that can last several days)myoglobinuriaskin reactionshypotensionCNS depressant effectsmyalgiairritates the tracheobronchial tree (coughing, salivation, bronchospasm)transient tachycardia and hypertension (with abrupt increases in concentration due to sympathetic stimulation)concentration-dependent increase in respiratory rate and decrease in tidal volumestrong airway irritant (coughing, breath-holding, laryngospasm, excessive respiratory secretions)hypotension (primarily by decreasing systemic vascular resistance)skeletal muscle relaxation

Serious