[Sevoflurane].

Abstract

Sevoflurane is a fluoridated derivative of methyl isopropyl ether. Its administration does not require the use of sophisticated vaporizers and its blood/gas partition coefficient is 0.69. Sevoflurane is the only ethereal anesthesia that does not trigger a reflex response or cause airway irritation during inhaled induction. It offers a high level of precision in the control of deep anesthesia during maintenance, recovery is rapid, and MAC is 2%. Sevoflurane seems to be the pediatric anesthetic of choice and it is also highly useful for anesthesia in ambulatory patients. Sevoflurane gives rise to hemodynamic stability, is not arrhythmogenic, and does not sensitize the myocardium to the effects of catecholamines. The effects on cerebral blood flow are minimal at low concentrations. Metabolism is 3-4%. Renal toxicity has not been reported even though fluoride is a metabolic product. Sevoflurane breaks down in the presence of soda lime, producing compound A and giving rise to controversy and investigation although the toxicity of compound A is more theoretical than real. Sevoflurane is not harmful to the ozone layer.