FLOURINATED ANESTHETICS – COMPILATION
IMPORTANT POINTS ON FLUORINATED ANESTHETICS:
1. Desflurane:
- Newer all fluorinated congener of isoflurane.
- Greenhouse gas causing maximum global warming.
- Mainly for outpatient surgery.
- Fastest-acting inhalation anesthetic with minimum blood: gas partition coefficient (0.42).
- Pungent odor.
- Highly volatile.
- Thermostatically heated special vaporizer used for delivering precise concentration of pure desflurane vapor in carrier gas (N2O + O2) mixture.
- Metabolically stable, only 0.2% metabolized.
Actions & Uses:
- Less potent than isoflurane.
- Safe anesthetic for geriatric patients.
- CVS effects similar to isoflurane without coronary steal.
- Causes mild myocardial depression.
- Lesser than enflurane/halothane.
- Do not provoke seizures, arrhythmia, no liver & kidney toxicity.
Adverse effect:
- Coughing & laryngospasm – Pungent odour – Unsuitable for induction.
2. Enflurane:
- Faster acting halothane substitute.
- Halogenated ether.
- Causes maximum respiratory depression.
- Contraindicated in epilepsy – Maximum propensity provoking seizures.
3. Methoxyflurane:
- Most potent inhalation agent (least MAC).
- Not used now. (Halothane – Most potent).
- Slowest onset & recovery.
- Should not be used in closed circuit – Reacts with rubber tubing.
- Boiling point more than water (104°C).
Metabolism:
- Intrarenal metabolism –> Fluoride ion production.
- Causes renal toxicity (high output renal failure & hepatotoxicity).
Exam Important
- Desflurane is greenhouse gas causing maximum global warming.
- Desflurane is mainly for outpatient surgery.
- Desflurane is fastest-acting inhalation anesthetic with minimum blood: gas partition coefficient (0.42).
- Desflurane is of pungent odor, highly volatile, metabolically stable, only 0.2% metabolized.
- Safe anesthetic for geriatric patients is desflurane.
- Desflurane has CVS effects similar to isoflurane without coronary steal.
- Desflurane causes mild myocardial depression but l
- Enflurane contraindicated in epilepsy with maximum propensity provoking seizures.
- Methoxyflurane is the most potent inhalation agent (least MAC).
- Methoxyflurane should not be used in closed circuit reacts with rubber tubing.
- Methoxyflurane boiling point more than water (104°C).
- Intrarenal metabolism of methoxyflurane produces fluoride ions causing high output renal failure & hepatotoxicity.
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